Why fat is back in favor in America.
Attitudes about fat are experiencing a sea change in the country, but the transformation is only very slowly reflected in official government advice. Take avocado toast, one of the biggest wholesome-food trends of the decade. It took until last month for the Food and Drug Administration to say that avocados can be labeled “healthy.” The fruit previously didn’t qualify — because it had too much fat.
In recent years, many prominent scientists, journalists and diet gurus have been sounding the alarm that our decades-long obsession with choosing carbs over fat is only making America more unhealthy, and that the government has overplayed the role of dietary fat in heart disease and obesity, among other chronic illnesses. Like almost everything in nutrition science, the issues are far from settled, but the new ideas about fat are taking root in grocery shopping.
“Avoidance of traditional health-related attributes like fat or cholesterol are waning,” says David Portalatin, vice president and industry analyst of the market research company NPD Group.
The percentage of adults who checked food labels for total fat decreased from 46 percent to 31 percent between 2006 and 2015, Portalatin found. The percentage who checked for calories and sodium also dropped, while the percentage who checked labels for sugar held steady at 41 percent.
Petaluma dairy producer Clover Stornetta Farms saw that trend play out in sales of organic full-fat milk, yogurt and other dairy products, which saw double-digit increases in 2015 and 2016. Because organic products are typically bought by more health-conscious shoppers, the attraction to these products is probably due to the fact that they are less processed, director of marketing Kristel Corson says.
For example, nonfat milk often contains milk powder in addition to liquid milk, and low-fat yogurt is frequently thickened with pectin, which gives it more of a gelatinous quality, rather than the naturally creamy texture of regular yogurt.
In response to consumer interest in richer dairy products, the company has a new line of Greek yogurts and will soon introduce a European-style butter, which has a higher percentage of fat than the standard kind.
Another reason many people are returning to full-fat products is their increased satiety, in ways we often don’t even fully realize. As Bay Area food scientist Ali Bouzari writes in his new book, “Ingredient: Unveiling the Essential Elements of Food,” it’s actually aroma — the building block of flavor — that is carried by fat more than flavor itself.
“Food without lipids is usually bland and lacking fragrance because aroma can’t stick around long enough for us to enjoy it,” Bouzari writes. That’s why fat-free cream cheese is terrible, he writes, even though it’s close in texture to the real thing.
When Nina Teicholz was growing up in North Berkeley, she ate low-fat dairy products while avoiding red meat, eggs and the Gouda and chevre filling cases at the nearby Cheese Board Collective. She even rejected her mother’s invitations to celebrate birthdays at Chez Panisse, since the fixed-price menu was always full of lamb and tripe.
At the time, Teicholz was, in essence, a follower of the low-fat diet enshrined in the federal government’s Dietary Guidelines for Americans, which influence school lunch menus, food labels and doctors’ advice. Little did she know she would become one of that diet’s most vocal critics as author of “The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet.”
“The basic contention of my book and my work is that the guidelines were launched based on weak science,” said Teicholz, who was recently visiting family in Berkeley from her home in New York.
The most recent version of the federal guidelines, 2015-2020 Dietary Guidelines for Americans, did remove a previous limit on total fat, as well as cholesterol. But they still recommend a limit on saturated fat to 10 percent of calories per day.
That’s despite ongoing science showing weak links between heart disease and diets high in fat. For example, a 2014 scientific review in the Annals of Internal Medicine determined: “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”
In the fall, a UCSF professor unleashed a nutrition bombshell when he uncovered documents
“The basic contention of my book and my work is that the guidelines were launched based on weak science.” Nina Teicholz, author of “The Big Fat Surprise”
showing that three Harvard scientists were paid handsomely by the sugar industry in the 1960s to downplay the role of sugar in heart disease and to shift the focus to saturated fat.
Meanwhile, food labeling continues to be confusing and slow to catch up to the times. Similar to avocados’ previous plight, eggs still cannot be labeled healthy because of their levels of fat and cholesterol, even though increasing evidence shows little connection between dietary cholesterol and blood cholesterol. In 2015, the FDA told the makers of Kind bars, the nut-heavy snack, that they couldn’t use the word “healthy” on labels because of the bars’ saturated fat. Last year, the FDA reversed its stance.
What troubles Teicholz is that even when Americans have followed the government’s lowfat recommendations, obesity and diabetes continue to rise.
“The dominant narrative that’s promoted by the public health community is it’s because Americans fail to follow the guidelines,” she says. “That is just totally not supported by the evidence.”
Between 1970 and 2014, the U.S. Department of Agriculture estimates that the annual per capita consumption of red meat dropped by 28 percent, and whole milk by almost 80 percent, from 6 ounces to 1 ounce per day. Meanwhile, we increased our consumption of grains by 23 percent.
But Teicholz and others who criticize traditional low-fat wisdom get a lot of pushback. When Teicholz argued in the BMJ, formerly the British Medical Journal, that the committee assigned to develop the recent dietary guidelines “abandoned established methods for most of its analyses,” the nutrition advocacy group Center for Science in the Public Interest called her article a “discredited and opinionated attack” and demanded a retraction. (After the BMJ had two scientists review Teicholz’s original article, it recently announced it would stand by the article.)
The question remains whether it’s better to stick to a low-fat or a low-carb diet to lose weight and stay healthy. For Christopher Gardner, professor of medicine at Stanford Prevention Research Center, it depends on a lot of complex factors.
Gardner is wrapping up a five-year study that included putting 600 overweight and obese adults on either a low-fat diet or low-carb diet for a year, depending on which one they thought would be most successful based on each subject’s insulin resistance. They weren’t given a specific guidance on calorie restrictions, but the average reduction was 500 calories per day.
Overall, the weight-loss results of each diet were almost identical, says Gardner. What surprised him most was how different people responded within each diet. In one group, one individual lost 60 pounds while another gained 20 pounds. Another subject lost 10 pounds of fat but gained 10 pounds of muscle.
Gardner will publish the full results of the study in March. He hopes that one day it will be possible for a patient to have their blood drawn to find out which kind of diet might be better for them.
For now, he suggests experimenting.
“For some of you it’s going to be a higher dairy-fat, a higher animal-fat diet. For others it’s going to be more whole grains, more beans and less dairy,” Gardner says.
Overall, he encourages moving away from a focus on specific nutrients and instead emphasizing whole foods and deliciousness, whether in a pork chop or a bowl of quinoa with roasted vegetables.
“Quite a few whole-food diets can be healthy and environmentally sustainable and be delicious. If we can bring those back, you can be healthier longer, because you can stick with it longer.”
That’s been true for Teicholz, who says she is 15 pounds lighter than she was in college, even though she now happily partakes of the Gouda at the Cheese Board.