Book Review: “The Big Fat Surprise”

Book Review: “The Big Fat Surprise” Nina Teicholz

In “The Big Fat Surprise,” Teicholz takes a thorough look at the scientific nutritional studies that set our society on track to become fat-phobic and fad-diet crazed. With the rise of heart disease related deaths in the 1950s, the American medical community was under pressure to find the cause, and thus the cure, for Americans’ greatest health threat. Early research labeled saturated fat the enemy, paving the road for decades of disease and misinformation. Teicholz points out that a few studies, buried by the low-fat hype, pointed toward refined carbohydrates as the villain, and that maybe if those studies had been given the platform they deserved, America would not be experiencing the obesity, cancer and heart-disease epidemics that plague today.

In her book, Teicholz rips apart the studies that laid the foundation for what became the diet-heart hypothesis – the crux of the low-fat craze. She points out that one of the first key studies was conducted during Lent in a city of devout Christians when most of the citizens were abstaining from meat. Other discrepancies in the materials that were conveniently disregarded by their researchers included the fact that some of the cities were still bouncing back from wartime famine, and their diets were reflective of that. As we’ve learned from Pottenger’s cats, the greater effects of nutrition are better seen on a multi-generational scale; and a snapshot of a city’s current diet, especially if skewed in anyway, cannot properly tell the nutritional-status story of a group of people. In addition, Teicholz shows where researchers cherry-picked information out of their studies to support the theories they intended to reinforce. This sometimes included ignoring nutritional deficiencies in study groups that were avoiding fats, the effects of certain diets on women versus men, or research that showed that refined carbohydrates (the very item Americans were told to switch to from fats) may actually be increasing the rate of heart disease in America. Teicholz points out that not only were crucial holes in research buried, but entire studies that stood in direct opposition of the diet-heart hypothesis were vilified and left unsupported by leaders in the field who feared retribution.

In the decades after 1970, when the American Heart Association officially started to tell Americans to reduce fat, a low-fat diet had not actually been tested in clinical trials, and the health of Americans became strikingly worse. In an effort to be healthy, Americans were unwittingly poisoning themselves: in addition to an increase in refined carbohydrates in place of fats, factory-made trans fats were supported for a time, and unstable vegetable fats that quickly rancidify under high heat replaced the more stable saturated fats in restaurants across the country. “The Big Fat Surprise” is a compelling look at how the American diet became what it is today. While I would recommend this book to clients who are interested in research, Teicholz’s in-depth coverage may be a bit daunting for those less interested in the details. It will be helpful, however, to use a synopsis of the book to explain to fat-phobic clients how and why such misinformation has been ingrained in them.

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