Book Review

            As I was perusing the shelves of my favorite bookstore (Half-Price Books), I caught sight of The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, written by Nina Teicholz. The cover was, I admit, rather off-putting for me: it features a roast of some sort below a glowing golden halo. However, “fat” is the magic word for me, so I took a gander at the cover blurb. There it was: “With conclusions based on her nine-year investigation, [she] reveals the unthinkable: everything we’ve ben told about fat is wrong. She documents how overzealous researchers allowed weak science to take hold in public imagination and become dietary dogma.” I bought the book and took it home with me.

            Teicholz is interesting in that she is not a nutrition industry “insider”: she is actually a journalist. As a reporter, she was in a far better position to look at current nutritional guidelines with a jaundiced eye. As she explains in her tome, nutritionists who question the long-held conclusions about fat face serious prejudice from their colleagues, up to and including outright refusal to provide funding for or publish studies. Free from concerns about professional blacklisting, she was able to openly question long-held beliefs about the relationships between dietary fat, cholesterol, and heart health.

            Teicholz provides ample evidence to support her conclusion that dietary fat is not the problem many of us have been taught to consider it: she clearly and carefully explains the limitations of observational studies in general and identifies some of the serious flaws of many of the most famous studies upon which the fat guidelines were based. For instance, Ornish, whose studies did show a correlation between lower fat consumption and improved heart health, did not isolate fat consumption as an intervention: his experimental groups were also told to exercise more, reduce their consumption of refined carbohydrates, and quit smoking. Furthermore, they were often provided with tangible support (in the form of smoking cessation support and provided meals), whereas the control group received were entirely free-living. Teicholz also found a study in which the experimental group received two interventions: cholesterol-lowering drugs and a dietary intervention.  The researchers conducting the study concluded that the diet was responsible for the reduction and conveniently downplayed the possibility that the medications (which the control group did not receive) played a role.

            The book is not an “easy read,” but it is interesting. Readers who are familiar with the theories and researchers explored in the books will likely enjoy seeing the other side. Laypeople will appreciate the footnotes that clarify ideas that might be unfamiliar. Teicholz does an excellent job of addressing counterarguments (indeed, the entire book is a rebuttal) and provides numerous citations in support of both her claims and those claims that she seeks to refute.

            An important note: Teicholz directly addresses the issue of meat and ethics in a short note at the end of her book. This thoughtful and direct concession is refreshing in a world in which people tend to ignore the ethical implications of their choices as consumers. Readers who are concerned about these issues (animal welfare, environment, etc.) should begin with the note and understand that Teicholz’s purpose in writing this was to explore which types of fats are the most health-inducing for humans: she did not seek to understand which ones were the most beneficial to the environment or to animals. While the bulk of the book focuses on the history of our nation’s descent into fatlessness, the health consequences of that trend, possible solutions, and the research supporting all of the above, Teicholz explicitly recommends a return to consumption of animal fats, including body fat. The idea of eating body fat is a little bit tough to swallow (yuk yuk) for a vegetarian or a vegan. Anyone who is vegetarian or vegan needs to know that  both tallow and lard make appearances on these pages: don’t let these ideas distract you from the “meat” of the book: fat isn’t the bad guy!