The Oiling of America
Lipid Research Clinics Trial
What was needed to resolve the validity of the lipid hypothesis once and for all was a well-designed, long-term diet study that compared coronary heart disease events in those on traditional foods with those whose diets contained high levels of vegetable oils-but the proposed Diet-Heart study designed to test just that had been canceled without fanfare years earlier. In view of the fact that orthodox medical agencies were united in their promotion of margarine and vegetable oils over animal foods containing cholesterol and animal fats, it is surprising that the official literature can cite only a handful of experiments indicating that dietary cholesterol has “a major role in determining blood cholesterol levels.” One of these was a study involving 70 male prisoners directed by Fred Mattson – the same Fred Mattson who had pressured the American Heart Association into removing any reference to hydrogenated fats from their diet-heart statement a decade earlier.
Funded in part by Procter and Gamble, the research contained a number of serious flaws: selection of subjects for the four groups studied was not randomized; the experiment inexcusably eliminated “an equal number of subjects with the highest and lowest cholesterol values;” twelve additional subjects dropped out, leaving some of the groups too small to provide valid conclusions; and statistical manipulation of the results was shoddy. But the biggest flaw was that the subjects receiving cholesterol did so in the form of reconstituted powder-a totally artificial diet. Mattson’s discussion did not even address the possibility that the liquid formula diet he used might affect blood cholesterol differently than would a whole foods diet when, in fact, many other studies indicated that this is the case. The culprit, in fact, in liquid protein diets appears to be oxidized cholesterol, formed during the high-temperature drying process, which seems to initiate the buildup of plaque in the arteries.
Powdered milk containing oxidized cholesterol is added to reduced-fat milk-to give it body-which the American public has accepted as a healthier choice than whole milk. It was purified, oxidized cholesterol that Kritchevsky and others used in their experiments on vegetarian rabbits. The NHLBI argued that a diet study using whole foods and involving the whole population would be too difficult to design and too expensive to carry out. But the NHLBI did have funds available to sponsor the massive Lipid Research Clinics Coronary Primary Prevention Trial in which all subjects were placed on a diet low in cholesterol and saturated fat. Subjects were divided into two groups, one of which took a cholesterol-lowering drug and the other a placebo. Working behind the scenes, but playing a key role in both the design and implementation of the trials, was Dr. Fred Mattson, formerly of Procter and Gamble.
An interesting feature of the study was the fact that a good part of the trial’s one-hundred-and-fifty-million-dollar budget was devoted to group sessions in which trained dieticians taught both groups of study participants how to choose “heart-friendly” foods-margarine, egg replacements, processed cheese, baked goods made with vegetable shortenings, in short the vast array of manufactured foods awaiting consumer acceptance. As both groups received dietary indoctrination, study results could support no claims about the relation of diet to heart disease. Nevertheless, when the results were released, both the popular press and medical journals portrayed the Lipid Research Clinics trials as the long-sought proof that animal fats were the cause of heart disease. Rarely mentioned in the press was the ominous fact that the group taking the cholesterol-lowering drugs had an increase in deaths from cancer, stroke, violence and suicide.
LRC researchers claimed that the group taking the cholesterol-lowering drug had a 17% reduction in the rate of CHD, with an average cholesterol reduction of 8.5%. This allowed LRC trials Director Basil Rifkind to claim that “for each 1% reduction in cholesterol, we can expect a 2% reduction in CHD events.” The statement was widely circulated even though it represented a completely invalid representation of the data, especially in light of the fact that when the lipid group at the University of Maryland analyzed the LRC data, they found no difference in CHD events between the group taking the drug and those on the placebo. A number of clinicians and statisticians participating in a 1984 Lipid Research Clinics Conference workshop, including Michael Oliver and Richard Krommel, were highly critical of the manner in which the LRC results had been tabulated and manipulated. The conference, in fact, went very badly for the NHLBI, with critics of the lipid hypothesis almost outnumbering supporters. One participant, Dr. Beverly Teter of the University of Maryland’s lipid group, was delighted with the state of affairs. “It’s wonderful'” she remarked to Basil Rifkind, study coordinator, “to finally hear both sides of the debate. We need more meetings like this” His reply was terse and sour: “No we don’t.”
National Cholesterol Consensus Conference
Dissenters were again invited to speak briefly at the NHLBI-sponsored National Cholesterol Consensus Conference held later that year, but their views were not included in the panel’s report, for the simple reason that the report was generated by NHLBI staff before the conference convened. Dr. Teter discovered this when she picked up some papers by mistake just before the conference began, and found they contained the consensus report, already written, with just a few numbers left blank. Kritchevsky represented the lipid hypothesis camp with a humorous five-minute presentation, full of ditties. Edward Ahrens, a respected researcher, raised strenuous objections about the “consensus,” only to be told that he had misinterpreted his own data, and that if he wanted a conference to come up with different conclusions, he should pay for it himself.
The 1984 Cholesterol Consensus Conference final report was a whitewash, containing no mention of the large body of evidence that conflicted with the lipid hypothesis. One of the blanks was filled with the number 200. The document defined all those with cholesterol levels above 200 mg/dL as “at risk” and called for mass cholesterol screening, even though the most ardent supporters of the lipid hypothesis had surmised in print that 240 should be the magic cutoff point. Such screening would, in fact, need to be carried out on a massive scale as the federal medical bureaucracy, by picking the number 200, had defined the vast majority of the American adult population as “at risk.” The report resurrected the ghost of Norman Jolliffe and his Prudent Diet by suggesting the avoidance of saturated fat and cholesterol for all Americans now defined as “at risk,” and specifically advised the replacement of butter with margarine.
The Consensus Conference also provided a launching pad for the nationwide National Cholesterol Education Program, which had the stated goal of “changing physicians’ attitudes.” NHLBI-funded studies had determined that while the general population had bought into the lipid hypotheses, and was dutifully using margarine and buying low-cholesterol foods, the medical profession remained skeptical. A large “Physicians Kit” was sent to all doctors in America, compiled in part by the American Pharmaceutical Association, whose representatives served on the NCEP coordinating committee. Doctors were taught the importance of cholesterol screening, the advantages of cholesterol-lowering drugs and the unique benefits of the Prudent Diet. NCEP materials told every doctor in America to recommend the use of margarine rather than butter.
Cholesterol screening for everyone
In November of 1986, the Journal of the American Medical Association published a series on the Lipid Research Clinics trials, including “Cholesterol and Coronary Heart Disease: A New Era” by longtime American Heart Association member Scott Grundy, MD, PhD. The article is a disturbing combination of euphoria and agony-euphoria at the forward movement of the lipid hypothesis juggernaut, and agony over the elusive nature of real proof. “The recent consensus conference on cholesterol… implied that levels between 200 and 240. . carry at least a mild increase in risk, which they obviously do…” said Grundy, directly contradicting an earlier statement that “Evidence relating plasma cholesterol levels to atherosclerosis and CHD has become so strong as to leave little doubt of the etiologic connection.” Grundy called for “… the simple step of measuring the plasma cholesterol level in all adults… those found to have elevated cholesterol levels can be designated as at high risk and thereby can enter the medical care system… an enormous number of patients will be included.
Who benefits from “the simple step of measuring the plasma cholesterol level in all adults?” Why, hospitals, laboratories, pharmaceutical companies, the vegetable oil industry, margarine manufacturers, food processors and, of course, medical doctors. “Many physicians will see the advantages of using drugs for cholesterol lowering…” said Grundy, even though “a positive benefit/risk ratio for cholesterol-lowering drugs will be difficult to prove.” The cost in the US of cholesterol screening and cholesterol-lowering drugs alone now stands at sixty billion dollars per year, even though a positive risk/benefit ratio for such treatment has never been established. Physicians, however, have “seen the advantages of using drugs for cholesterol lowering” as a way of creating patients out of healthy people.
Grundy was equally schizophrenic about the benefits of dietary modification. “Whether diet has a long term effect on cholesterol remains to be proved,” he stated, but “Public health advocates furthermore can play an important role by urging the food industry to provide palatable choices of foods that are low in cholesterol, saturated fatty acids and total calories.” Such foods, almost by definition, contain partially hydrogenated vegetable oils that imitate the advantages of animal fats. Grundy knew that the trans fats were a problem, that they raised serum cholesterol and contributed to the etiology of many diseases-he knew because a year earlier, at his request, Mary Enig had sent him a package of data detailing numerous studies that gave reason for concern, which he acknowledged in a signed letter as “an important contribution to the ongoing debate.”
Other mouthpieces of the medical establishment fell in line after the Consensus Conference. In 1987 the National Academy of Science (NAS) published an overview in the form of a handout booklet containing a whitewash of the trans problem and a pejorative description of palm oil-a natural fat high in beneficial saturates and monounsaturates that, like butter, has nourished healthy population groups for thousands of years, and, also like butter, competes with hydrogenated fats because it can be used as a shortening. The following year the Surgeon General’s Report on Nutrition and Health emphasized the importance of making low-fat foods more widely available. Project LEAN (Low-Fat Eating for America Now) sponsored by the J. Kaiser Family Foundation and a host of establishment groups such as the America Heart Association, the American Dietetic Association, the American Medical Association, the USDA, the National Cancer Institute, Centers for Disease Control and the National Heart, Lung and Blood Institute announced a publicity campaign to “aggressively promote foods low in saturated fat and cholesterol in order to reduce the risk of heart disease and cancer.”
National Food Processors Association Conference
The following year, Enig joined Frank McLaughlin, Director of the Center for Business and Public Policy at the University of Maryland, in testimony before the National Food Processors Association. It was a closed conference, for NFPA members only. Enig and McLaughlin had been invited to give “a view from academia.” Enig presented a number of slides and warned against singling out classes of fats and oils for special pejorative labeling. A representative from Frito-Lay took umbrage at Enig’s slides, which listed amounts of trans fats in Frito-Lay products. Enig offered to redo the analyses if Frito-Lay would to fund the research. “If you’d talk different, you’d get money,” he said. Enig urged the association to endorse accurate labeling of trans fats in all food items but conference participants-including representatives from most of the major food processing giants-preferred a policy of “voluntary labeling” that did not unnecessarily alert the public to the presence of trans fats in their foods. To date they have prevailed in preventing the inclusion of trans fats on nutrition labels.
Enig’s cat and mouse game with Hunter and Applewhite of the Institute of Shortening and Edible Oils continued throughout the later years of the 1980’s. Their modus operandi was to pepper the literature with articles that downplayed the dangers of trans fats, to use their influence to prevent opposing points of view from appearing in print and to follow-up the few alarmist articles that did squeak through with “definitive rebuttals.” In 1987 Enig submitted a paper on trans fatty acids in the US diet to the American Journal of Clinical Nutrition, as a reply to the erroneous 1985 FASEB report as well as to Hunter and Applewhite’s influential 1986 article, which by even the most conservative analysis underestimated the average American consumption of partially hydrogenated fats. Editor-in-chief Albert Mendeloff, MD rejected Enig’s rebuttal as “inappropriate for the journal’s readership.”
His rejection letter invited her to resubmit her paper if she could come up with “new evidence.” In 1991, the article finally came out in a less prestigious publication, the Journal of the American College of Nutrition, although Applewhite did his best to coerce editor Mildred Seelig into removing it at the last minute. Hunter and Applewhite submitted letters and then an article of rebuttal to the American Journal of Clinical Nutrition, which were published shortly thereafter. In the article, entitled “Reassessment of trans fatty acid availability in the US diet,” Hunter and Applewhite argued that the amount of trans in the American diet had actually declined since 1984, due to the introduction of soft margarines and tub spreads. The media fell in line with their pronouncements, with numerous articles by food writers recommending low-trans tub spreads, made from polyunsaturated vegetable oils, as the sensible alternative to saturated fat from animal sources-not surprising as most newspapers rely on the International Food Information Council, an arm of the food processing industry, for their nutrition information.
Other research on trans fats
Enig and the University of Maryland group were not alone in their efforts to bring their concerns about the effect of partially hydrogenated fats before the public. Fred Kummerow at the University of Illinois, blessed with independent funding and an abundance of patience, carried out a number of studies that indicated that the trans fats increased risk factors associated with heart disease, and that vegetable-oil-based fabricated foods such as Egg Beaters cannot support life. George Mann, formerly with the Framingham project, possessed neither funding nor patience-he was, in fact, very angry with what he called the Diet/Heart scam. His independent studies of the Masai in Africa, whose diet is extremely rich in cholesterol and saturated fat, and who are virtually free of heart disease, had convinced him that the lipid hypothesis was “the public health diversion of this century… the greatest scam in the history of medicine.” He resolved to bring the issue before the public by organizing a conference in Washington DC in November of 1991.
“Hundreds of millions of tax dollars are wasted by the bureaucracy and the self-interested Heart Association,” he wrote in his invitation to participants. “Segments of the food industry play the game for profits. Research on the true causes and prevention is stifled by denying funding to the “unbelievers.’ This meeting will review the data and expose the rascals.” The rascals did their best to prevent the meeting from taking place. Funding promised by the Greenwall Foundation of New York City was later withdrawn, so Mann paid most of the bills. A press release sent as a dirty trick to speakers and participants wrongly announced that the conference had been canceled. Several speakers did, in fact, renege at the last minute on their commitment to attend, including the prestigious Dr. Roslyn Alfin-Slater and Dr. Peter Nixon of London. Dr. Eliot Corday of Los Angeles canceled after being told that his attendance would jeopardize future funding.
The final pared-down roster included Dr. George Mann, Dr. Mary Enig, Dr. Victor Herbert, Dr. Petr Skrabenek, William B. Parsons, Jr., Dr. James McCormick, a physician from Dublin, Dr. William Stehbens from New Zealand, who described the normal protective process of arterial thickening at points of greatest stress and pressure, and Dr. Meyer Texon an expert in the dynamics of blood flow. Mann, in his presentation, blasted the system that had foisted the lipid hypothesis on a gullible public. “You will see,” he said, “that many of our contributors are senior scientists. They are so for a reason that has become painfully conspicuous as we organized this meeting. Scientists who must go before review panels for their research funding know well that to speak out, to disagree with this false dogma of Diet/Heart, is a fatal error. They must comply or go unfunded. I could show a list of scientists who said to me, in effect, when I invited them to participate: “I believe you are right, that the Diet/Heart hypothesis is wrong, but I cannot join you because that would jeopardize my perks and funding.’ For me, that kind of hypocritical response separates the scientists from the operators-the men from the boys.”
90s see the nation well oiled
By the nineties the operators had succeeded, by slick manipulation of the press and of scientific research, in transforming America into a nation that was well and truly oiled. Consumption of butter had bottomed out at about 5 grams per person per day, down from almost 18 at the turn of the century. Use of lard and tallow had been reduced by two-thirds. Margarine consumption had jumped from less than 2 grams per person per day in 1909 to about 11 in 1960. Since then consumption figures had changed little, remaining at about 11 grams per person per day-perhaps because knowledge of margarine’s dangers had been slowly seeping out to the public. However, most of the trans fats in the current American diet come not from margarine but from shortening used in fried and fabricated foods. American shortening consumption of 10 grams per person per day held steady until the 1960’s, although the content of that shortening had changed from mostly lard, tallow and coconut oil-all natural fats-to partially hydrogenated soybean oil. Then shortening consumption shot up and by 1993 had tripled to over 30 grams per person per day. But the most dramatic overall change in the American diet was the huge increase in the consumption of liquid vegetable oils, from slightly less than 2 grams per person per day in 1909 to over 30 in 1993-a fifteen-fold increase.
Dangers of polyunsaturates
The irony is that these trends have persisted concurrently with revelations about the dangers of polyunsaturates. Because polyunsaturates are highly subject to rancidity, they increase the body’s need for vitamin E and other antioxidants. Excess consumption of vegetable oils is especially damaging to the reproductive organs and the lungs-both of which are sites for huge increases in cancer in the US. In test animals, diets high in polyunsaturates from vegetable oils inhibit the ability to learn, especially under conditions of stress; they are toxic to the liver; they compromise the integrity of the immune system; they depress the mental and physical growth of infants; they increase levels of uric acid in the blood; they cause abnormal fatty acid profiles in the adipose tissues; they have been linked to mental decline and chromosomal damage; they accelerate aging. Excess consumption of polyunsaturates is associated with increasing rates of cancer, heart disease and weight gain; excess use of commercial vegetable oils interferes with the production of prostaglandins leading to an array of complaints ranging from autoimmune disease to PMS. Disruption of prostaglandin production leads to an increased tendency to form blood clots, and hence myocardial infarction, which has reached epidemic levels in America.
Vegetable oils are more toxic when heated. One study reported that polyunsaturates turn to varnish in the intestines. A study by a plastic surgeon found that women who consumed mostly vegetable oils had far more wrinkles than those who used traditional animal fats. A 1994 study appearing in the Lancet showed that almost three-quarters of the fat in artery clogs is unsaturated. The “artery clogging” fats are not animal fats but vegetable oils. Those who have most actively promoted the use of polyunsaturated vegetable oils as part of a Prudent Diet are well aware of their dangers. In 1971, William B. Kannel, former director of the Framingham study, warned against including too many polyunsaturates in the diet. A year earlier, Dr. William Connor of the American Heart Association issued a similar warning, and Frederick Stare reviewed an article which reported that the use of polyunsaturated oils caused an increase in breast tumors. And Kritchevsky, way back in 1969, discovered that the use of corn oil caused an increase in atherosclerosis.
As for the trans fats, produced in vegetable oils when they are partially hydrogenated, the results that are now in the literature more than justify concerns of early investigators about the relation between trans fats and both heart disease and cancer. The research group at the University of Maryland found that trans fatty acids not only alter enzymes that neutralize carcinogens, and increase enzymes that potentiate carcinogens, but also depress milk fat production in nursing mothers and decrease insulin binding. In other words, trans fatty acids in the diet interfere with the ability of new mothers to nurse successfully and increase the likelihood of developing diabetes. Unpublished work indicates that trans fats contribute to osteoporosis. Hanis, a Czechoslovakian researcher, found that trans consumption decreased testosterone, caused the production of abnormal sperm and altered gestation. Koletzko, a German pediatric researcher found that excess trans consumption in pregnant mothers predisposed them to low birth weight babies. Trans consumption interferes with the body’s use of omega-3 fatty acids found in fish oils, grains and green vegetables, leading to impaired prostaglandin production. George Mann confirmed that trans consumption increases the incidence of heart disease. In 1995, European researchers found a positive correlation between breast cancer rates and trans consumption.
Until the 1995 study, only the disturbing revelations of Dutch researchers Mensink and Katan, in 1990, received front-page coverage. Mensink and Katan found that margarine consumption increased coronary heart disease risk factors. The industry-and the press-responded by promoting tub spreads, which contain reduced amounts of trans compared to stick margarine. For the general population, these trans reductions have been more than offset by changes in the types of fat used by the fast food industry. In the early 1980’s, Center for Science in the Public Interest campaigned against the use of beef tallow for frying potatoes. Before that they campaigned against the use of tallow for frying chicken and fish. Most fast food concerns switched to partially hydrogenated soybean oil for all fried foods. Some deep fried foods have been tested at almost 50% trans. Epidemiologist Walter Willett at Harvard worked for many years with flawed databases which did not identify trans fats as a dietary component. He found a correlation with dietary fat consumption and both heart disease and cancer. After his researchers contacted Enig about the trans data, they developed a more valid database that was used in the analysis of the massive Nurses Study. When Willett’s group separated out the trans component in their analyses, they were able to confirm greater rates of cancer in those consuming margarine and vegetable shortenings-not butter, eggs, cheese and meat. The correlation of trans fat consumption and cancer was never published, but was reported at the Baltimore Data Bank Conference in 1992.
In 1993 Willett’s research group at Harvard found that trans contributed to heart disease, and this study was not ignored, but received much fanfare in the press. Willett’s first reference in his report was Enig’s work on the trans content of common foods. The industry continues to argue that American trans consumption is a low six to eight grams per person per day, not enough to contribute to today’s epidemic of chronic disease. Total per capita consumption of margarine and shortening hovers around 40 grams per person per day. If these products contain 30% trans (many shortenings contain more) then average consumption is about 12 grams per person per day. In reality, consumption figures can be dramatically higher for some individuals. A 1989 Washington Post article documented the diet of a teenage girl who ate 12 donuts and 24 cookies over a three day period. Total trans worked out to at least 30 grams per day, and possibly much more. The fat in the chips that teenagers consume in abundance may contain up to 48% trans which translates into 45.6 grams of trans fat in a small ten-ounce bag of snack chips-which a hungry teenager can gobble up in a few minutes. High school sex education classes do not teach American teenagers that the altered fats in their snack foods may severely compromise their ability to have normal sex, conceive, give birth to healthy babies and successfully nurse their infants.
Benefits of animal fats
Foods containing trans fat sell because the American public is afraid of the alternative-saturated fats found in tallow, lard, butter, palm and coconut oil, fats traditionally used for frying and baking. Yet the scientific literature delineates a number of vital roles for dietary saturated fats-they enhance the immune system, are necessary for healthy bones, provide energy and structural integrity to the cells, protect the liver and enhance the body’s use of essential fatty acids. Stearic acid, found in beef tallow and butter, has cholesterol lowering properties and is a preferred food for the heart. As saturated fats are stable, they do not become rancid easily, do not call upon the body’s reserves of antioxidants, do not initiate cancer, do not irritate the artery walls.
Your body makes saturated fats, and your body makes cholesterol-about 2000 mg per day. In general, cholesterol that the average American absorbs from food amounts to about 100 mg per day. So, in theory, even reducing animal foods to zero will result in a mere 5% decrease in the total amount of cholesterol available to the blood and tissues. In practice, such a diet is likely to deprive the body of the substrates it needs to manufacture enough of this vital substance; for cholesterol, like saturated fats, stands unfairly accused. It acts as a precursor to vital corticosteroids, hormones that help us deal with stress and protect the body against heart disease and cancer; and to the sex hormones like androgen, testosterone, estrogen and progesterone; it is a precursor to vitamin D, a vital fat-soluble vitamin needed for healthy bones and nervous system, proper growth, mineral metabolism, muscle tone, insulin production, reproduction and immune system function; it is the precursor to bile salts, which are vital for digestion and assimilation of fats in the diet.
Recent research shows that cholesterol acts as an antioxidant. This is the likely explanation for the fact that cholesterol levels go up with age. As an antioxidant, cholesterol protects us against free radical damage that leads to heart disease and cancer. Cholesterol is the body’s repair substance, manufactured in large amounts when the arteries are irritated or weak. Blaming heart disease on high serum cholesterol levels is like blaming firemen who have come to put out a fire for starting the blaze. Cholesterol is needed for proper function of serotonin receptors in the brain. Serotonin is the body’s natural “feel-good” chemical. This explains why low cholesterol levels have been linked to aggressive and violent behavior, depression and suicidal tendencies.
Mother’s milk is especially rich in cholesterol and contains a special enzyme that helps the baby utilize this nutrient. Babies and children need cholesterol-rich foods throughout their growing years to ensure proper development of the brain and nervous system. Dietary cholesterol plays an important role in maintaining the health of the intestinal wall, which is why low-cholesterol vegetarian diets can lead to leaky gut syndrome and other intestinal disorders. Animal foods containing saturated fat and cholesterol provide vital nutrients necessary for growth, energy and protection from degenerative disease. Like sex, animal fats are necessary for reproduction. Humans are drawn to both by powerful instincts. Suppression of natural appetites leads to weird nocturnal habits, fantasies, fetishes, bingeing and splurging. Animal fats are nutritious, satisfying and they taste good. “Whatever is the cause of heart disease,” said the eminent biochemist Michael Gurr in a recent article, “it is not primarily the consumption of saturated fats.” And yet the high priests of the lipid hypothesis continue to lay their curse on the fairest of culinary pleasures-butter and Bernaise, whipped cream, souffles and omelets, full-bodied cheeses, juicy steaks and pork sausage.
Coming full circle-And yet, learning nothing
On April 30, 1996 a senior researcher named David Kritchevsky received the American Oil Chemists’ Society’s Research Award in recognition of his accomplishments as a “researcher on cancer and atherosclerosis as well as cholesterol metabolism.” His accomplishments include co-authorship of more than 370 research papers, one of which appeared a month later in the American Journal of Clinical Nutrition. “Position paper on trans fatty acids” continued the debate on trans fats that began in the same journal with Hunter and Applewhite’s 1986 attack on Enig’s research. “A controversy has arisen about the potential health hazards of trans unsaturated fatty acids in the American diet,” wrote Kritchevsky and his coauthors. Actually the controversy dates back to 1954. In the rabbit studies that launched Kritchevsky on his career, the researcher actually found that cholesterol-fed with Wesson oil “markedly accelerated” the development of cholesterol-containing low-density lipoproteins; and cholesterol-fed with shortening gave cholesterol levels twice as high as cholesterol-fed alone. Enig’s work and that of Kummerow and Mann and several others-merely confirmed what Kritchevsky ascertained decades ago but declined to publicize, that vegetable oils, and particularly partially hydrogenated vegetable oils, are bad news.
But the “Position paper on trans fatty acids” took no position at all. Studies have given contradictory results said the authors and the amount of trans in the average American diet is very difficult to determine. As for labeling There is no clear choice of how to include trans fatty acids on the nutrition label. The database is insufficient to establish a classification scheme for these fats. There may be problems with trans says the senior researcher but their use helps to reduce the intake of dietary fats higher in saturated fatty acids. Also vegetable fats are not a source of dietary cholesterol unlike saturated animal fats. Kritchevsky and his coauthors conclude that physicians and nutritionists should focus on a further decrease in total fat intake and especially the intake of saturated fat… A reduction in total fat intake simplifies the problem because all fats in the diet decrease and choices are unnecessary. However, even senior scientists find that fence straddling is necessary. We may conclude wrote Kritchevsky and his colleagues that consumption of liquid vegetable oils is preferable to solid fats.
Early this year 1998 a symposium entitled Evolution of Ideas about the Nutritional Value of Dietary Fat reviewed the many flaws in the lipid hypothesis and highlighted a study in which mice fed purified diets died within 20 days but whole milk kept the mice alive for several months. One of the participants was David Kritchevsky who noted that the use of low-fat diets and drugs in intervention trials did not affect overall CHD mortality. Ever with a finger in the wind this influential Founding Father of the lipid hypothesis concluded thus: Research continues apace and as new findings appear it may be necessary to reevaluate our conclusions and preventive medicine policies.
– 1999 Mary G. Enig PhD and Sally Fallon.
First published in Nexus Magazine Dec ’98-Jan ’99 and Feb ’99-Mar ’99.
Mary G. Enig Ph.D. is an expert of international renown in the field of lipid biochemistry. She has headed a number of studies on the content and effects of trans fatty acids in America and Israel and has successfully challenged government assertions that dietary animal fat causes cancer and heart disease. Recent scientific and media attention on the possible adverse health effects of trans fatty acids has brought increased attention to her work. She is a licensed nutritionist certified by the Certification Board for Nutrition Specialists a qualified expert witness nutrition consultant to individuals industry and state and federal governments contributing editor to a number of scientific publications Fellow of the American College of Nutrition and President of the Maryland Nutritionists Association. She is the author of over 60 technical papers and presentations as well as a popular lecturer. Dr. Enig is currently working on the exploratory development of an adjunct therapy for AIDS using complete medium chain saturated fatty acids from whole foods. She is the mother of three healthy children brought up on whole foods including butter cream eggs and meat.
Sally Fallon is the author of Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats (with Mary G. Enig PhD) as well as of numerous articles on the subject of diet and health. She is President of the Weston A Price Foundation and founder of A Campaign for Real Milk. She is the mother of four healthy children raised on whole foods including butter cream eggs and meat.
- D Kritchevsky et al Effect of Cholesterol Vehicle in Experimental Atherosclerosis Am J Physiol July-September 1954 178:30-32
- Notice of Supelco-AOC Award to Kritchevsky Inform 1996 7:315
- M Enig Trans Fatty Acids in the Food Supply: A Comprehensive Report Covering 60 Years of Research 2nd Edition 1995 Enig Associates Inc. Silver Spring MD pp 4-8
- D Groom Population Studies of Atherosclerosis Annals of Int Med July 1961 55:1:51-62; W F Enos et al Pathogenesis of Coronary Disease in American Soldiers Killed in Korea JAMA 1955 158:912
- W Laurie et al Atherosclerosis and its Cerebral Complications in the South African Bantu Lancet Feb 1958 pp 231-232
- W B Robertson Atherosclerosis and Ischaemic Heart Disease Lancet 1959 1:444
- T Gordon Mortality Experience Among Japanese in the US Hawaii and Japan Pul Health Rep 1957 51:270; O J Pollak Diet and Atherosclerosis Lancet 1959 1:444
- H C McGill et al General Findings of the International Atherosclerosis Project Laboratory Investigations 1968 18:(5):498
- R L Smith and E R Pinckney The Cholesterol Conspiracy 1991 Warren H Green Inc. St. Louis MO. p 125
- M De Bakey et al Serum Cholesterol Values in Patients Treated Surgically for Atherosclerosis JAMA 1964 189:9:655-59
- A Keys Diet and Development of Coronary Heart Disease J Chron Dis Oct 1956 4(4):364-380
- G Cristakis Effect of the Anti-Coronary Club Program on Coronary Heart Disease Risk-Factor Status JAMA Nov 7 1966 198:(6):129-3512a. Researchers at the University of Florida at Gainsborough found trans levels as high as 4.6% in processed canola oil. (S. O’Keefe and others. Journal of Food Lipids1994;1:165-176.) The conversion of omega-3 fatty acids to trans fats can be prevented by certain careful processing methods. (JL Sebedio and others. European Journal of Clinical Nutrition 2000 Feb;54(2):104-13.
- Dietary Goals for the United States-Supplemental Views prepared by the Staff of the Select Committee on Nutrition and Human Needs United States Senate November 1977 Government Printing Office Washington DC pp 139-140
- R L Rizek et al Fat in Today’s Food Supply-Level of Use and Sources J Am Oil Chem Soc 1974 51:244
- M G Enig et al Dietary Fat and Cancer Trends-A Critique Federation Proceedings July 1978 37:(9):2215-2220
- T H Applewhite Statistical Correlations’ Relating Trans-Fats to Cancer: A Commentary Federation Proceedings Oct 1979 38:(11):2435-2439
- F A Kummerow Effects of Isomeric Fats on Animal Tissue Lipid Classes and Atherosclerosis Geometrical and Positional Fatty Acid Isomers E. A. Emken and H. J. Dutton eds American Oil Chemists’ Society Champaign IL 1979 pp151-180; D Kritchevsky Trans Fatty Acid Effects in Experimental Atherosclerosis Federation Proceedings 1982 41:2813
- M G Enig Modification of Membrane Lipid Composition and Mixed-Function Oxidases in Mouse Liver Microsomes by Dietary Trans Fatty Acids Doctoral Dissertation for the University of Maryland 1984
- New Focus on Trans Fatty Acids Food Processing December 1982 pp 64-66
- E J Hunter More on Those Trans Fatty Acids Food Processing May 1983 pp 35-36
- W M N Ratnayake et al Fatty Acids in Some Common Food Items in Canada J Am Coll Nutr 1993 12:(6):651-660
- M G Enig et al Fatty Acid Composition of the Fat in Selected Food Items with Emphasis on Trans Components J Am Oil Chem Soc 1983 60:(10):1788-1795
- J E Hunter Letter to the Editor Science 1984 224:659
- C E Elson et al The Influence of Dietary Unsaturated Cis and Trans and Saturated Fatty Acids on Tissue Lipids of Swine Atherosclerosis 1981 40:115-137
- F R Senti ed Health Aspects of Dietary Trans Fatty Acids Bethesda MD Life Sciences Research Office-Fed Am Soc Exp Biol 1985
- J E Hunter and T Applewhite Isomeric Fatty Acids in the US Diet: Levels and Health Perspectives Am J Clin Nutr 1986 44:707-717
- Ace Federal Reporter Inc. Stenotype Reporters 444 North Capitol Street Suite 402 Washington DC 20001 (202) 347-3700
- Food Chemical News January 25 1988 29:(47):52; Nutrition Week Community Nutrition Institute (CNI) June 16 1988 p 6
- Smith R and E R Pinckney Diet Blood Cholesterol and Coronary Heart Disease: A Critical Review of the Literature Vol 2 1991 Vector Enterprises Sherman Oaks CA
- Castelli William Concerning the Possibility of a Nut… Archives of Internal Medicine Jul 1992 152:(7):1371-1372
- Multiple Risk Factor Intervention Trial; Risk Factor Changes and Mortality Results JAMA September 24 1982 248:(12):1465
- F H Mattson et al Effect of Dietary Cholesterol on Serum Cholesterol in Men Am J Clin Nutr 1972 25:589
- P Addis Food and Nutrition News March/April 1990 62:(2):7-10
- The Lipid Research Clinics Coronary Primary Prevention Trial Results. I. Reduction in Incidence of Coronary Heart Disease JAMA 1984 251:359
- S M Grundy Cholesterol and Coronary Heart Disease: A New Era JAMA Nov 28 1986 256:(20):2849-2858
- Letters to the Editor and Authors’ Responses J Am Coll Nutr 1991 10:5:510-521
- E J Hunter and T H Applewhite Reassessment of Trans Fatty Acid Availability in the US Diet Am J Clin Nutr 1991 54:363-369
- F. A. Kummerow Nutritional Effects of Isomeric Fats: Their Possible Influence on Cell Metabolism or Cell Structure Dietary Fats and Health (E. G. Perkins and W. J. Visek eds) Americna Oil Chemists’ Society Champaign IL 1983 pp 391-402; F. A. Kummerow Nutritional Aspects of Isomeric Fats Lipids in Modern Nutrition M Horisberger and U Bracco eds 1987 Nestle Nutrition Vevey/Raven Press New York
- Mann G V et al Atherosclerosis in the Maasai Am J Epidemiol 1972 95:26-37
- Coronary Heart Disease The Dietary Sense and Nonsense George V Mann ed 1993 Veritas Society London p 1
- A general review of citations for problems with polyunsaturate consumption is found in E R Pinckney and C Pinckney The Cholesterol Controversy 1973 Sherbourne Press Los Angeles pp127-131
- C V Felton et al Dietary Polyunsaturated Fatty Acids and Composition of Human Aortic Plaques Lancet 1994 344:1195
- D Kritchevsky Medical Counterpoint March 1969
- B B Teter et al Milk Fat Depression in C57B1/6J Mice Consuming Partially Hydrogenated Fat Journal of Nutrition 1990 120:818-824; Barnard et al Dietary Trans Fatty Acids Modulate Erythrocyte Membrane Fatty Acid Composition and Insulin Binding in Monkeys Journal of Nutritional Biochemistry 1990 1:190-195
- T Hanis et al Effects of Dietary Trans Fatty Acids on Reproductive Perforamnce of Wistar Rats British Journal of Nutrition 1989 61:519-529
- B Koletzko and J Muller Cis– and Trans-Isomeric Fatty Acids in Polasma Lipids of Newborn Infants and Their Mothers Biology of the Neonate 1990 57:172-178
- D Horrobin The Regulation of Prostaglandin Biosynthesis by Manipultion of Essential Fatty Acid Metabolism Reviews in Pure and Applied Pharmacological Sciences 1983 4:339-383
- G V Mann Metabolic Consequences of Dietary Trans Fatty Acids The Lancet 1994 343:1268-1271
- L Kohlmeier et al Stores of Trans Fatty Acids and Breast Cancer Risk Am J Clin Nutr 1995 61:896;A25
- R P Mensink and M Katan Effect of Dietary Trans Fatty Acids on High-Density and Low-Density Lipoprotein Cholesterol Levels in Healthy Subjects N Eng J Med 1990 323:439-445
- M G Enig et al Isomeric Trans Fatty Acids in the U.S. Diet J Am Coll Nutr 1990 9:471-486
- W C Willett et al Consumption of Trans-Fatty Acids in Relation to Risk of Coronary Heart Disease Among Women Society for Epidemiology Research June 1992 Annual Meeting Abstract 249
- W C Willett et al Intake of Trans Fatty Acids and Risk of Coronary Heart Disease Among Women Lancet 1993 341:581-585
- J J Kabara The Pharmacological Effects of Lipids J J Kabara ed The American Oil Chemists’ Society Champaign IL 1978 1-14; L A Cohen et al J Natl Cancer Inst 1986 77:43
- B A Watkins et al Importance of Vitamin E in Bone Formation and in Chrondrocyte Function Purdue University Lafayette IN AOCS Proceedings 1996; B A Watkins and M F Seifert Food Lipids and Bone Health Food Lipids and Health R E McDonald and D B Min eds Marcel Dekker Inc. New York NY p 101
- J F Mead et al Lipids: Chemistry Biochemistry and Nutrition Plenum Press 1986 New York
- A A Nanji et al Gastroenterology Aug 1995 109(2):547-54; Y S Cha and D S Sachan J Am Coll Nutr Aug 1994 13(4):338-43
- M L Garg et al The FASEB Journal 1988 2:(4):A852; R M Oliart Ros et al Meeting Abstracts AOCS Proceedings May 1998 p 7 Chicago IL
- L D Lawson and F Kummerow B-Oxidation of the Coenzyme A Esters of Vaccenic Elaidic and Petroselaidic Acids by Rat Heart Mitochondria Lipids 1979 14:501-503
- E M Cranton and J P Frackelton Free Radical Pathology in Age-Associated Diseases: Treatment with EDTA Chelation Nutrition and Antioxidants Journal of Holistic Medicine Spring/Summer 1984 pp 6-37
- H Engelberg Low Serum Cholesterol and Suicide Lancet March 21 1992 339:727-728
- R B Alfin-Slater and L Aftergood Lipids Modern Nutrition in Health and Disease 6th ed 1980 R S Goodhart and M E Shils eds Lea and Febiger Philadelphia p 134
- M Gurr A Fresh Look at Dietary Recommendations Inform April 1996 7:4:432-435
- AIN/ASCN Task Force on Trans Fatty Acids Position Paper on Trans Fatty Acids Am J Clin Nutr 1996 63:663-670
- R M Lemmon D Kritchevsky et al The Effect of Delta-7-Cholestenol Feeding on the Cholesterol and Lipoproteins of Rabbit Serum Archives of Biochemistry & Biophysics (NY) July 1954 51:(1):1161-9; D Kritchevsky et al Effect of Cholesterol Vehicle in Experimental Atherosclerosis Am J Physiol July-September 1954 178:30-32
- R E Olson Evolution of Ideas about the Nutritional Value of Dietary Fat: Introduction J Nutr 1998 128:421S-425S