What Is a Healthy Diet? The Answers Are Unsatisfying

TEXT ON SCREEN: June 1, 1998

ARCHIVAL (NBC, 6-1-98): TOM BROKAW: Is America the land of the heavy…

ARCHIVAL (CBS, 7-28-76): DR. MARK HEGSTED: We should eat less meat, we should eat less fat.

ARCHIVAL (NBC, 6-1-98): TOM BROKAW: …the hefty…

ARCHIVAL (ABC, 2-1-77): NEWS REPORT: Less beef, eggs, junk foods.

ARCHIVAL (NBC, 6-1-98): TOM BROKAW: …the large, the roly-poly…

ARCHIVAL (ABC, 4-4-85): DR. TIM JOHNSON: Most Americans must lower their cholesterol, whatever it takes.

ARCHIVAL (NBC, 6-1-98): TOM BROKAW: …the chunky…

ARCHIVAL (ABC, 4-14-88): PETER JENNINGS: Eat oat bran..

ARCHIVAL (NBC, 6-1-98): TOM BROKAW: In other words, is America too fat?

NARRATION: After nearly 40 years of advice about what to eat and how to exercise, millions of Americans are getting fatter. And that’s not all.

GARY TAUBES (SCIENCE JOURNALIST, AUTHOR, “WHY WE GET FAT”): You have these massive increases of obesity and diabetes that coincide with this epidemic of nutritional advice we’ve been given.

NARRATION: And the role our diets play is as confusing and controversial as ever.

ARCHIVAL (BLOOMBERG, 6-19-14): NEWS REPORT: More protein, more meat..

ARCHIVAL (CBS MORNING NEWS, 6-12-14): NEWS REPORT: It’s ok to eat butter again.

NARRATION: Leaving us once again with the question: “What should we eat for dinner?”

FIGHTING FAT

ARCHIVAL (NEWSREEL FROM 1955):
ANNOUNCER: A stunned nation hears that its president is stricken with a heart attack. The chief executive is rushed to Fitzsimmons hospital where he is immediately placed in an oxygen tent.

DR. JEREMIAH STAMLER (PROFESSOR EMERITUS, NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE) President Eisenhower was a very good example of what was happening with middle-aged men.

ARCHIVAL (STREAMLINE, 1955):
ANNOUNCER: The president had been stricken by the greatest man killer: heart disease.

NARRATION: In the 1950s and 60s Americans were having heart attacks at an alarming rate.

ARCHIVAL (ABC, 11-28-77):
NEWS REPORT: Nearly a million of us will die this year. Heart disease is an epidemic.

DR. JEREMIAH STAMLER: The average American male reaching adulthood had one chance in five of having a heart disease before age 60. That’s a very high risk.

NARRATION: And top researchers like Dr. Jeremiah Stamler thought they knew a big reason why…..a diet high in saturated fat and cholesterol.

ARCHIVAL (ABC, 2-1-77): NEWS REPORT: The nutrition committee was told that Americans are eating themselves to death, eating too much of the wrong food. Dr. Jeremiah Stamler said this is an epidemic that can be curbed only by a massive change in lifestyle.

NARRATION: But many researchers complained that the science was too controversial to recommend major changes in diet.

ARCHIVAL (CBS, 7-26-77): NEWS REPORT: Eight studies involving 5,000 patients failed to show hard medical evidence that diet has anything to do with heart attacks.

ARCHIVAL (NBC, 12-27-78): NEWS REPORT: The body also makes its own cholesterol. That is why it’s impossible to prove that heart disease is caused by what we eat.

GARY TAUBES: Some of the best scientists said, “Look, this is a very controversial subject. It’s a very complicated subject. You can’t just tell people to reduce the amount of fat in their diet, because diet is a trade off.” If you reduce the amount of fat, you have to replace it with something.

ARCHIVAL (CBS, SENATE SELECT COMMITTEE ON NUTRITION AND HUMAN NEEDS, 7-26-77): DR. ROBERT OLSON (ST. LOUIS UNIVERSITY): I have pleaded in my report and will plead again orally here, for more research on the problem before we make announcements to the American public. SENATOR GEORGE MCGOVERN: Well, I would only argue that senators don’t have the luxury that a research scientist does of waiting until every last shred of evidence is in.

NARRATION: Definitive studies could take years and cost hundreds of millions of dollars… and in 1980, the government issued the first dietary guidelines, which called for cutting back on a variety of nutrients, including fat and cholesterol.

GARY TAUBES: The physician’s perspective was look, you’ve got people who are sick and dying. We have pretty good evidence that dietary fat is the problem. We don’t have time to dot the I’s and cross the T’s.

DR. JEREMIAH STAMLER: We were reasonably secure that these recommendations were not being harmful.

NARRATION: The issue appeared to be put to rest four years later, with a landmark study that showed that lowering cholesterol reduced the risk of heart attacks. But there was one problem: the study also used cholesterol-lowering drugs, and the scientists assumed that a low cholesterol diet could work as well.

GARY TAUBES: When I interviewed the administrator who oversaw the trial, he said to me, “Look, we confirmed that lowering cholesterol, at least by drugs, seems to reduce heart disease risk. And we took a leap of faith.”

ARCHIVAL (ABC, 1-12-84): PETER JENNINGS: Scientists now have conclusive proof that lowering the amount of cholesterol, or fat, that we eat can significantly reduce the chance of heart attacks.

NARRATION: Cutting all fat and cholesterol became a national obsession.

ARCHIVAL (ABC, PUBLIC SERVICE ANNOUNCEMENT, 10-25-89): Cholesterol could be building up in your arteries…

ARCHIVAL (NBC, 12-12-84):
TOM BROKAW: Cholesterol is now thought to be a danger for everyone.

ARCHIVAL (NBC, 12-12-84): NEWS REPORT: Even children, once they’ve passed their second birthday, should try to reduce fat in their diet by 25 percent and cholesterol by 30 percent or more.

GARY TAUBES: The gist of it was that if a food didn’t have fat in it, it couldn’t make you fat. Bread, pasta, potatoes, rice, now become the base of the food guide.

ARCHIVAL (ABC, 4-28-92): PETER JENNINGS: We should eat more of the foods at the bottom of the pyramid, like bread and cereal, and less of the foods at the top.

ARCHIVAL (HISTORIC FILMS):
ANNOUNCER: No cholesterol…

HOWARD MOSKOWITZ (CONSUMER RESEARCHER AND FOOD SCIENTIST): All of the food companies think, “Ah-ha, now we have to talk about how our product cuts back on fat.”

ARCHIVAL (HISTORIC FILMS, LOW FAT ICE CREAM AD): SINGING: It’s so creamy, it’s so dreamy, 96 percent fat free.

ARCHIVAL (BEST FOODS AD): Even though you’re watching your cholesterol you can still bring out the best.

HOWARD MOSKOWITZ: There was a whole line of Snackwells which had no fat whatsoever.

ARCHIVAL (SNACKWELLS COMMECIAL): Fat free Devil’s Food Cookie…

HOWARD MOSKOWITZ: SnackWells was a very successful product because it was on the no-fat craze.

NARRATION: Low-fat dissenters like Robert Atkins, who said to eat meat and cheese while avoiding carbohydrates, were branded as heretics.

GARY TAUBES:The idea was that if you tell people to eat fat, saturated fat, you were going to kill them.

ARCHIVAL (2-24-00): DR. DEAN ORNISH: Telling people that pork rinds and sausage is good for you is an appealing way to sell books, but I think it’s irresponsible.

GARY TAUBES: It was the equivalent of committing mass murder.

NARRATION: But even as Americans were cutting down on fat, a new health problem was emerging.

ARCHIVAL (NBC, 3-6-97): TOM BROKAW: Americans are fatter than ever before.

ARCHIVAL (ABC, 6-1-98): BETH NISSEN: Obesity is a major risk factor for heart disease, heart attacks.

ARCHIVAL (ABC, 8-23-00): CHARLES GIBSON: There is an alarming report today about an increase in diabetes.

DR. DARIUSH MOZAFFARIAN (FRIEDMAN SCHOOL OF NUTRITION SCIENCE & POLICY, TUFTS UNIVERSITY): It really turned on almost like a switch in 1980. Obesity was stable for many decades. So, what, what changed in 1980?

GARY TAUBES: We put the whole country on a low-fat diet – and lo and behold we have an obesity epidemic – and that’s what started my research.

NARRATION: Science journalist Gary Taubes and doctors like Dariush Mozaffarian soon began to question the conventional wisdom.

DR. DARIUSH MOZAFFARIAN: I started reading, myself, about the dietary guidelines, and starting to look into the evidence, and I was stunned. I was stunned to find that about 90 percent of the dietary guidelines were, basically, best guesses.

GARY TAUBES: There was a small and growing minority of researchers who were coming to believe that the problem in modern diets were the sugars and refined grains and not the fat. If the American Medical Association had a nightmare it was the possibility that Atkins was right all along.

ARCHIVAL (ABC, 5-21-03): NEWS REPORT: It is one of the hottest battles in public health today – high carb versus high fat.

ARCHIVAL (ABC, 2-7-06): NEWS REPORT: The landmark study of 49,000…

DR. DARIUSH MOZAFFARIAN: The evidence started accumulating that there’s really no association at all between total fat intake and heart disease or stroke.

ARCHIVAL (ABC, 11-9-06): CHARLES GIBSON: The results might surprise you.

ARCHIVAL (ABC, 2-7-06): NEWS REPORT: Consuming less fat did not reduce the risk of cardiovascular disease and cancer.

NARRATION: And many foods made to capitalize on the low fat craze had their own drawbacks.

HOWARD MOSKOWITZ: If you looked at the calorie content, it was all high-calorie, lots of carbs. When you take out the fat, the person’s going to eat more because there aren’t any signals I’m full, full, full.

DR. DARIUSH MOZAFFARIAN: We had an explosion of high carbohydrate, sugary foods —and those have contributed to the obesity epidemic.

ARCHIVAL (CBS MORNING NEWS, 11-18-09): NEWS REPORT: Obesity is growing faster than any other public health problem in U.S. history…

GARY TAUBES: This is the law of unintended consequences. You just don’t know what’s going to happen when you make your recommendation. You’re putting, in effect, the American public on this grand experiment and you have no idea how it’s going to work out.

NARRATION: Dr. Stamler says his recommendations were misinterpreted.

DR. JEREMIAH STAMLER: Those of us who were recommending were recommending vegetables, fruit, and not special desserts.

NARRATION: Now facing an obesity epidemic, the public continued to be inundated with nutrition studies and diet advice.

ARCHIVAL (CBS, 11-17-05): NEWS REPORT: The raw food diet.

ARCHIVAL (MSNBC, 5-15-14): NEWS REPORT: Eat more butter, meat and cheese!

ARCHIVAL (CNN, 4-29-12): NEWS REPORT: Don’t eat sugar.

ARCHIVAL (ABC, 1-19-06): NEWS REPORT: What would Jesus eat?

NARRATION: And Taubes says one of the main sources of confusion is conflicting — and inadequate — diet science. Past studies have rarely been large enough, long enough, or the diets different enough to provide definitive answers.

GARY TAUBES: If you search obesity, and or diabetes, you can pick and choose your research. And say, “Look, we should all be eating a vegan diet.” Or “we should all be eating a ketogenic diet, or a fruitarian diet.” You pick it, you can find research to support it. It’s a huge problem with nutrition.

NARRATION: In 2012, Taubes co-founded the Nutrition Science Initiative to fund new, more rigorous studies … and try to find out not just what foods to avoid, but what we should really be eating instead.

GARY TAUBES: Everyone agrees for the most part now that we shouldn’t be eating a lot of sugar and white flour. And then the question is what do you replace those calories with?

NARRATION: Professor Christopher Gardner, who’s leading one of the studies, is finding that the answer may be different for different people.

CHRISTOPHER GARDNER (PROFESSOR, STANFORD UNIVERSITY): There’s this massive variability in response to the same diet. We had some women losing 60 pounds and some losing zero. So maybe it was the wrong question, which diet is best? Maybe the better question was, is there a way to match different people to a diet that they’re more pre-disposed to?

NARRATION: With the answer still unclear, Mozaffarian worries that the conventional wisdom is being oversimplified again… from “low-fat” to “just cut carbs and calories.”

DR. DARIUSH MOZAFFARIAN: We made a mistake, focusing on just total fat, and I think we’re in danger of making the same mistake now. Now we have a public health crisis of obesity and diabetes, and so everybody’s trying to do something.

ARCHIVAL (ABC, 6-23-11): NEWS REPORT: A new government rule requiring big restaurant chains to post their calorie counts.

DR. DARIUSH MOZAFFARIAN: The major focus now has been on calories. Just cut calories, portion size control.

ARCHIVAL (NBC, 9-13-11): NEWS REPORT: Smaller portions of French fries..

DR. DARIUSH MOZAFFARIAN: There are foods that have more calories that are good for us, that are good for obesity and diabetes. There are foods that are fewer calories that are bad. It’s not just about fat and it’s not just about calories. It’s about the quality of the food that you eat.We have to stop thinking about single targets as though just focusing on one thing will give us the answer.

ARCHIVAL (CBS, 2-10-15): SCOTT PELLEY: Here we go again. Experts are changing their recommendations about what we shouldn’t eat.

ARCHIVAL (ABC, 2-10-15): NEWS REPORT: The Dietary Guidelines Advisory Committee now considers taking cholesterol off the list of things we should avoid.

NARRATION: In 2015 a scientific advisory panel revisiting the dietary guidelines said there is actually little evidence that high cholesterol foods lead to high cholesterol in our blood.

ARCHIVAL (ABC, 2-11-15): DR. RICHARD BESSER: Cholesterol is still linked to heart disease, but what we’ve learned is that cholesterol in our blood, most of it doesn’t come from food, our body makes it on our own.

NARRATION: And when the new guidelines were released in January 2016, they did away with the cholesterol limits, but still recommended cutting back on foods that are high in both saturated fat and cholesterol.

ARCHIVAL (NBC, 1-7-16): NEWS REPORT: Among the recommendations, limit your intake of added sugars and saturated fats to 10 percent of your daily calories.

NARRATION: Some experts were disappointed that the guidelines didn’t adopt all the recommendations of the advisory committee.

ARCHIVAL (CBS, THIS MORNING, 1-7-16): NEWS REPORT: The guidelines could have a big impact at a time when more than two thirds of Americans are overweight or obese.

NARRATION: Meanwhile, Mozaffarian says nutrition science has come a long way since the 1980s, as advances have led to a better understanding of the importance of whole foods and eating patterns. And, he says, we’re still learning the lessons of the past.

DR. DARIUSH MOZAFFARIAN: I think now we know about 50 percent of what we need to know. And we need to be, you know, a little bit more modest, and not set strong guidelines for areas that we’re still not certain about. We have to get the science right.

(END)