Newspaper reporters can be notoriously cynical. It's an occupational hazard that comes from covering the seamy side of life, often because they start out on the police beat where they see people at their worst.
I was fortunate to start my journalistic career in sports and to move on to small business and now to write about health, specifically diabetes. So I avoided the cynicism that seems to come with the territory. Until now.
The unfolding scandals that several pharmaceutical companies deep-sixed many of the drug trials they had conducted that didn't turn out well for them disturb any of us who are following the news. But even more than that, two new books are making me deeply suspicious if not outright cynical about so much that the American medical establishment has preached for years. As a result I have radically changing my opinions about the best diet for people with diabetes.
The first of these books to open my eyes was Good Calories, Bad Calories by science writer Gary Taubes. He totally demolished the demonizing of fat, and I reviewed aspects of his work in four previous articles here, most recently in "The Fat Paradox."
Then, I just finished reading In Defense of Food by journalism professor Michael Pollan. Penguin Press published it a few days ago for $21.95, but it is already available for the Amazon Kindle, which my favorite Certified Diabetes Educator gave me. So I was able to get In Defense of Food's electrons for just $9.99.
Pollan's book is an eater's manifesto, and in fact carries that sub-title. What he means is that his book is for people, not the corporations that profit from our bad food choices or the nutritionists and journalists (ahem) who have led us astray.
I have read with great pleasure and enlightenment all five of his books -- on topics as varied as food, botany, gardening, and construction -- as well as many of his most important articles. Still, I faced his new book with a little trepidation.
Pollan's often-repeated mantra is "Eat food. Not too much. Mostly plants." It's a great slogan, but my concern focused on what I thought might be his bias against animal protein and fat. On a low-carb diet it is just about impossible to avoid eating meat.
So I was delighted to find that Pollan and Taubes are on the same wave length. The person who exposed the whole fat paradigm as a historical disaster "is a science journalist named Gary Taubes, who for the last decade has been blowing the whistle on the science behind the low-fat campaign," Pollan writes. "In a devastating series of articles and an important new book called Good Calories, Bad Calories, Taubes has all but demolished the whole lipid hypothesis, demonstrating just how little scientific backing it had from the very beginning."
Now, "a great many scientists are beating a quiet retreat from the main tenets of the lipid hypothesis," Pollan writes. "The whole nutritional orthodoxy around dietary fat appears to be crumbling," says Pollan, citing in particular an influential article by a group of prominent nutrition scientists at the Harvard School of Public Health. In this analysis of the relevant research called "Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review," the authors "proceed to calmly remove, one by one, just about every strut supporting the theory that dietary fat causes heart disease."
The "bombshell" in this review, Pollan writes, is the statement that, "It is now increasingly recognized that the low-fat campaign has been based on little scientific evidence and may have caused unintended health consequences." Only trans fat "can contribute to increased risk of CHD [coronary heart disease]."
The total levels of fat in our diet apparently has little bearing on the risk of heart disease, Pollan summarizes. But the ratio between types of fat does, specifically between the omega-3 fatty acids, of which we get too little, and omega-6, of which we get too much.
The other inescapable conclusion that the Harvard experts draw is that, contrary to all the advertising, we generally just don't lose weight on a low-fat diet. "A major purported benefit of a low-fat diet is weight loss. But long-term clinical trials have not provided convincing evidence that reducing dietary fat can lead to substantial weight loss. On the contrary, there is some evidence that a diet containing a high amount of refined carbohydrates may increase hunger and promote overeating, which can lead to weight gain and obesity."
True, Pollan prefers plants to animal protein. He likes his meat as a side dish to veggies and not vice versa and encourages us to avoid "industrial meat" in favor of meat fed a natural diet.
I do share his ethical and environmental concerns with our heavy reliance on livestock. One article that he cites, "Livestock’s long shadow: Environmental issues and options," is well worth reading.
Still, I differ with his statement that, "Unlike plants, which we can't live without, we don't need to eat meat -- with the exception of Vitamin B12, every nutrient found in meat can be obtained somewhere else." Every other nutrient? Here Pollan himself seems to fall into the nutritionism trap that he lambasts the food industry and scientists for promoting, where they act as if they know what all the nutrients are. We don't. We are still learning.
In fact, we have long had excellent evidence that we don't need to eat any plants or any carbohydrate. Arctic explorer Vilhjalmur Stefansson proved this by eating nothing but protein and fat during many years of living with Eskimos (Inuit) before any of us were born and later in a controlled hospital setting. I reprint his three excellent articles on my website, beginning here.
But low-carb vegetables do provide a raft of nutrients, most of which we understand very poorly. In fact, that is one of Pollan's best arguments against the reductionist paradigm of nutritionism, analyzing individual micronutrients in isolation from the food that we eat. I won't fall into that trap, and neither do the leading exponents of low-carb diets.
"There is no such thing an an essential carbohydrate for normal development, despite what the popular press might have you believe," writes Richard K. Bernstein in his book, Dr. Bernstein's Diabetes Solution (third edition, Little, Brown, 2007), page 169. "The main reason I don't suggest that you avoid all carbohydrate is that there are many constituents of vegetables -- such as vitamins and minerals, but also many other nonvitamin chemicals (phytochemicals) -- that are only recently becoming understood but that are nonetheless crucial to diet and cannot be obtained through conventional vitamin supplements."
If these arguments against the conventional wisdom confuse you, join the crowd. All of so-called "food science" is in an uproar right now. These are confusing times, and they are times when even sunny people like me can become cynical of what the "experts" have been teaching us for years.
Always remember that we are the real experts on controlling our diabetes. Whatever works for us is the correct science.