The Big Fat Surprise


The Big Fat SurpriseThis 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

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 (click here 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 Hrdli?ka, 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 Hrdli?ka 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 Hrdli?ka 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.”

Hrdli?ka 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. Hrdli?ka 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 Hrdli?ka 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

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.

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230 thoughts on “The Big Fat Surprise

  1. “Or we will all be eating our food cooked in lard, butter, beef tallow and duck fat”

    I’m always a little perturbed by these predictions. What will happen to the price of these most beloved of fats?

    Currently we’re still enjoying cut-price butter in NZ – it’s the least wanted and consequently best value dairy product by far. Simple matter of supply and demand.

    • Always a consideration, I suppose. But I would imagine the laws of supply and demand will kick in and more will be produced keeping the prices low. I just hope that day comes.

      • Not in Denmark. They taxed very high pork products and butter in an effort to drive the population away from these. And those are some of their most prized products. Government intervention….

          • I just wrote about a thousand word response to your comment and, thanks to the unstable nature of my site right now, it disappeared. I’m not going to write it again as a comment. I’ll write it as a blog post in the near future. My tech guys tell me that in just a couple of weeks (at max) from getting a new site, so I’ll do it then.

            The short answer is that neither Gary nor Nina twisted the facts as the review implies. For a number of reasons (which I laid out in the vanished comment) honest errors creep into books over the years it takes to write books such as these. Then folks who have an axe to grind (it’s my understanding that the guy who wrote the review you linked to is a vegetarian) nit pick at these errors and try to make it seem as if the entire book is suspect.

            The review is, what, a few pages long max. If every thing he says is correct (which is not the case – much of what he says is his opinion), then compare a few pages of errors with almost 500 pages of book. And a handful of citations he claims are misinterpreted with the 1200 or so citations in the book.

          • Answer is a lay person can’t play the Professor roll. She is NOT a medical scientist, biochemist, physiologist or chemical pathologist. IF by chance she read all the scientific papers she would have found the correlation already proofed time and again by medical scientists.
            Science halve also shown the correlation if deceasing the cardiac death’s by limiting and ACTIVELY treating the hyperlipidemia we experiencing. So why would this fact be ignored?

    • Here in the U.S., 100% grass-fed butter is not cut-rate. In my area, it sells for $7.00/lb, $6.00/lb. on the rare sale.

      • It’s expensive here too, so I just cut it with a few eggs and some onions and garlic. It’s yummy and it stretches the beef out.

  2. I note with no surprise that Ms Teicholtz holds a degree in biology.

    What I have observed is that thought leaders with opinions contra conventional wisdom on nutrition generally have an actual science background, not a nutrition science background.

  3. Thanks for a wonderful review. My copy of this book is due to arrive today. I can’t wait to read it. I hope you are going to post your review on Amazon. There is only one review so far. The book is ranked #306 overall and #1 in health and diet.

    • I guess I should stick a review on Amazon. I never think of doing that because I always review books I like on this blog. I have never written an Amazon review. I guess it’s easy enough to figure out how to do it.

        • Amazon doesn’t allow off-site links. But you can publish part or all of your review here as your Amazon review. Preface it with a sentence or two about who you are & then insert this column or a condensed version. It will hugely help her sales.

  4. There’s a hole in the timeline. Deaths from heart disease began rising in 1905. Keys’ attempt to explain the rise wasn’t published until 1952.

    Does the author discuss why heart disease was increasing between 1905 and 1950?

    • She does go into the sudden rise of heart disease. It didn’t really begin until the 1920s, though. Paul Dudley White, the physician who later treated President Eisenhower, wrote that during his training in the immediate pre-WWI years, he saw only four patients with chest pain.

      • Heart disease death’s began rising in the early 20th…is there not a strong correlation between the use of Transfats (Crisco) during that time and also a rise in cigarette smoking during the same period? I frequently notice most researchers discount or ignore this factor when discussing heart disease.

        According to Wikipedia, per capita consumption of cigarettes went from 54 per year to over 4200 per year by 1965.

        • Crisco came on the scene in 1911 (here’s a post I wrote about it), and there was indeed an enormous increase in cigarette consumption from the early 20th century to the 1950s-1960s. Although correlation is not causation, there is no doubt that at least the smoking contributed a great deal to the increases in heart disease over the same period of time.

          I think the point Nina is making is not that a reduction in saturated fat was the driving factor in the development of heart disease, but that since saturated fat consumption was great in an era during which heart disease was rare, it’s unlikely that consumption of saturated fat is risk factor, which was what Keys set out to prove.

          • There was also a rise in the availability of potable water and mains drainage during the twentieth century, together with the discovery and increased availability of fever reducing drugs such as aspirin.

            What has this to do with the rise of heart disease in middle age? Well when a fever causing outbreak occurs in a population of infants and young children some will die. While there are many reasons why any indivual child will die, having a weak cardio-vascular system would seem to be a prime candidate.

            This is one reason that I always mistrust population studies of different countries or different times. Children in the USA in 1945 had much greater access to aspirin, clean drinking water and a flush toilet than those in war torn Italy or other mediterranean countries. Chart the rise of heart disease against the fall in infant mortality in any country and see what that looks like.

            Then again, there are respected medics who belive that the rise and fall of CHD was caused by an infectious agent – it was an epidemic – and there is increased evidence pointing to gut bacterial populations as a big factor in the obesity epidemic.

            BTW, I do agree that the whole dietary fat thesis was hogwash from the beginning, but I’m not at all sure that we have a good handle on what dietary advice should be – except to note that taking dietary advice from politicians and government bureacrats is not a good idea.

          • “While there are many reasons why any indivual child will die, having a weak cardio-vascular system would seem to be a prime candidate.”

            That’s a huge leap. More likely is the fact that a child’s immune system is not fully developed and therefore, can’t fight off pathogens as well as adults.

          • I grew up in the 50s with Crisco, butter, lard and plenty of meat fat. Was always skinny.

            I still use Crisco, but now I just put it on my face at night. I’m 66, look 46:P

            Take THAT, Mr. Keys!!

    • Trans fats were developed in the late 1800’s and the effects were being seen in the early 20th century. Google Mary Enig and you will find some interesting information regarding your question.

    • Guess what food inventions went viral/nuclear in the US in the early 20th century?
      1. Sliced bread (literally), and prepackaged
      2. Extruded prepackaged ready to eat breakfast cereals.

      Massive new, convenient carb consumption – converted in the gut into pure sugar – began the insulin/inflammation high we still have today; Keys and his government goons merely piled deadly fats onto that pyre, and stripped out the good fats.

      The bulk of my own childhood diet was skim milk (zero fat), sugared breakfast cereal, margarine, white toast, hamburger (the only real positive) potato and iceberg lettuce with sugary ‘French’ dressing.

      My grandfather lived to 103. Me? Despite being athletic and of normal weight, I have allergies of all kinds, migraines, elevated BP…at 45 yrs of age it’s looking like the roulette wheel is slowing down after Keys, McGovern and the State got done twisting the youth diet into a deadly cocktail. I’m like a case study in mysterious, undiagnoseable chronic inflammation. Pills! That’s the answer!

      But my kids will not suffer the same fate, thanks to truth-seekers like this author, blogger and documentaries like Fat Head. My thanks.

  5. Thanks for the well done review. I ordered the book. I have been a low carber for about 6 years now starting with Dr. Richard Bernstein and it’s made a real difference in my life. I also remember how McDonalds was badgered into eliminating beef tallow from their french fries in favor of vegetable oil. I feel the tide turning but in discussion with my friends of the 65+ era it’s almost hopeless.

  6. Hi Dr. Mike,
    I read the first two paragraphs of your review of “The Big Fat Surprise”, hit the link and purchased then and there. NOW I’ll go back and read the rest of your review! Thanks for the heads-up!

  7. She was on Fox & Friends this morning, and the hosts were practically laughing at the fact that she said bacon and eggs were better for breakfast than a bagel, and so on. They didn’t seem to take her very seriously. It’s still going to take a lot of pounding on peoples heads to rid them of the lies we’ve been fed for so many years.

    • I’ve been on that same show and received the same treatment. This book is going to sell and make a tremendous impact because it is that good. Fox and Friends is entertainment, and the viewers tomorrow will forget who was even on today. But serious people will find this book, and it will change their lives.

      Sometimes it takes just one person to read a book and end up changing the lives of thousands of others:

    • I think the size of the food was for the tv camera. Eating fat is self limiting because it is very satiating. What bothered me is that Elisabeth Hasselbeck is famously celiac and should know that bagels/carbs are bad food choices for meals.

      Count me as another one who is super excited about this book!

    • I just watched the clip from Fox. While I realize that time was limited, it seemed wrong to take away the big bowl of arrugula! I think the egg salad on top of the arrugula would have been the ultimate choice. I have been on a pretty strict Paleo diet for about 6 months, and did a Whole 30 (; It Starts with Food) in there too…and have NEVER felt better. Lost 8 pounds in 30 days. was never hungry and had more energy than ever! (I am 62). We do aim for grass fed, organic meats and uncured bacon (no sugar added), because we have come to believed that the grain fed meats were not as good for us…
      It is really hard to overcome the ingrained messages that “fats are bad” and “whole grains are good”….but the evidence is in how much better i feel. I have ordered the book and eagerly await its arrival…I do hope that she advocates fresh produce along with those fats!

    • “who would/should eat that much for breakfast??!! ”

      Me, that’s who! Typically on Saturday or Sunday, around noon. Actually it’s brunch, not breakfast, since I normally only eat twice a day.

    • I took the display to be a serving platter, rather than an individual plate of lovely scrambled eggs and crispy bacon. Yum.

  8. Wall Street Journal published an article by Teicholz entitled “Fat Reconsidered” about a week ago, making the same points that you describe in her book. I was astonished to see a major medium embracing good science about food. Since WSJ is one of the top three newspapers in circulation in the country, this is a major blow for reversing the idiocy of the past 62 years.

    • Please read all the excepted medical scientific publication and trials done over decades. You may land up reading 100 000 articles which support the basis from which we treat and advise people on Hyperlipidemia ( a fact you cant deny).
      Why not listen to the world experts, sitting from time to time to discuss the guidelines for treating patients with the dreaded disease ( not to forget its a genetic disease.. right) These experts have an evidence based approach. They cant afford to make their names “tootie”. Why NOT except the truth when it already stuck on your forehead!!

  9. After reading your review, Mike, I have placed an order for this book ! It’s just the sort of book I want to have as I eat a lot of fats, saturated ones as in butter, meat and cheese (plus coconut oil !), but so many people are still under the illusion that those fats are bad. The more I can learn some of the science of what I know to be true the better !

    I don’t know how long the book will take to come as I live in the UK and it’s only today that it has been published here.


    • I think Amazon sends them pretty quickly. I order a lot of books I can’t get over here through, and they get to me in pretty short order.

      • The book came in this morning’s post ! I flicked through it excitedly and regretting that I was painting the outside of our conservatory so couldn’t stop to read, but during lunch just now (cold roast beef with broccoli stir fried in coconut oil), I happened to notice the bit on HDL and saturated fat ! Lovely ! My HDL has been steadily, steadily, rising over the years since I’ve been on low carb Paleo – started after I read your book ‘Power Protein’ seven years ago. Eight years ago my total cholesterol was 5 (193), my trigs 0.8 (53) and my HDL 1.8.(70). Both this year and last year my results are total 7.6 (294), trigs 0.5 (44) and HDL 3.6 (139) 🙂 I’m so pleased 🙂

        Will start from the beginning of the book tonight, but I can tell it is very well written with lots of references !


  10. Great review of a great book …
    I will buy it and tell my clients to do the same…
    All the best..

  11. How could a person not love a blog post with nearly 4700 words?!?! You da man!!

    I do have a question about the Gambian study. If carbs are so fattening then why are the babies underweight? I guess, by the age of three, insulin-resistance hasn’t kicked in yet. And, you do suggest it’s a vertical issue, not a horizontal one. But, the quote, from Teicholz, is, “the Gambian babies weighed 75% less than they should.”

    I am confused. They weigh less because they’re shorter? The way that quote is worded, these babies must be really short.

    • Protein is required for growth. The body can make carbs from protein, but it can’t make protein from carbs. So protein deficiency in the growing years leads to shortness of stature. Due to the great nutrition we had here, the US pretty much led every country in height until the early 70s/, which was when we started feeding everyone low-fat diets a la Keys. Since protein usually accompanies fat (in natural sources), protein intake went down. In other countries that didn’t buy into that foolishness and that caught up to the US in nutrition, heights continued to climb. Now the average height in the European countries that maintained their higher fat diets exceeds that of people in the US.

  12. i enjoy the personal vision of Ancel Keys spending his afterlife roasting in hell, being constantly basted with partially-hydrogenated soybean oil….

    you’ve sold me — i’m going to get the book … but i really WOULD like to know what tribe Hrdlička found who was able to eat BUFFALO in 1898, let alone 1905….

    • The footnote in the book references a book on the history of the Lakota. All the elderly Hrdlička would have evaluated would have been alive when buffalo were everywhere.

  13. I have ordered the book. I wonder if a majority of the medical profession is going to sue itself for making the entire US population sick. You can lump the AHA and the managers at NIH into that same group.

    The WSJ letters to the editor were kind of funny. You had one guy describing how he asked for advice from his doctor and did the opposite. His lipid profile radically transformed itself into something more desirable. Then there was a another letter touting the Mediterranean diet and that if you eat saturated fat your arteries may clog, and he feels sorry for you.

    It would be nice if the culprits all got what should be coming to them, but I doubt that will happen. Obese young people are very much a casualty group, and they will live with this for the rest of their lives.

  14. You’ve piqued my interest in the book; I read the WJS article last week and therefore was already aware of the idea. However, the one thing that I did not see addressed in your excellent review was how LIFESTYLE has changed over the years. The majority of our forefathers who ate those meats and fats also worked very hard physical labor every day. Surely the very active lifestyle also has bearing, yes?

      • Growing up in the 50’s and 60’s in the middle of motown my experience goes along with what Taubes said. Exercise has little to do with it.

        Detroit was a huge mix of white collar and blue collar workers. The blue collars outnumbered the white collars, but just looking at the Detroit skyline in the 50’s you ought to be able to infer that there were plenty of white collar workers.

        So how much exercise outside of work was there, and how did waist lines break down? There was no exercise outside of work, at least not like there is now. Exercise was associated with a sport – bowling, softball, but this was a minority Whether you were blue collar or white collar everybody worked their butt off, and I never saw anyone in my entire childhood jogging in the neighborhood. In fact, the whole stay healthy by by buying a membership in a local gym was unheard of.

        Obesity was associated with drinking too much, and there was plenty of that. Auto workers headed for the local bar after their shift, and who could blame them. Perhaps the white collar set went home for a martini and a smoke. I don’t know. We were lower class, no designer food for us. We could not afford it.

        Both my grandfathers died in their 50’s and 60’s. One was an alcoholic, and they both smoked, probably unfiltered cigarettes. One died of liver failure and the other of a heart attack. They were both skinny, and their diet probably resembled some version of Paleo. They were both farmers, and the norm was a vegetable garden and canning to get you through the winter months. Meat came from their own livestock mostly.

        Their children, none of which smoke or drink seem to be making it into their 90’s. As far as I know, my aunts and uncles never got interested in the low fat craze, and they certainly did not jog or work out at a gym. My mother has always practiced moderation when it comes to sugar, which probably stems from the idea that she was taught that sweets make you fat at an early age. Apparently some things never change.

  15. This graph reminds me of Al Gore’s from “an inconvenient truth”. Can we survive two such disasters only a half century apart?

  16. Hi! The only thing I don’t see mentioned is, while I have recently become aware that good saturated fat is not only crucial for good health, I’m concerned that people will start eating meat from sources that are not grass-fed and fed grains, antibiotics, etc. Unless I missed this in your review — or, possibly it’s in the book (which I will purchase), I think it’s very important for everyone to be aware of this. Thank you!

    • I’ve got a little different take on this.

      Early man, and even Americans up till the early to mid 1900s, ate a lot of viscera, marrow, brain, lard, tallow, etc. All of these animal products were loaded with saturated fat. Today’s modern man has switched over to foods our Paleo ancestors fed to their dogs – the muscle meats. In wild game, those are the cuts that have the least fat, which is why they were low on the list of desirability for the Inuit and other hunter-gatherers.

      Since modern man likes his steaks and chops, animal science has figured out how to make those cuts loaded with saturated fat. By finishing the animals on grain. So today we can eat a high-fat Paleo diet by eating the cuts of meat we enjoy instead of having to eat the viscera, brains, etc. that are off-putting to most people.

      • Dr. Eades, do I understand your comment correctly in that we don’t need to seek out the 100% grass-fed animals, and can instead eat grain-fed guilt-free? And, that grain-fed might be preferential, more “paleo,” thus beneficial because of being high-fat due to the animals being fed grain. Just about everything I’ve read says to stay away from grain-fed meats for several reasons. I would LOVE to not have worry about finding 100% grass-fed.

        Also, I watched the Fox News clip, hearing the author mention that dietary cholesterol has nothing to do with serum cholesterol (I’ve heard this before). I had been on a low-low-fat, whole-foods plant-based diet for a few years. Before starting that my total cholesterol (TC) was 240. After a few months of low-fat, vegan eating my TC went to 170 (no exercise). Because of a few reasons, including not being satiated I went to a low-carb, paleo diet, and TC went back up, to 190. It appears I can indeed lower my TC with a low-fat whole-foods vegan diet (and raise it with meat and high fat).

        My doc has dietary beliefs similar to yours, and recommends a grain-free, paleo diet and does not believe in the dietary cholesterol/lipid heart disease theory so even at a TC of 240 he was not concerned because other inflammatory markers were fine. From my experience I think it is incorrect to say that dietary cholesterol has nothing to do with serum cholesterol. I do believe one could say dietary cholesterol has nothing to do with heart disease. Thank you for your work.

        • Remember, total cholesterol is the sum of all the different cholesterol subfractions. It is well known that HDL goes up on higher fat diets, so all things being equal, you would expect a higher fat diet to make TC rise.

          But we’re talking saturated fat here, not dietary cholesterol.

          Dietary cholesterol has minimal effects on serum cholesterol because the body makes the vastly more cholesterol than comes in through the diet. If we eat more, we make less, and vice verse. At first it was thought that dietary cholesterol had a large impact on serum cholesterol, but a considerable amount of research demonstrated that not to be the case, so that theory was dropped.

          Guess who did all the early research on this very subject? None other than Ancel Keys himself. And he pronounced dietary cholesterol to not be a risk for elevated serum cholesterol.

        • My take on the grain vs grass fed stuff:

          Pastured grass-fed beef is the best – but not because of O3:O6 ratios or toxins or hormones etc as they are far and away a tiny issue (especially if you eat gluten/sugar/plant oils/fructose), it’s just a nicer way to treat the cow, it’s more sustainable in the long-term, and it can often taste better – of course that’s subjective.

          So if you can afford it, get good quality meat from a butcher who gets their produce from a local farm, but don’t stress if you can only stretch to supermarket grain-fed stuff – it’s not rubbish, it’s just not as good as pastured grass-fed, but even the “worst” red meat is usually a whole lot better than most other mass-produced meat products.

          If you want more details, there’s an absolute boatload of info on hormones and sustainability and other angles here:


  17. Awesome review of an awesome book. Hopefully, you’re right, and it will shift the paradigm or at least bend it a bit. I also wrestled with the question of how many superlatives to add in my review:

    Of course, another book that belongs in the canon of “must-read” diet/health books is The Slow Burn Fitness Revolution 🙂 My wife and I both do SB, and I cannot recommend the book and its methods highly enough. Your and Fred’s prescription is so simple and so useful. Just got back from the gym — from my once a week (!), 45 min workout — and I feel great.

    By the way, my apologies for the following tangential question, but is it okay, as a kind of indulgence, to have carbs like rice or sweet potato after a SB workout? I know it’s not necessary. But it might be nice to try now and again.

    • I’m glad you enjoyed Slow Burn and glad you’re a fan of The Big Fat Surprise.

      Re your question: Give the rice and/or sweet potato after a workout or two and see what happens.

      • I am interested in this.
        I have seen studies that suggest that carb ingestion pre workout will increase the amount of muscle glucose uptake during a workout via an insulin independent pathway during muscle contraction.
        Now seeing low carb diets can cause physiological insulin resistance(benign) in muscle and other tissues to preserve glucose for blood cells, eyes etc.
        Does a single glucose bolus allow significant muscle uptake after exercise when physiologically insulin resistant or are we just giving ourselves hyperglycemia to no real benefit?

        • When the muscle switches from aerobic to anaerobic respiration – as it does during high-intensity training – glucose is the fuel used. This glucose has to get rapidly into the muscle and does so without being driven in by insulin. I’m not an expert in this field, but I doubt the insulin resistance brought about by long-term low-carb dieting (if there even is such a thing – I’ve read papers going both ways on the subject) will impede the flow of glucose into the exercising muscle. And I’m not sure a bolus of glucose will run any more sugar in than the muscle can get from normal sources, i.e., gluconeogenesis.

        • For excellent info on low carb vs carb loading for athletes, check out Phinney and Volek’s books, one specifically about Low Carb for High Performance Athletes.

  18. Wonderful post, as usual. I’m buying the book – through your portal – as usual.

    Now, how do we increase the supply of the food we know we should eat – that all humans should eat – and save the world at the same time? (And refute every well-intentioned vegetarian who thinks S/HE is saving the world/)

    Watch this:

    Allan Savory, 22 minutes:

    Allan Savory, one hour:

    • Thanks very much for posting these talks. I encourage everyone to watch them. Answers the question of what would happen if everyone switched to a low-carb, meat-based diet.

    • I had the opportunity to spend some time in the field with Alan Savory about 20 years ago when he was active here in the US. We all thought he had the best “eyes” we had ever seen – he could read animal sign on the ground better than anyone we had ever seen. Really, really smart impressive guy.

      Turns out the situation with traditional management of grazing lands (range lands) is similar in some ways to the situation with nutrition.

      [Traditional views on range management] is to [Alan Savory]
      [mainstream nutrition – e.g. ADA] is to [HCLF/ protein power/ Paleo]

      Watch the videos – this guy knows his stuff.

  19. Oops! Meant to send the link, only. Sorry. Can you just delete the embedded video, or is it OK as is? If not, I can resend the whole comment to eliminate it; it’s not really necessary.

  20. I have purchased The Big Fat Surprise and I am excited to read it. But do you have a diet book that you could recommend that goes along with ideas in this book. I really am confused about carbs should we be eating them at all.

  21. Although I’m already a convert and have been since reading Protein Power years ago, I just purchased the book via Amazon. Can’t wait to read it.
    I’m a strict Paleo diet follower these days and couldn’t be happier or healthier!

    Thanks for a great review!

  22. Confirmation bias or not, I just can not see any good science supporting low fat eating. All these low fat, vegan, and other “experts” of their can only talk about pseudoscience, and the sad part is that many people believe. Anyway, same as Nina, I believe that many of us fight to change the beliefs and improve the well being of our fellow humans.

    We need to keep on pushing the message. Thanks Mike!

  23. Just bought the book based on your review. I was very surprised to see in the Wall Street Journal two Saturdays ago a section-leading article on why fat is not bad for you — a great article — and it turns out to have been written by the self-same Nina Teicholz. Usually the mainstream press slavishly adheres to the low-fat mantra.

    In fact, a friend loaned me Chris Crowley’s new book, “Thinner Next Year,” and I was frustrated to open it at random and read “Saturated fat is bad for you!” as one of the golden rules. I greatly admired Crowley’s “Younger Next Year” and got about seven friends to buy that one, but I think he missed the boat with “Thinner.” In fact he invited comment months ago when “Thinner” was just coming out (part of a promotional effort, obviously), and after reading a few snippets (in which he called low-carb a “fad diet”) I wrote him I thought he was giving low-carb short shrift and would regret it in time– but I never heard back.

    “The Big Fat Surprise,” on the other hand, is really on to something…

  24. Just this past year I was speaking with a doctor who works at a local urgent care clinic. He told me he had retired in order to spend more time traveling with his wife but she had developed Alzheimer’s and was now in a nursing home so he decided to go back to work. I asked him if he had heard of research involving coconut oil to try to prevent or slow the progress of Alzheimer’s. He said “but that will ruin your lipid profile”.
    I smiled and turned away. I couldn’t think of anything more to say that wouldn’t seem rude.

  25. I gave Vegan a good run and got fat…still working to remove the fat off my body, with low carb high sat fat way of eating. Thanks for the review. As usual well researched and thought out.

  26. Wow, just checked my library online in little ole Auckland (New Zealand) and I see two copies are on order. I’ve put in a request and there are five people ahead of me. I love to support authors but if you are on a budget support your local library too. Maybe you can ask them to order it in.

    Great review.

  27. January of this year, I ended 8 years telling my doc ‘no’ when he suggested I start taking a statin drug for a moderately high total cholesterol 250, I am now taking generic Lipitor (I know, ssssssss).
    What I want to ask you is this: In spite of my reducing my daily carb intake by approx 75%, while increasing my saturated fat intake by stopping consciously avoiding &/or greatly limiting butter, thus eating a moderate amount of butter and other sat fats in meat, eggs, etc.), my total cholesterol continued to increase at the same rate it had for the previous 10 years, as went from 220-250 total cholesterol. My HD cholesterol, however, rose notably higher and faster, from 72-90, than LDL.

    What’s wrong with this picture. Was the low-carb moderately high sat.fat diet working or not, in your opinion? Or, please comment…
    Thanks, Tom

    • In my view, it is working well. An HDL of 90 is wonderful. Focus on that, not on the total cholesterol. Total cholesterol is partially made up of HDL, so if your HDL goes up, your total cholesterol often will, too.

      What were your triglyceride levels?

  28. When I first heard of the book a couple weeks ago (probably via the WSJ article) I was a bit dismissive:

    Not much of a surprise to some of us, but hey, the more literature out there the better.

    But your review leaves me wondering – I feel like I’ve read everything I’ll ever need on this topic, and I’m kinda tired of the whole argument after all this time. So as a sat fat loving carcass gristly bits eating carnivore who dodges any form of processed plant “food”, do I really need ANOTHER history and biology lesson which for all intents and purposes is actually yet another bunch of confirmation bias?

    I guess at some stage someone had to collate all this info into a near perfect unrefutable tome, perhaps something to pass on to those who are interested in the whole deal but skeptical and need somewhere to start.

    • Listen, I’ve read everything that has come down the pike concerning low-carb, high-fat eating, and I was mesmerized by this book. You won’t change your eating habits after reading it just as I didn’t change mine. But it is a terrific source of information as to how we got to where we are today. And where we’re headed if things don’t change. That part has definitely changed my eating habits. I love French fries, but I seldom eat them. Occasionally, however, I will indulge in a few. Never more after reading teh chapter on what has followed on the heals of the trans fat debacle.

      But the book. Read it. You’ll be glad you did.

      • Righto, fair enough.

        Yeah up until about 2 years ago after reading/listening a bunch of Enig/Kummerow/etc I was still “just one or two fries can’t hurt”…

        …3 minutes later *FOOMP* they’re all gone, so I just dodge them altogether nowadays.

          • There’s still a few establishments going against the grain so to speak. I know of one doing fries in horse fat, as they should be–this is the ultimate. A few doing beef tallow can be found, and duck fat is trendy of course. On that note, I read Hot Doug’s Encased Meat Emporium is closing down. Very sad, they did duck fat fries, too.

          • Oh my. I LOVED this book, and tell people it’s almost an action-adventure story (well, true tale!) about how our American / western diets got so completely screwed up!

            For me? It wasn’t fries. Nina’s book made me take a 3/4-full Costco-sized box of Cheezits and dump them out for the raccoons! (Sorry raccoons, good luck with them!) And, as desperately as I love Cheezits, NOTHING will get me to eat one ever again! Even when I see them or smell them somewhere — they smell great — and there is no way I would ever eat one! (And, of course, that expands to cover any such processed crackery-thing… I used to struggle to not have them, and now — no struggle. (Sorrow, but no struggle!)

            Her book was enlightening and amazing and I am very grateful to you, Mike, for recommending it — AND for telling those of us who’ve already ‘read everything out there’ to read this too.

  29. It is not credible to believe that Ancel Keys had this amount of influence. One man can’t get that kind of traction unless the whole culture is behind you and just looking for the means, and a myth, to justify it’s will. The real story of the last century is how we found the means – how the American Dream became, not working hard, but escaping from labor, getting off the farm, getting a cushy office job, and a liberal education. Technology finally allowed that to happen, with artificial fertilizers and gasoline. This allowed us to stop raising animals, and support a larger (though much sicker) population on grains alone, easily mass-produced.

    Once that happened, then all we needed was a myth to justify the means, along came Mr. Keys, and the rest is propaganda. What is shocking is how quickly and thoroughly the rest of the medical and research professions jettisoned every drop of their integrity in capitulation to the myth. But it was easier to give in to the cultural pressure, and as long as the culture supports it, they still have nothing to fear from it. And it was not really the professionals’ fault, it was really our whole population which chose to worship the myth, it was what we all wanted to believe, the dream of “progress”, ease, creature comforts. Sadly, still looking to technology to help us escape reality, we have invented the pharmaceutical industry to hide our symptoms.

    Now it’s a Food/Med/Pharma/Insurance health-finance-industrial complex, which is self-sustaining. But as the financial/mortgage meltdown proved, no giant is too big to fail. Our export-less, anti-manufacturing, fantasy economy is still collapsing, with no end in sight. The biggest just fall longer and farther and harder.

    • Man, that is a great post. Spot on accurate! It’s terrifying how the food/Pharmaceutical Complex has people in a vicious cycle of health destruction. As a medical professional I cringe at all the people on a laundry list of unnecessary medications. And people are younger and younger on these destructive medications.

  30. After reading this entire post and comments, I just placed my order. Can’t wait to get the book.

    BTW Dr. Mike, I read “Mistakes Were Made” upon your recommendation – a big thanks – and am now reading “When Good Thinking Goes Bad.” You’re batting 1000 in the literary cues dept. with me. Thanks!

  31. Dr. Eades, I was surprised to see that Ancel Keyes lived to be 100+ and his wife was lived almost as many years as he did. Do you have any comment on that? Thanks.

  32. Meant to write that Ancel Keys’ wife lived almost as many years as he did. Sorry for the spelling/typing errors. I would have expected them to live a less impressive number of years. His life span appears to support his theories although I, as a low-carber, do not agree with them. Were you surprised at his longevity?

  33. ‘kay. Ordered it. (Read your whole review first. {wink}) Wish they had a paperback though, I prefer them to hard-bound…


  34. Dr. Eades,

    Thanks for another great article.
    I’m sorry if this is a post hi-jack, but I wonder if you have/would/will publish an article on “leaky guts”? It’s laymen causes, and ways to mitigate it?

    M. Sisson recently did a podcast on the subject, but I always enjoy reading your scientific analysis on the subject matter…

  35. Having read your review for which I commend you, as the most comprehensive and thought provoking review I’ve read to date, I will purchase the book as soon as I’m done writing here.

    Currently, I am traveling the world with my husband which will continue until we drop with 18 months behind us. Eating a low carb, sugar free, grain free, starch free, chemical free diet most certainly ensures that our travels may prove to be longer than one might expect.

    I’ve read so many books on this topic that I’ve begun to annoy my friends, family and FB friends with my constant harking on following this way of eating. It saved me a lifetime in a wheelchair having suffered with chronic pain for 30 years…now pain free traveling the world. Most assuredly, I’ll further pester them with this book when many are overweight, diabetic and suffering from a wide array of imflammation based illnesses. Isn’t all illness inflammation based, after all?

    I have a blog where I write daily about our world travels including many of the food challenges we experience as we travel from country to country. Leaving Marrakech Morocco tomorrow after a 75 days stay has proved most challenging of all of the countries we visited thus far. Somehow I’ve managed to maintain my health, weight and dedication to this way of life by diligent directions to non-English speaking cooks and chefs on how my food must be prepared. Now almost three years in the making, I am a new person at 66 years old, full of life, energy and passion.

    Thank you doctor, for your dedication as a pioneer in ths lifelong mission to educate the world one person at a time as we extricate ourselves from the poison fed to us by the government and the media.
    Warmest regards,

    • You’ve got a great blog and what sounds like a wonderful life. I’m insanely jealous. Would love nothing better than to cut loose and travel wherever I wanted to go. But, unfortunately, my new career as an appliance salesman intervenes.

  36. Respectfully sir this is not ‘news’. Ancel Keys has been bashed, rightfully so, for quite a while now. I am sure the book is brilliant but the news you say it contains ie fats are good for you, is not news. It seems to be news for the doctors out there practicing medicine but the word is already spreading.

    • My fear in writing the review was that folks would think it was just another book bashing Keys. It isn’t. It’s vastly more than that, but any study of recent dietary history has to start with Ancel Keys because he was the one who shifted the course of that history.

      I’ve read numerous books and articles about Keys, and I can tell you categorically that there is way more in this book than I’ve ever read anywhere. Nina has gone back and read every single study done by Keys that are the underpinning of his famous Seven Countries Study, and found what amounts to pure scientific fraud. Amazing and anger-inducing to read.

      One of the things I hate when reading a scientific article is when a critical part of the methodology of the study is not described, but instead the reader is directed to another paper. For example, I may be reading a study on an outcome when a certain diet has been evaluated, and when I check the methods section of the paper for the diet composition, I find a footnote directing me to another paper that supposedly contains the diet composition. It adds a layer of aggravation to have to go pull that paper – which may not be readily available – to find basic information that, in my view, should have been contained in the paper I am reading. I mean what’s more important in a dietary study than the composition of the diet? Let’s say the paper I’m reading shows that low-carb diets don’t provide the benefit in a group of subjects that I know such a diet does after years of treating thousands of patients. I look for the composition of the low-carb diet, and what I find is that the diet was 10 percent carb, 15 percent protein and 75 percent fat. Okay, but what foods made up those percentages. When I look for that, I find the reference to another study in which this same diet was used. Tracking that down, I find out that the majority of the 75 percent fat was vegetable oils, which may well have been rancid and/or partially hydrogenated, which explains a lot. And it especially explains why the authors of the study wanted to make that info difficult to find.

      Keys took this subterfuge to another level, often citing the parts of his work that were spurious in non-English journals.

      But the Keys part of the book is fairly minor. He just set the snowball to rolling. It’s the resultant avalanche we’re now dealing with that is the main story.

  37. I’m not even going to wait for my Audible credits this month. I’m getting the book now. Thanks for such a wonderful review!

    • According to interviews with Keys himself, he was not averse to the occasional steak. He loved Italy and had an estate there where he spent a lot of time. And he loved Italian food, which is not low-fat, or at least wasn’t when Keys was living there.

  38. While I appreciate all the research about the value of a high-fat, low-carb diet, when I tried it I developed fatty liver (which I’m still dealing with).

  39. Hi,

    very interesting read. Hopefully the low fat dogma will fall.

    However, I think the saturated fat issue and heart disease or even Alzehimer is more tricky. I miss a discussion on the relation between APO-E status and saturated fats. From the current research looks like saturated fat is not that good for APOE 4.


    • Of all things, they used a common irritant (whey protein isolate) that many gluten-sensitive people can’t tolerate as a “placebo.” What a badly designed study.

  40. When I went to my doctor in Oct. she said I was her healthiest patient and how did I stay that way. I told her I eat no processed foods, eat lots of eggs and meat and butter and coconut oil. I’m 70 years old and other than a small dose of thyroid medication I have no other prescriptions and very rarely take even an aspirin.

    Slowly but surely it will sink in with people. It’s happening now and will take time. So sad that an egoist had to ruin the health of so many. Hope this book and your review help people to open their eyes.

  41. Wow…thanks for the outstanding review, Dr. Eades. I was prepared to read about yet another book about wrongfully accused saturated fat, but it sounds like this one is much more than a rehash of the same-old same-old. Like Ash (and you) I sometimes feel like I’ve read just about all I need to on the subject, but it never hurts to have more ammo in the arsenal, especially when it comes so highly recommended.

    I was at a health fair the other day, telling people how important it is to eat the egg yolks and not just the whites, and there was a major cognitive dissonance there. I think even now, with so many articles and interviews coming out in mainstream media of all forms (TV, newspapers, blogs – *everywhere* at this point), laypeople have been inundated with the “bad things” about saturated fat and cholesterol that even though it’s coming from all sides that that is INCORRECT, people just cannot wrap their heads around it.

    I honestly think it might take the old guard (in the medial establishment, academia, and in the general public) to die out and be replaced by people more familiar with (or at least open to) the ancestral health movement before the tide really begins to turn. Unfortunately, it needs to turn PDQ, because this country is literally going bankrupt because of 60+ years of fat fear-mongering and worshiping at the altar of whole grains and complex carbs.

    But maybe this will happen sooner than I think: when we get to a point where Alzheimer’s sets in in people’s 40s and almost every child is born diabetic and becomes obese before age 5, people will have no choice but to finally, *finally* rethink the eat less move more mantra and start questioning the nutritional wisdom they *think* they know.

  42. I think (hope) there are mistakes in your quotation:
    “by age three, the Gambian babies weighed 75% less than they should, according to standard growth charts, which the English babies were growing according to expectations and weighed, on average, eight pounds more than the Gambians.”

    I guess it should read more along the lines of:
    “by age three, the Gambian babies weighed 75% *of what* they should, according to standard growth charts, *while* the English babies were growing according to expectations and weighed, on average, eight pounds more than the Gambians.”

    I have a hard time believing that the Gambian babies wieghed 2.7 pounds while the English ones weighed 10.7 pounds (that’s what the original quote implies).

    • You are correct. I did all my underlining and quote picking from the bound typed version of the manuscript. Then when I typed out the excerpt for this blog, I went to the typeset galleys to get the actual verbiage as it would show up in the final book. For some reason, I copied this one from the bound typed version, and it was incorrect. I have fixed it in the post. Thanks for the heads up.

      Here is the link to the reference for the statement about the Gambian children being underweight.

      • Your post still reads “75 percent less than they should.” It should be “25 percent less than they should” or “75 percent of what they should.”

        • My post still reads “75 percent less than they should” because it’s a quote. That’s what it says in the book. Those aren’t my words. You’ll need to contact Nina to get her to change them.

          Having said that, I have only the bound review copy of the book, and that’s what it says there. I don’t actually have a real copy of the book yet. If anyone does have one, take a look at the bottom of the second paragraph on page 157 to see what it says. And let me know. If it’s different from what I have, I’ll change the excerpt.

  43. What a story of the hyper-influence of a one man’s ego. Hitler was responsible for many millions of deaths. I can imagine that Ancel Keys may beat him, directly and indirectly. What a sad tale of our culture’s inability for doing critical thinking and due diligence, and the power of (undue) influence — personal, publishing, and financial.

    I look forward to reading the book. Sounds excellent. Always appreciate your thorough reviews, Dr. Michael.

  44. I was going to ask if Gary Taubes didn’t cover much of this ground in GCBC, at least regarding the history and quality of research used to demonize sat fat. Can you say how this book extends what Gary did?

    • Sure. Gary hit the dodgy research that vilified saturated fat, but sort of ended it there. He went on to the alternative theory of obesity, i.e., it is driven by too much insulin, which is itself driven by too much carb.

      Nina’s book more or less takes the vilification of saturated fat as the starting point down the pathway to trans fats, the Mediterranean diet (which isn’t at all what most people think it is), to the banning of trans fats and the awful products that are following that. She then ends up discussing the research – much of it done fairly recently – rehabing saturated fat.

  45. My child has type 1 diabetes and eats a low carbohydrate/high fat diet. His blood glucose and lipid profile is completely normal. That is evidence enough for me that eating this way is imperative for good health. We eat butter, eggs, coconut oil, macadamia nut oil and animal fat. We eat no processed food. wheat or other grains. His doctor has NEVER seen a type 1 with a normal lipid and cholesterol profile except my son. I know for a fact that he is the only low carber in the clinic. I came up with this diet from my own research. If he followed the dietary advice given to us by the “diabetic dietitian” he would be a very sick child with a host of hideous complications awaiting him. I will definitely read this book!

    • You will certainly enjoy it. Kudos for a great job with your son. It’s a true challenge, and so many people just let their kids eat whatever then try to cover it with insulin. Bad, bad, bad in the long run.

  46. “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.” — I can’t tell you how wonderful I think it is that you wrote that statement. I have lost 35 lb thus far since October of 2013 and am continuing to lose by implementing the general, nutritional principles of a low-carb diet such as Protein Power, and there are times I stop and wonder if I am indeed sabotaging my own health as a result. But not only am I losing weight at a safe, comfortable pace, I have not been sick with a cold, the flu, or even allergies in the last seven months. I can’t help but believe this is the healthiest way for me to eat; still, it’s nice to see that even MDs, such as yourself, stop to wonder such a thing.

  47. Hi. First of all, thank you for your excellent review. I have bought the book and I can’t wait to dig into it. Recently I have tried to learn more about nutrition since I’m the mother of five little kids and devising a healthy diet for them (and me) has often confounded me because of there vast amount of opinions and advice available on diet and nutrition. But recently, somebody recommended a movie called Forks Over Knives which is based on a book I think called The China Study. I’m sure you’re familiar with it. Can you please comment on the data that’s presented in this book and critique that China Study book and the forks over knives movie so I can understand which theory is based more on fact versus a massage of the data? Thanks very much!

    • Denise Minger, mentioned and linked in the blog post on the China Study linked in Mr. Eades’s reply, wrote the definitive analysis of the China Study, entitled Death by Food Pyramid.
      Most of the beginnings of the book are covered in here blog, so you could start there.
      The cliff notes version is that the data collected in the China Study does not support the conclusions presented in The China Study (the book).

  48. Dr Eades,

    I recently read Gary Taubes’ Why We Get Fat and thought it was similarly life-changing in its message and scope. Can you comment on how BFS compares in terms of presenting evidence and argument in favor of a LCHF lifestyle? It seems to me that these are both very important books.

    Enjoyed your review here, looking forward to reading BFS soon. Thank you.

    • They are both life-changing books. But they are different and complimentary. The last part of BFS addresses the rehabilitation of saturated fat and includes information about and an argument for the LCHF lifestyle.

  49. I downloaded Ms Teicholz’s book this morning, based on your review and her recent article in the WSJ, and have read the first few chapters.

    Ms Teicholz is clearly a gifted writer. I am enjoying her book immensely. I have read many accounts of the Ancel Keyes saga but Nina presents it in a most lucid and readable manner and provides new info…..the Lent fasting impact on Med diet data for example.

    Thanks so much for the review and tip off to this great book.

    I have, regrettably, spent too much time recently at the Free The Animal asylum. It is refreshing to read a rational and lucid discourse from a professional with a real name for a change as opposed to stuff written by characters calling themselves Duckdodgers and Tatertot.

    Protein Power Life Plan changed my life back in the day when I picked it up off one of the special tables at Barnes And Noble. I sent a copy to my father and it changed the remainder of his life for the better as well. You and your wife have had a positive impact on so many lives.

    I really enjoy your blog and hope you continue posting.

    Thank you sir.


    • Thanks for the kind words. Glad to learn the PPLP worked for you. I’m going to continue to post as often as possible given my time commitments. I’m happy your enjoying it when I do.

      • FYI – would sure love to see a kindle version of PPLP.- that book was and still is a life changer for me.

        • I would, too. But unfortunately, I don’t have any control over that. I think there is a place on Amazon where you can request a Kindle version of a particular book.

  50. Bought a hard copy of the book Tuesday after reading your recommendation; finished the book this afternoon before rereading your review. I will just send everyone to your review, since it is so comprehensive.

    This is one the most important nutrition books anyone can ever read. In my opinion it ranks with The Vegetarian Myth as far as life changing books, which I was fortunate to stumble upon two years ago. That book led me directly to paleo/primal/LC, which undoubtedly added years to my life, not to mention the incredible benefits to health.

    I also expect The Big Fat Surprise to change a great many peoples’ lives. But equal to its importance to nutrition, The Big Fat Surprise is an important history book with lessons in how science and public policy has been corrupted by confirmation bias.

    There were countless times I had to simply stop after reading some passage in The Big Fat Surprise and absorb the enormity of the information. For example, refusing to use HDL-cholesterol as a more reliable indicator of cardiovascular risks. And then there is Chapter 9…

    As with ‘Myth,’ I will be reading this book all the way through, again.

    • Ah, I’m glad you’ve posted an independent review. I agree with everything you’ve written. And then there is Chapter 9, indeed. Terrifying.

    • See this is my thing – The Vegetarian Myth is only life-changing to people who got sucked in by vegetarian myths to start with.

      I’m no revolutionary, I didn’t even start researching this stuff until like 5 years ago – but what I discovered very quickly was that by opting out of believing a single word any authority said about nutrition, I already had a good handle on it.

      I’ll take my anti-authoritarian stance back to age 5 where I questioned the teacher on her telling us “I before E unless after C” as a rule, because I’d actually learnt to read from the age of 2, and this smelled like BS to me.

      Fast forward to age 16, the only TV I would watch was stuff that critically analysed other TV programs. (stuff like Media Watch with Stuart Littlemore for any Aussies)

      Then come 1996 when I moved out of home, I left and didn’t have a television. I’ve been pretty happy NOT hearing the mainstream views of society blared at me since then.

      So oneday in my early 30’s when some guy saw me tucking into a steak and potato both COVERED in butter told me I was going to die of a heart attack because cholesterol but not before I had 20lbs of rotting steak in my colon giving me cancer and constipation I was just like – really?

      I have to investigate this…

      Anyhoo, youse get where I’m going, I’ve never once bought into some nutritional scam, I know vegetarianism is dumb, I know cholesterol is awesome, red meat is amazing, fatty fish is tops, shellfish is our savoir, nose to tail from the inside out is king, saturated fat is BEST, veggies are way overrated, soy is meh, most nuts aren’t that great but some are ok in small doses, and we all live in a big stupid world that we’re just not evolutionarily ready for…

      Call it more confirmation bias, but I’ve never yet come across anything convincing that says my very high fatty boney red meat and fish and shellfish diet with the occasional random plant that happens to come along for the ride is particularly bad.

      One day surf.

      One day turf.


      • Thanks, it’s great you found what works for you. But let me emphasize the book has the potential to change anyone’s life. I read The Vegetarian Myth without ever having the slightest inclination to be a vegetarian, which always struck me as a dangerously impoverished diet (yes, completely unshakable confirmation bias). In my view, the most important messages in the book are about life on this planet, our place in nature and where industrial agriculture is taking us. It is unfortunate if anyone prejudges this book due to the title.
        Again, Dr. Eades has the comprehensive book review: Therein he states: As MD said after she read it, “everyone who eats should read this book.” Exactly right.

  51. Hi,

    I’m confused by all this now. I’ve lost a lot of weight on a diet that is very close to Paleo over the past year, but I’m quite uncomfortable with the amount of meat I’m eating. I used to have a balance before, of meat days, veg days and fish days which I really would like to return to because it feels like a more sensible approach. I keep hearing from various sources that a diet high in red meat can cause cancers, especially prostate and colon cancers.

    Recently I listened to this quite sensible sounding podcast by Abel James and the 2 episodes that I listened to sound quite sensible really, they recommend increasing “micronutrients” more than just “macro” and it all makes a lot of sense really, I don’t see what’s wrong with this advice.

    They recommend eating a TON more veggies while still having some meat, and one them (Dr Joel Fuhrman) does not even use ANY oil at all! He says oil didn’t exist way back when so the whole idea of Paleo people eating tons of oils (coconut, olive, butter, ghee) contradicts their own ethos. In particular, he highlights the prostate cancer link, which has always worried me about eating this.

    What do you think about this, all these different viewpoints just make it harder to decide, but I’m basically now thinking of reducing some of the meats down and eating more veg (not fruits and fructose) in it’s place, there’s really no harm that I can see from that.

    • Go for it, and see how it works for you. You can take all the micronutrients in the world, and they won’t do as much good as a sound diet. Reading Nina’s extremely well researched book should get you over the notion that you have to worry about eating too much meat.

      • I was hoping you would have some comments on the prostate cancer claims? Does she cover this in the book, or is all the science behind those studies circumstantial as well? I haven’t read all of them obviously but I was hoping you might be more familiar than I and would have some comments on the matter?


        • The prostate cancer claims ALL come from observational studies. And observational studies do not prove causality, only associations or correlations.

          • Thank you for your answer, I will scrutinise such studies a bit more thoroughly the next time I see them 🙂

  52. Thank you so much for this review. I am excited to read to book as I have recently changed how I eat to more of a Paleo framework (Autoimmune Protocol, to be exact) in hopes to help with some health issues. I am enjoying this new way of eating and have fully embraced the ideas, but still have that nagging feeling of “what if I am scr*wing myself,” as you mentioned. My father had triple bi-pass surgery when he was 65, no heart attack, but close to it. He drastically changed his diet to the Mediterranean diet (and has been on Statins) so I have been one of the many brainwashed into thinking saturated fat is bad. My father is about to turn 80, and although he hasn’t had a heart incident again, sadly he was diagnosed with ALS this fall (I have my own suspicions about Statins having a role this).

    Anyway, I haven’t read the book yet, but in your review you mentioned how the Olive Oil industry really benefited from Keys’ promotion to the Mediterranean diet. I was under the impression that olive oil has been safely used for thousands of years many cultures. Is also a myth? Did the Mediterranean cultures use more animal fats for cooking then we are lead to believe? I am still trying to work out which fats to use in my new way of eating. I thought olive oil was a good one. I have also been using a lot more coconut oil, but have been reading a lot of accounts from people on various Paleo forums that coconut oil does indeed raise their LDL levels.

    I understand that saturated fat is now shown to have no influence on serum cholesterol, but is it also false that high serum LDL levels are a predictor to heart disease?

    Sorry, just still confused.

    • It’s easy to be confused with all the conflicting and competing evidence out there. Reading Nina’s book will help you clear up a lot of issues, especially the ones related to olive oil. The Mediterranean peoples use vastly more animal fats for cooking than we’re lead to believe, and olive oil, though a pretty good product, isn’t really all it’s cracked up to be. Lard, which is what most Mediterraneans use to cook with, is much better. Nina tells why.

      LDL levels do go up with low-carb, high-fat diet, but they don’t go up as much as HDL (the so-called good cholesterol) levels do. So, in the end, you have a better lipid profile. Plus, the LDL people have on a low-carb diet are different from those from low-fat diets. The ones driven by the low-carb diet are much less harmful, if, indeed, LDL is harmful. It’s still only a theory. But the last chapters of The Big Fat Surprise go through all this in detail.

  53. Great review, thank you: inspired me to order the book on the spot, and reading it so far does not disappoint – it’s great.

    My only question arose early in the book as she’s describing numerous “nutritional/medical anthropologists” over the last century… the conflicts over saturated and trans fats… organ meats … and not a mention of Dr. Weston Price or the Weston Price Foundation, Mary Enig (mentioned in one of the comments above) or Nourishing Traditions.

    Any insight as to why she left any mention of WP/WAPF out of her book?

    • Nina does discuss Mary Enig in the book. In fact, she discusses her quite a bit. Don’t have a clue as to why Weston Price was excluded.

      Neither do I have a clue as to why I was excluded in the chapter about the history of low-carb diets… 🙂

    • Price and his studies of nutrition and health are mentioned in the book, although I too was surprised by how small the mention is, given what an eye-opener Price’s book is. But it’s there.

  54. Thanks so much for this review. I plan to get the book. This is good stuff.

    Recently, I have seen David Perlmutter on TV a couple of times. Do you have any thoughts on his book, Grain Brain?


  55. I ordered the book immediately upon starting to read your blog post. I have it on my “get around to” reading list, which hasn’t happen yet.

    Does Ms Teichols have any discussion of Vitamin B12? Insurance medical coding systems often prevents doctors from diagnosing and treating B-12 deficiency.

    So many comments and discussions revolve around cholesterol causing arterial blockage, which causes heart disease and heat attacks. Recently read this article from Weston Price Organization which makes a lot more sense to me.

    • Nina’s book isn’t a medical or diet book. It shows how we got to where we are now in terms of dietary recommendations. As such, it doesn’t go into vit B12 deficiency. Consuming more meat generally gets rid of vit B12 deficiency.

  56. Great article – I’m finding the new evidence and research on this topic so fascinating and so frightening given how ingrained the anti-fat mentality is in society. What I’d like to know is in reference to there being very low numbers of heart disease/attack cases in the pre-low-fat days, could any of this be attributed to the fact that medical knowledge was less developed at this point so these diseases went un/mis-diagnosed?

    Am also confused as to ‘how many carbs are too many’ and ‘are all carbs created equal’ so will be looking more into protein power and other sources to research this further.


  57. Just watched her Ted Talk- WONDERFUL: just ordered the book. Thank you for the review. Here’s a shock from today and this might be off topic ( but not really, cholesterol and Lipitor). Statins are a ‘class X, contraindicated in pregnancy’ drug. And maybe the ‘infertility’ claimed here and blamed on cholesterol is really from high carb, high blood sugar, pre-diabetes instead.
    I know you are busy and swamped with information, but I cannot let what I heard today go by. I heard this on the news, and it so shocked me, I have to write this down.

    There is a new ‘study’ linking difficultly getting pregnant with “high” cholesterol. I am just stunned.

    This is one statement (in the news article, not the journal article itself) “From our data, it would appear that high cholesterol levels not only increase the risk for cardiovascular disease, but also reduce couples’ chances of pregnancy.” And this….
    “It is known to be bad for the heart. But high cholesterol could also damage a couple’s chances of becoming parents.”

    I try to let this stuff go, but I’m so upset. When they tick me off with the first assumption (‘cholesterol causes heart disease and everyone knows’, blah blah blah) out of the box – wrong, it can only go down hill from there.

    I was thinking—. 1) more young people will think they have to go on brain-dissolving statins (and they are even more disastrous for a developing fetal brain).

    “He added that if other studies confirm the finding, advice on watching cholesterol levels may no longer be centered on the middle-aged and elderly.

    Similarly, young people may be given cholesterol-busting drugs to maximize their odds of having children, the Journal of Clinical Endocrinology and Metabolism reports.”
    And then this, 2). While I’m not minimizing in any way the difficulty and pain some individuals have when they struggle with infertility — not making light of it at all- but as a species, we humans, overall, have NO trouble WHATSOEVER reproducing. We are spectacularly successful at it. There is no problem, and ‘high cholesterol’, therefore cannot be the cause of a non-existent malady. I’m sorry but saturated fat and cholesterol are the cause of us humans, and why we are thriving. “The planet is thick with replicating primates”.

  58. Bless you, Dr. Mike, for introducing The Big Fat Surprise to us. And thank Nina Teicholz for selecting you as the guide for the final drafts of her remarkable book. We will all benefit. Your guidance produced a new friendship for you and a really insightful book review for us.

    Despite the great importance of the subject matter, your post suggests that the significance of this book is far greater than just reclaiming the truth about dietary fat. Nina’s data on the actual benefits of dietary fats, including the much maligned saturated ones, are essential to correct a wrong done to the health of the public by the government-sponsored heart-healthy diet. However, that is only part of Nina’s story. She also describes how the wrong came to be. It entails a half century-long flagrant fraud and deception conducted by agencies, institutions, and even a few respected officials charged with setting official nutrition policy. These disclosures offer a great potential for Nina’s document to have a tremendous impact on the public’s sense of right and wrong.

    How can a public NOT be outraged on learning that millions of their fellow citizens are now slowly dying from one or more or the many chronic diseases that have been foisted on them, by the many-decades-old official nutrition policy of their own government? These diseases are not the products of some unknown disruption of life processes. The truth that they are nutritionally based and caused by the pseudoscience of the official dietary guidelines is revealed by the science of biochemistry.

    It is important to note that public apathy concerning the wholesale adoption of bogus epidemiology by the nutrition community is the linchpin of the current so-called heart-healthy diet. If public outrage backed by sound nutritional science is not able to dislodge the linchpin, the massive human feeding experiment imposed on the American public decades ago will continue to take its toll.

    We cannot afford to let Nina become a Cassandra. READ Eathropology (above)

  59. I read Protein Power in 2001 and it changed my life. I’ve been fearlessly eating protein and fat since then (without the carbs!). I have felt no need to read any diet books since then. I got prostate cancer last year and my kids beat me up about my diet being the cause. Nonsense. (I had a successful prostatectomy and I’m absolutely fine). But it made me open to some reinforcement. This book is awesome and fit the bill perfectly. I’m halfway through it. But the big revelation is not that fats are healthy. I knew that. The thing that grabs me is the really remarkable incompetence of our government. My gosh! And we seem to want them in charge of MORE stuff. God help us all.

  60. Finished The Big Fat Surprise yesterday – a stunningly good book – certainly worth several readings.

    I also read Tom Naughton’s (Fathead – the movie) posts where Paul Jaminet responds to reader’s questions regarding safe starches. He makes several quite serious claims regarding the dangers of low carbohydrate diets including: “low T3 thyroid hormone…high cortisol…HbA1c [elevation]…hypoglycemic episodes, dysregulation of serum fatty acid levels, ketoacidosis, and adrenal dysfunction…higher risk for some infections, kidney stones, and other ailments” Quite serious claims which if true should switch us all to Jaminet’s Perfect Health Diet or in not true should be directly answered in that they likely will disuade some from trying the LCHF/Protein Power diet.

    Does the evidence exist in the literature to answer Jaminet’s claims? If not it would surely be a great contribution for a detailed answer to be developed by a clinician.

    I feel like Jaminet has been given a pass in the name of “peace and brotherhood” but these are serious claims and I think they deserve an answer.

  61. Am looking forward to a review of this. I take potato starch in the morning with no ill effects, but when I tried the potatos/yams, cooked then chilled, the weight started coming back on. I must be very carb sensitive.

    • I’m also looking forward to your review of The Perfect Health Diet. Like Jeanne, I started taking potato starch (or a raw potato, which I love) every morning. I also started having a serving of sweet potato or regular potato with dinner most nights. I gained 10 pounds in a couple months. Now those foods are again on my once-in-a-blue-moon list.

      I was very concerned by the thought that my having restricted carbs for so long (since around 1998 when I read Protein Power … still my go-to resource!) had wrecked my metabolism and digestion and that it was the cause of my current issues.

      But then I was reading “Big Fat Surprise” last night, and it reinforced my belief that fat and protein, with a few veggies thrown in, was the best approach … as opposed to the Perfect Health Diet of 100+ grams of carbs per day and what I consider to be low protein (around 75 grams per day).

      Thank you so much for all the time you put into this blog, answering all our questions and providing all this free information. I say “free,” and yet I’ve purchased every single one of your books, so you’re getting at least some compensation from me! 🙂

      You’re a good man, Dr. Eades!

      • I’ve heard the same thing re the weight gain with so-called resistant starch from a number of people. I’m sure some do okay with it, but certainly not all. Everyone – myself included – is looking for a way to get ‘free’ carbs because everyone loves carbs. But just like the old saying goes about there being no free lunch, there really aren’t any ‘free’ carbs. At least not any most people would want.

        Glad you enjoyed The Big Fat Surprise.

        Thanks for the props. And thanks for buying through my Amazon portal. I appreciate it.

  62. Well, I wasn’t going to order this book because I had the same thought as one of the other commenters: Been there, done that. Read it all before.

    I’m so glad I went ahead and ordered it (through this site). It sat on my bookshelf for several days and yesterday afternoon I finally, almost begrudgingly, picked it up.

    I couldn’t put it down! So well written and informative. Yes, a lot of it I’ve read before, but so much was new!

    Thanks for your masterful review of this masterful book!

  63. Mike:

    This is off-topic, but I thought you just might like it for your Twitter account. And I have yet to figure out how to use Twitter, so I’m posting this here as a private message for you. Use it or not, as you like.

    This thin (but I suppose muscular) 9-year-old girl ran afoul of the idiotic BMI formula, which (as you’ve pointed out) penalizes body weight (including lean muscle mass) rather than body shape (like pot bellies) . Take a look.


  64. Hi Dr Eades,

    As I wrote earlier, I ordered the book as soon as I read your review and I have really enjoyed it. Been Paleo low carb since reading your book in 2007.

    One question which I was unable to find the answer to in the book (have tried to contact Nina): I would love to be able to find a study which shows that saturated fat raises HDL. My HDL is wonderful (3.6 – 139 in the US) but I daren’t tell my docs that it’s wonderful because of my high sat fat even though I ‘know’ it is, I would love to tell them so as to educate them, but feel I need to produce a study to prove why my HDL is so high….since I know it’s not just the low carb, the exercise or the red wine (my HDL was just as high a few months after heart surgery, for genetic defect, when I was not having either wine or exercise – just low carb, high fat and high protein). If you know of link to a study I can print off I’d be very greateful please. Up till now I tell the docs that I eat ‘good’ fats – ha, they assume I mean polyunsatured fats, but I don’t eat those unless they’re in fish ! I never eat vegetable fats apart from coconut oil 🙂

  65. I’ll just add my “WOW” to all the positive comments for the book, ordered it before I finished the review, read it in a very short period of time and in spite of reading many, many books and journal articles, I learned a tremendous amount….page turner indeed, thanks Dr. Eades!


    Has anybody noticed that the illustration of a Fatty Acid (saturated) on page 25 is incorrect?

    1) The terminal (end) carbon atoms are just 3 coordinated (only 3 single bonds).

    2) The acidic radical — COOH is missing so it isn’t an organic acid at all.

    CH3(CH2…….)COOH where CH2…. is the chain of the fatty radical group – the majority of the carbon fat chain.

    I was shocked when I saw this appear so early in the book. Evidently, it isn’t shocking to the majority of enthusiastic readers, but it leaves a strong cheap shot for the critics to dismiss the rest of the book.

    Thank goodness that the book was professionally edited, or something serious could have slipped through

    • Yep, I noticed that, too. Didn’t have the picture in the earlier versions I read or I would have caught it. I think she was so intent on displaying the total saturation that she forgot the COOH, which makes it an acid.

  67. I decided not to read all the comments. I don’t Know when farm animals started being fed large amounts of seeds. If seed feeding is a 20th century phenomen then 20th century meat will have a lot more omega 6 fat than 19th meat. There is the Adelle Davis notion that fat consumption shouldn’t exceed the body’s ability to make fat water soluable. As in manufacturing lecithin(phospotydl choline)

  68. Thank you, mr. Eades, for the recommendation.

    I thought at first I don’t need the book after GCBC, but I read it and enjoyed it greatly. It does add to the Taubes book, while at the same time it can for many work as a more approachable introduction to the area than the daunting GCBC.

    Maybe the final chapter, Conclusion, was a bit disappointing in my opinion: she jumps to pretty strong conclusions about low carb diets, and while I’m confortable with that, I can imagine the “establishment” is going to use it against her book as a whole, claiming “she’s biased” and does the same that she accuses the low-fat’ers of doing – jumping to conclusions because of wanting to prove a point in favor of something she believes in.

    But again, maybe, I’m being overly pessimistic. Hopefully the book will cause people to seriously reconsider the mess.

  69. “There’s a popular assumption that the profit-driven food industry must be at the root of all our dietary troubles…

    “The source of our misguided dietary advice was…driven by experts…working toward what they believed to be the public good.”

    I’m sold. And I’ll blurt out the libertarian mantra that Nina was (understandably) too politically correct to deliver in unmeasured terms.

    I hear the ‘profit-seeking industries’ line in the paleo/LCHF community so often that it barely causes me to roll my eyes anymore. In reality, profit is a good thing, because it promotes trade. We all look out for our own interests, and that competitiveness–among producers, and between producers and consumers–holds everyone involved accountable.

    However, when we indulge in government solutions, we (wittingly or not) bias the profit motive with limited competition–in the case of dietary science, the limitation is on competitive hypothesis and theory development. That of course reinforces groupthink, selection/confirmation bias, and other decidedly unscientific phenomena, even in a supposedly scientific profession.

    In other words, crony capitalism is to blame for our troubles, not capitalism. And we cannot have crony capitalism without government interference. I’m not trying to sound like an anarchist…I believe government can be very effective and useful when it sticks to its constitutional limits, rather than trying to save the world on every issue. The latter is forbidden by the harsh realities of economics, not that we haven’t tried in spite of them.

    We outside-the-mainstream dietary folks would focus our efforts much more wisely and effectively by putting the blame where it’s due, rather than whining like a bunch of resurgent Marxists about ‘the profit motive’ and other such economically ignorant nonsense.

      • I didn’t read the entire review as it was way too wordy. I couldn’t figure out who the reviewer was or his/her qualifications to review the book.
        I will look elsewhere for a more concise review with credentials. Life is short. Especially if I follow these dietary guidelines.

    • “And we cannot have crony capitalism without government interference.” Can you elaborate on this point? It seems to me we’ve ALWAYS had crony capitalism, with or without government help. I think your libertarian utopia is based on fantasy.

      • I’d be delighted to elaborate. First, you may define the term ‘crony capitalism’ differently, but to me it means protection of a corporation by government. A business is economically legitimate if it can make a profit by selling or trading its products to willing customers/traders, period. But all too often, government keeps certain businesses alive with subsidies (e.g. bailouts). Government also enriches some businesses with special tax breaks, which creates an uneven playing field and thus puts that business’ competitors at a disadvantage, because their net profit is lower, which means they have less opportunity to expand their business, refine operations, etc. Tight government regulation of industry is another interesting frankenstein monster out there, which people tend to believe keeps corporations in check. But in reality, the big businesses influence how the regulation is written to their own favor, and even if they didn’t, all the rules end up being nearly impossible to afford to comply with for any competitors in the market except for the giant incumbent companies who can afford to stuff three floors of their corporate offices with teams of lawyers to devote their full attention to stuff like this. Mom and Pop small business cannot do this. So Mom and Pop go out of business when regulators shut them down because the bathroom counter edge is not at least 14″ from the door and other such insanity (don’t believe me? go dig into the federal register some time, and tell me the rules are not incomprehensible).

        With real capitalism, unfettered corporate competition keeps businesses in check. In cases where businesses do get too big and too successful (short of monopolies, which would legitimately be broken up by government), it is just a matter of time before they become spoiled and lazy and are made irrelevant by smarter, hungrier competitors. You can see this happening to Microsoft in the PC business right now.

        In my observation, folks who favor lots of government intervention in markets tend to believe that capitalists are evil, greedy misers, who hog all the wealth to themselves, so that everyone else is poor. In reality, that makes no sense. People in business cannot stay in business unless consumers willingly buy from them.

  70. O.M.G.! I finally got time to read the book. I finally read Chapter 9. Most of the book was familiar territory, and I knew that heated polyunsaturated fats were best avoided. But Chapter 9 was stuff I hadn’t see before.

  71. I just finished reading The Big Fat Surprise. I have practiced Medicine for 30 years and I am sorry to say that the profession has been on the wrong side of history when it comes to the low fat diet. I just reviewed the American Heart Association guidelines and they still recommend the low fat diet. It will take a miracle to get them to change their ways. Tomorrow I will face the task of starting to reeducate all my patients. For the non believers I will tell them to read the book.

    • Your experience is why I think this book is so important. Only by Nina’s going back to the beginning and meticulously, step-by-step, reconstructing the events that got us to where we are today can we really see what has happened. And what a bunch of hogwash it is. By legions of well-meaning people (including yours truly for many years) following what they thought was valid advice, the amount of damage inflicted is incalculable.

  72. I just finished reading The Big Fat Surprise and thought it was great and am beginning to cut even more carbs from my diet, even though I need to GAIN weight..(The wine with dinner stays in!) However, am almost sorry I read it .. .have been looking for tortillas without trans-fats and finally found one that uses safflower oil, only to discover from the book that the polyunsaturates are worse!

  73. I’m currently reading The Big Fat Surprise, and I can’t stop highlighting entire pages of my ebook copy. This is a shockingly well-researched book — very informative, and very insightful. I can’t begin to imagine the effort that has gone into its creation.

    Thank you for this review.

  74. This is a fabulous review for a brilliant book. I hope it inspires others to read it and be left dumbstruck by what it reveals.
    It could be argued that Ancel Keys has single handedly caused more deaths and misery around the world than some other more obvious contenders. By bulldozing his unproven hypothesis through and influencing the ‘powers that be’ has resulted in a worldwide health catastrophy.
    We can only ponder on the possibility that he may have gradually realised and regretted what has happened since the mistaken beliefs took hold around the globe as he lived out his long life in the Mediterranean.
    Now that big businesses, health organisations and governments are embroiled in the fallout from this epic blunder, it will be hard to reverse.
    I feel confident, however, that if people like Nina and you, Dr Eades can reach people – a grass roots, bottom up movement is inevitable. If the diet of the world was changed by ‘advice’ before, it can happen again – but it may take a while.
    Thank you so much for a great read.

  75. I will all be eating my food cooked in lard, butter, beef tallow and duck fat, just as my ancestors ate it back in the days before Ancel Keys came on the scene. I’ll eat the way they ate when a case of heart disease was an anomaly. I will still control total calories, and will look for foods with other essential nutrients, of course, but fats are in.

    It does not matter if you change your diet, you should still read Nina Teicholz simply because it is a splendid introduction to how the science of nutrition and diets has progressed, and how it needs to be.