The Ancestral Weight Loss Registry, an international assembly of people who have tried a paleo or carb-restricted diet, just posted their first trends. It is a wordle of the responses to the question “What was the biggest challenge to adopting a paleo/carb-restricted diet?“, separated by male and female responses.

The size of each word is a function of how much it appeared in the free response question. Here they are:

Women:

Men:

Nutrition and Weight Loss, Trends

The newest issue of Consumer Reports compared various popular diets based on how they match up to the the USDA dietary guidelines, as well as how successful they are. Coming as a surprise to many, the Atkins diet seemed to perform the best. Here is their chart (red means good, black is bad. Whole circles are better than half circles):

If a calorie is a calorie, regardless of what macronutrient it comes from, then how is it possible that the Atkins diet allows the most calories, yet they boast the best short term and long term weight loss results? Consumer reports took an average of meal plans for two weeks on each diet (taken from the published books) and found that on average, an Atkins diet suggests eating over 1900 calories per day, while the Zone and Ornish suggest eating 1260 and 1525 respectably.

According to traditional logic, if you want to lose weight, there must be a calorie deficit. In other words, you should find out how many calories your body uses each day, then eat 500 calories less each day and you will lose 1 pound per week. According to PhotoCalorie.com (which employs the widely used mifflin-St Jeor basal metabolic rate equations), for a 5’3″ 160 pound woman to lose one pound per week she should eat about 1480 calories a day. If this person went on the Atkins diet summarized in Consumer Reports, they would be predicted to GAIN a pound each week! And those consuming the Zone diet would be predicted to lose the most weight since they allow the least calories per day.

Yet this doesn’t seem to be the case. In this review of diets and the scientific literature supporting them, calories don’t predict weight loss.

This seems to be an unspoken consistent finding in the scientific literature. I have summarized this exact topic, with a link to all the recent studies in our research library.

If calories don’t predict weight loss, then what does?

To try to explain these findings, or any other weight loss questions, as Gary Taubes points out, we should figure out three things:

• What does “getting fat” mean?
• What regulates our fat cells?
• Is there anything we eat that modifies or enhances the effects of these regulators?

Of course getting fat means having more fat in your fat cells. The more fat that is stored in your fat cells located under your skin, the fatter you become. Next, we would want to find out if there is anything that causes the calories we eat to be diverted into our fat cells for storage as opposed to used by the body for energy? And the answer is yes. It is a hormone called Insulin. When insulin is high, calories are stored as fat. If it is low, calories are released from fat cells for energy.

This is uncontroversial. Any biochemistry textbook can explain this in depth.

The million dollar, controversial question then becomes: If insulin causes us to store fat in our fat cells, then does anything we eat cause insulin to spike?

Without a doubt, sugar or refined carbohydrates tend to spike insulin the most. Carbohydrates in general spike insulin levels. Protein does too, but too a lesser degree. So assuming this theory is true, then a net reduction in sugar and carbohydrates in your diet should result in more weight loss regardless of how many calories you are eating. This does seem to be true in the report above, since the Atkins group ate the most calories and the least carbohydrates. This also is suggested in dietary clinical trials, in which the various diets report eating the same amount of calories, yet the Atkins group seems to lose the most weight.

The next counter argument tends to be that a diet so high in saturated fats is bad for your heart. Here is how Consumer Reports explains this concept:

Isn’t it dangerous to eat so much fat? That’s still a subject of vigorous scientific debate, but it’s clear that fat is not the all-round villain we’ve been taught it is. Several epidemiology studies have found that saturated fat doesn’t seem to increase people’s risk of cardiovascular disease or stroke. Other studies suggest that you might be even better off if you replace saturated fat with unsaturated fat instead of with certain carbs, the ones that turn to blood sugar quickly after you eat them, such as white bread and potatoes. A nutrition researcher, Frank B. Hu, M.D., of the Harvard School of Public Health, recently wrote that he believes “refined carbohydrates are likely to cause even greater metabolic damage than saturated fat in a predominantly sedentary and overweight population.” Moreover, clinical studies have found that an Atkins or Atkins-like diet not only doesn’t increase heart-disease risk factors but also actually reduces them as much as or more than low-fat, higher-carb diets that produce equivalent weight loss.

There does not seem to be any strong evidence that saturated fats cause heart disease. You can read more about this here.

Nutrition and Weight Loss

Treadmill Desk does not include a treadmill??

Sounding like another crazy infomercial, the Treadmill Desk is for real! The brainchild of Dr. James Levine of the Mayo Clinic, the idea is exactly what it sounds like. Walk on a treadmill instead of sitting in a chair while answering emails and writing code. The website is filled with outrageous claims, such as “lose 50-70 pounds in a single year” and “90% decreased risk of having an initial heart attack.” There are also 52 BENEFITS TO USING THIS DESK listed on their website:

1. Switches on the body’s metabolic furnace, allowing efficient calorie burning.
2. Treadmill desks stimulate the lymphatic system and wards off disease.
3. Stimulates brain function, improving memory as much as 15% in a 6 month period using a treadmill desk.
4. Increases blood flow to the brain and increases productivity.
5. Improves mood and wards off mild depression without medication.
6. Treadmill desks promotes significant weight loss and control of appetite.
7. Prevents onset of Type II Diabetes and assists with control.
8. A treadmill desk improves blood circulation throughout the body.
9. Improve lung capacity and strength walking with a treadmill desk.
10. Promotes healthy restorative sleep patterns.
11. Bolsters the immune system.
12. Treadmill desks prevent bone loss (osteoporosis).
13. Reduces the risk of coronary heart disease and stroke.
14. Treadmill desks reduce bad cholesterol (LDL).
15. Improves blood lipid profiles.
16. A treadmill desk increases good cholesterol (HDL) levels.
17. Walking at a treadmill desk reduces overall body fat.
18. Treadmill desks enhance mental well being.
19. A treadmill desk reduces the risk of colon cancer.
20. Walking with a treadmill desk may reduce the risk of breast cancer.
21. Reduces inflammation from arthritis and osteoarthritis.
22. Increases flexibility and coordination, reducing risks of falls.
23. Reduces the risk of dementia and Alzheimers.
24. Walking with a treadmill desk consistently INCREASES LIFE SPAN.
24. Relieve back pain walking on a treadmill desk.
25. Treadmill desks assist in recoveries after some surgeries.
26. Treadmill desks may reduce side effects of chemotherapy.
For the remaining list of benefits, click here.

I mean how can you not buy one now!? Here is Dr. Levine, describing his product to some excited reporters:

Lose 50-70 pounds a year? Where does he get this number from?

According to common logic, if walking at 1 mile per hour burns about 100 calories per hour, then if you walk for 8 hours a day for a year, at the end of that year you have burned 219,000 calories! Since 1 pound equals 3,500 calories, that means you would lose 62 pounds in one year! Trying to use this basic math equation to predict the complex process of human weight loss relies on one major assumption: That you will eat exactly as much as you did before walking 6 hours a day! It assumes that exercising and getting hungry (and therefore eating more) are independent variables. But anyone who lives in a city, or has walked an 18 hole golf course probably disagrees.

Later in the video, Dr. Levine says that just standing burns 20 more calories/hour than sitting. Then the reporter says that if you chew gum, that’s an extra 11 calories per hour! While it may take that much energy to stand and chew gum at the same time, if I were to say that you can lose 26 pounds a year by standing and chewing gum, It would be ridiculous.

But it is the exact same logic: If I stand (burns 20 extra calories/hour according to Dr. Levine) and chew gum (burns 11 calories per hour) for 8 hours a day, after a year I will have burned 90,520 calories and lost 26 pounds! So if this is true, why would anyone go through the hassle and social embarrassment of walking on a treadmill while checking your e-mail at work!?

This logic is fundamentally flawed. And wait a minute…this exercise at work idea sounds awfully familiar:

Nutrition and Weight Loss

The following is a guest post by Dr. Michelle Berman of Celebrity Diagnosis:

We received two books in the mail yesterday: an advance review copy of Gary Taubes’ Why We Get Fat and What To Do About It and The Dukan Diet: The French Medical Solution for Permanent Weight Loss by Dr. Pierre Dukan. Our regular readers may remember our previous story about Taubes and his compelling case against the “energy balance” paradigm, which may have inadvertently contributed to the epidemics of obesity and diabetes in the U.S. and elsewhere.

The significance of The Dukan Diet is that it’s the plan Prince William’s future mother-in-law, Carole Middleton (pictured below), is using to slim down for the Royal wedding of William and Kate. It’s also been reported that Dukan’s diet was the “magic” behind the post-pregnancy slim-downs of both Brazilian supermodel Gisele Bundchen and American singer/actress Jennifer Lopez.

There is a very superficial similarity between these books: both advocate low carbohydrate diets as the best way to lose weight and permanently maintain the loss. But there the similarity ends and these books couldn’t be more different in background and substance. As described in our earlier story, Taubes’ work is based upon years of meticulous research and represents a synthesis of evidence drawn from the fields of biochemistry, metabolism, physiology, endocrinology, epidemiology, and clinical research.

In contrast, Dukan’s dietary beliefs and recommendations are based on i) anecdotal evidence and trial-and-error observations in his clinical practice and ii) “market validation” from sales figures of his book. In 2007 The Dukan Diet was second only to Harry Potter on Amazon France and also sold well in Bulgaria and Poland. (The book is currently only available for pre-order in the U.S. and isn’t due out until May 2011. Our copy came from Amazon UK). We could not find any publications by Dukan or about his diet among the ~20 million biomedical research articles indexed by the U.S. National Library of Medicine. The only research studies referred to in the book are “coprological studies” comparing the calorie contents of stools from individuals who have or have not eaten oat bran.

Here is an overview of The Dukan Diet adapted from the U.K. edition:

The Attack diet: Pure Proteins (no caloric restrictions) lasting about 5 days

The Cruise diet: 100 unlimited foods (72 from animals, 28 from plants), lasting three days for each pound you want to lose

The Consolidation diet: Average length of five days per pound lost

The Stabilization diet: One pure protein day every Thursday for life; No more lifts (elevators) or escalators, and 3 tablespoons of oat bran a day.

If you’d like more information on the four phases of Dukan’s diet, there’s a review and critique on WebMD.
If you think The Dukan Diet is irrelevant to your practice, check the copy of People Magazine that’s probably sitting in your waiting room. We strongly recommend that you put a couple of copies of Why We Get Fat in your waiting room as well. The diet that Taubes recommends (the What To Do About It part of his book) is from the Duke University Lifestyle Medicine Clinic.

Nutrition and Weight Loss

I just finished a one week road trip to the south, visiting Atlanta, Memphis, Nashville (AKA Nash Vegas), New Orleans, Orange Beach, Alabama, and Como, Mississippi. Apart from the confederate flags, giant trucks, and southern hospitality, one of the most striking observations was the size of the people. As it turns out, my trip went through the heart of the most obese states in the country:

This scary chart (from calorielab) is only the obese people, with a BMI of 30 or greater. When you take into account those that are overweight as well, the statistics are quite overwhelming:

70% of Mississippi Residents are overweight! Taking a glimpse at the food I ate may offer some insights into this phenomenon.

With the beer, sweat tea, soda, breaded and fried everything, barbeque sauce and sugar coated baked beans it is no surprise that these southerners may have some trouble with their weight. Food that is great for a week vacation, yet terrible when eaten for an entire lifetime.

Nutrition and Weight Loss, Restaurants

New York City is making incredible strides in the improvement of kids food choices and health. The progress they’ve made is a far cry from what comes to mind when you think of “school lunch.”

Supplying food to the New York City schools is no easy task. Imagine serving 1600 schools with 860,000 meals every single day!

That includes seven MILLION gallons of (low fat) milk per year.

Yet they do it brilliantly, and for about $1 per meal!

The change began when the Department of Education started planning food based lunches, as opposed to nutrient based menus. These plans are the brain child of Jorge Collazo, the executive chef hired to revamp NYC school food. They moved away from frying foods, and started baking chicken fingers. Salad bars and fruits appear in abundance. Mr. Collazo describes how the system worked before he arrived:

Its a food based menu as opposed to a nutrient based menu. Many districts do analyses on their menus with software, you know milligrams of vitamins or nutrients. Like the Sauce that’s underneath pizza would be counted as 1/8 of a vegetable. We don’t do that.

Michelle Obama would be proud. Since the NYC school system is so large, it puts tremendous pressure on food manufacturers to create healthier food, and it proves to the rest of the country that a change is possible, even on a budget of $1 per meal. Read more about this here.

Nutrition and Weight Loss, Policy

Cow milk is so 1990s...

Yes you heard correctly. Breast milk ice cream. Lactation has never been so in….at least in the U.K. An eccentric ice cream shop in the London called the Ice Creamists started serving ice cream made with human breast milk, calling it “Baby Gaga”.
Strange? Yes. Waste of breast milk that could have prevented vitamin deficiencies and malnutrition in the Donor-mothers’ babies? Maybe. But disgusting it is not, at least according to store founder Matt O’Connor:

How could anyone POSSIBLY say this is disgusting. If it is good enough for our kids, it’s good enough for anyone else.

Mr. O’Connor went on to say, “it’s pure, it’s natural, it’s organic, and it’s free range — and if it’s good enough for our kids, it’s good enough to use in our ice cream.”

The Ice Creamists shop is not exactly your typical ice cream shop, with a parental advisory on their website and scantily clad, lady-gaga look-a-likes wearing Madonna cone bras serving you ice cream made from human body fluids:

Maybe it tastes great, but is it safe? And is it any healthier then regular cow’s milk, as some may claim?

The nutrition in 1 cup of whole milk as calculated by PhotoCalorie:

And 1 cup of human breast milk, according to the USDA’s Nutrient Database:

They are quite similar. Human milk has slightly more calories and fat, but surprisingly much less protein. But what if the donor was sick, like with HIV for example? The FDA cautions against donor breast milk, saying:

If you are considering feeding a baby with human milk from a source other than the baby’s mother, you should know that there are possible health and safety risks for the baby. Risks for the baby include exposure to infectious diseases, including HIV, to chemical contaminants, such as some illegal drugs, and to a limited number of prescription drugs that might be in the human milk, if the donor has not been adequately screened. In addition, if human milk is not handled and stored properly, it could, like any type of milk, become contaminated and unsafe to drink.

According to the Ice Creamists, the milk came from women found on an Internet advertisement, and their milk was screened in line with hospital/blood donor requirements. Sadly the city of London is not convinced, removing the ice cream from the shop, amid concerns that it is unsafe.

Unfortunately Mr.O’Connor will have to come up with a new type of ice cream, hopefully not including any other body fluids…

Founder Matt O'Connor

Food Marketing, Nutrition and Weight Loss, Restaurants

If stale pizza, soggy french fries and fried tater tots had the right to vote, Sarah Palin would assuredly win the 2012 presidential election in a land slide. Twitter extroirdinare and reality-TV-show star Sarah Palin isn’t happy about Michelle Obama’s Let’s Move campaign. Palin recently spoke out about it:

Take her anti-obesity thing that she is on. She is on this kick, right. What she is telling us is she cannot trust parents to make decisions for their own children, for their own families in what we should eat…And I know I’m going to be again criticized for bringing this up, but instead of a government thinking that they need to take over and make decisions for us according to some politician or politician’s wife priorities, just leave us alone, get off our back and allow us as individuals to exercise our own God-given rights to make our own decisions and then our country gets back on the right track.

This quote embodies Sarah Palin’s anti-government attitude towards most left-wing initiated ideas. But childhood obesity – among all issues our country faces – should not be a political one.

Even Republican Governor Mike Huckabee thinks Palin is confused: “With all due respect to my colleague and friend Sarah Palin, I think she’s misunderstood what Michelle Obama is trying to do…Michelle Obama’s not trying to tell people what to eat or not trying to force the government’s desires on people,” Huckabee said.

With childhood obesity rates tripling, with one in three kids born after 2000 predicted to suffer from diabetes, maybe offering some better options isn’t a terrible idea.

Here is a sample of the new lunch menus planned in the recently passed Child Nutrition Reauthorization Healthy, Hunger-Free Kids Act of 2010.

Doesn’t seem too harmful.

This is not the first time Palin took offense to anti-junk food initiatives. When she heard about a government intervention in Pennsylvania to offer healthier snacks, she stepped in saying “I had to shake it up a little bit, because I heard there is a debate going on in Pennsylvania over whether most schools condemn sweets, cakes, cookies, that type of thing. I brought dozens and dozens of cookies to these students.”

Palin says she is upset because the first lady is “telling us is she cannot trust parents to make decisions for their own children, for their own families in what we should eat.” But this misses two critical points. The first is that not all American kids are home schooled. The overwhelming majority of American children eat lunch and snacks at school – a place that is absent of parental supervision.

Secondly, what about all the kids without caring parents. Or those whose parents either don’t know enough or care about nutrition, or can’t afford to feed them. Or worst of all, without parents. This group of kids also just happens to be the most susceptible to obesity and nutrition-related health problems. What would Mrs. Palin suggest for these children?

Critics view these attacks on a healthier America just Palin’s continuous attempts to rile up her ever-dwindling 2012 presidential supporters who feel government should play a minimal role in our lives, and probably should not be taken too seriously.

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Nutrition and Weight Loss, Policy

We’ve been hearing the same thing for the past 30 years: Fat is bad. It has more than twice as many calories as protein or carbs AND it shares the same name with the very characteristic so many of us have acquired during this obesity epidemic.

It has been the general consensus because it makes sense. If people are gaining weight by eating too many calories, then eliminating fat (the most potent calorie-contributor) from the diet should ameliorate the problem. The recommendations soon followed: “Choose lean meats; Use low fat salad dressing; Eat fat free potato chips.” After 30 years of trying, Americans – as well as the rest of the world – have not been very successful. 75% of Americans are projected to be overweight or obese by 2020.

Inadequate advice or poor compliance are the two obvious explanations for this failure. The latter has been incriminated thus far: the majority of Americans just aren’t listening. Yet much evidence suggests they may have been listening quite well.

Clinical Trial Evidence

The appearance and sudden popularity of the Atkins diet in the 1990s had dieters running to the meat department, leaving carbs in the dust. The apparent success of this diet, mostly ascertained from anecdotal evidence, had the overweight population excited and health experts worried. A diet characterized by high amounts of meat and fat was deemed impossible to be effective and a serious health risk.

At the time, few clinical trials had been done analyzing the efficacy and safety of such a diet, which understandably led to extreme skepticism among dietitians and doctors. Recent years have seen numerous studies comparing a calorie unlimited, low carbohydrate diet to various other low-fat, low calorie diets.In other words, a battle between two notorious opponents: Eat until you are full and limit carbs Vs. Eat until you reach a calorie limit and restrict fat. Since fat has 9 calories per gram and protein or carbs have 4 calories per gram, a high fat diets seem destined to fail.

Yet to the surprise of many, when compared to other diets, the calorie unrestricted, lowest carbohydrate diet group generally — but not always — loses more weight. With few exceptions, their HDL increases and their blood triglyceride levels decrease without having any significant effect on LDL (bad cholesterol). When subjects keep their carbohydrate intake lower than 50-75 grams per day, they seem to be most successful.

Often times the various groups fare the same, both losing approximately the same amount of weight. But NEVER, in dietary clinical trial history, has the low-fat, low-calorie diet group lost more weight (more).

The High-Fat Paradox

The very idea that a diet characterized by high-fat foods and unlimited calories can do as well, or better, than a low-fat, calorie-restricted diet poses a challenge to the current weight-loss recommendations. However, conceding to this evidence, and altering the recommendations would mean the advice from the last 30 years may have been premature.

Yet it seems that slowly, the anti-carb message is seeping in. Here is a recent public service announcement from the New York City Health Department:

Researchers at Harvard seem to agree.

Fat is not the problem. If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases.

-Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health

The country’s big low-fat message backfired. The overemphasis on reducing fat caused the consumption of carbohydrates and sugar in our diets to soar. That shift may be linked to the biggest health problems in America today.

-Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health.

Compliance to the high-carbohydrate recommendations

According to the center for disease control, since 1975 Americans have eaten less fat and more carbohydrates:

Perhaps it is possible that the blame does not lie entirely on the individual, due to the fact that this change in eating behavior is EXACTLY what we were asked to do:

Dietary Research, Nutrition and Weight Loss, Policy

MyPyramid: Steps to a...more confused you?

The 2010 Dietary Guidelines suggest lowering our saturated fat intake even more. For the past 15 years, Americans have done a tremendous job of nearly achieving the current goal of no more than 10% of their calories coming from saturated fats. However, due to the less than satisfactory reduction in heart disease rates, the new guidelines suggest we should eat even less:

given that in the US population 11-12 percent of energy from SFA [saturated fatty acids] intake has remained unchanged for over 15 years, a reduction of this amount resulting in the goal of less than 7 percent energy from SFA should, if attained, have a significant public health impact.

For a 2,000 calorie diet, this means eating about 15 grams of saturated fat a day, a value that seems unattainable for the omnivore. The equivalent of a glass of milk and two 6 ounce pieces of chicken breast; or one 9 ounce piece of steak:

9 ounce ribeye

Given these rather strict limitations on saturated fat, it seems logical to assume that the clinical trials supporting this relationship are clear-cut and abundant. However, this is not the case.

Clinical Trials

Since the 1950s, there have been a relatively small number of large, long-term clinical trials examining the potential benefits of decreased saturated fats in the diet as a primary focus. All major trials (along with a study description and link to the original article) since 1966 are listed here. Some took place in mental institutions, some were not randomized, and some also involved major cocontaminant interventions such as weight loss, exercise, or increased fruit and vegetable consumption. Many show benefits to replacing saturated fats with polyunsaturated fats, while others do not.

It is therefore very difficult to come up with a straight answer, and very simple to cherry-pick research that best fits your hypothesis. If there is a benefit to decreasing saturated fat intake, increasing polyunsaturated fats, or both, the evidence is mixed at best. The larger trials seem to suggest no major effect, while others do show significant benefits.

If we were to focus on the largest (i.e. > 100 subjects), randomized, most famous trials ever done lasting longer than 1 year, we are left with very few to assess that meet the following 2 criteria:

1) The only significant intervention involved a reduction in fat and saturated fat and an increase in polyunsaturated fats
2) They ask the question: does this diet reduce heart disease? (defined as heart attacks or death from heart disease)

Listed in reverse chronological order:

Women’s Health initiative (2006) – 48,835 women, 8 years, no significant difference between intervention and control.

Diet and Reinfarction trial (1989) – 2,033 men, 2 years, no significant difference between the groups given and not given fat and fiber advice. No significant differences in ischaemic heart disease between intervention and control (intervention was only advice in this trial)

Minnesota Coronary Survey* (1989) – 4,393 men and 4,664 women, double-blind, mean 1 year, no significant reduction in cardiovascular events or total deaths from the treatment diet

Finnish Mental Hospital (1972) – 12 years, physicians not blinded, significant decrease in coronary heart disease (CHD)death in men ( 5.7 deaths /1000 person-years vs 13 deaths /1000 person-years in the control. Non-significant decrease in CHD in women. (Not randomized, although included here because this is main experiment cited in support of diet-heart hypothesis)

Los Angeles Veteran’s Trial* (1969) –  846 subjects, up to 8 years, non significant difference in primary endpoints –  sudden cardiac death or myocardial infarction. When cerebral infarcts were added, it reached significance. More non-cardiac deaths in experimental group

Oslo Heart Study (1968) – 412 men, 5 year, significant decrease in CHD with intervention. When stratified by age, the results were significant only in subjects younger than 60.

* Double blind

A full list of all the trials done supporting and refuting the saturated fat-heart-disease relationship, and a more in depth description of each can be found here . There are many others that did not meet the criteria I defined above.

Extra weight loss in high saturated fat groups adds complexity

To further complicate things, the diets that are typically characterized by high amounts of saturated fats seem to result in the most weight loss. When researchers compare a calorie unlimited, low-carb, high saturated fat diet to a traditional low calorie, low-fat diet, the low carb group generally — but not always — loses more weight. With few exceptions, their good cholesterol levels go up and their triglycerides go down. Despite having an unlimited calorie budget and often consuming 3x the amount recommended saturated fats, the subjects tend to lose more weight and rarely increase their bad cholesterol levels. ( For more on this and a list of all major clinical trials, see Low Carb Diets.)

Recommending such low levels of saturated fat, primarily found in meats, may have indirect consequences. Since saturated fats are mainly found in protein-dense animal products, decreasing saturated fat intake to very low levels  by definition encourages low-protein diets, which seem to be less effective for weight loss and satiety (feeling full). Given our seemingly unyielding obesity epidemic, this may not be the best approach. Such a drastic decrease in one nutrient of our diets can lead to a large increase in another. This is exactly what has happened the past 30 years with carbohydrates. Especially refined ones:

Gross et al. 2004. American Journal of Clinical Nutrition

For a more in depth analysis of this relationship, see our page on saturated fats and heart disease in our new research library, Data Driven Dining.

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Dietary Research, Nutrition and Weight Loss, Policy