Fat: Part Four
No More Fear No More Contempt
All the Other Fats and Confusion About Low-Fat Diets
There are a few conditions for which there is unequivocal evidence that a specifically low-fat, low animal protein diet is valuable: adult males with existing heart disease; perhaps those with certain kinds of kidney disease (specifically low animal protein diets) [1]; and less so for post-menopausal women with existing heart disease [2]. And the benefits of these dietary changes to those involved sub-populations pale in comparison to lifestyle changes such as smoking cessation and regular exercise. [3]
As with all nutritional clinical data, the conclusions will often miss the forest for the trees.
Almost all recommendations for lowering or raising the consumption of any macronutrient are based on some clinical data that doing so will improve morbidity and/or mortality outcomes (meaning you will experience less illness and/or live longer).
Fundamentally though, we live a very long time now. The highest life expectancy rates are all enjoyed in highly developed nations swimming in ultra-processed foods, animal proteins, refined carbohydrates and dietary fats.
In fact, it has taken us this long to get back to life expectancy rates that were likely enjoyed in pre-agricultural nomadic societies. While infant mortality rates were likely high in Paleolithic times, once beyond childhood, most could expect to live into their seventh decade.[4],[5]
At some point even I get tired of reading all the studies on the mix and match macronutrient game to try to avoid sickness and somehow never die.
Eat food. Love life. Die anyways.
I bet if you have read through to this point you are feeling a bit let down. I am hardly offering any deep and heretofore unknown concept of living the good life. At some point, living and enjoying life has to take precedence over worrying about how much life and how much enjoyment might be squeezed out of microalgae-derived DHA compared to butter.
I love butter. I love salt. I love lots of foods. And yes, I am specifically using an emotionally laden word, “love”, because food is meant to be an emotional connection.
For those struggling with eating disorders and looking to recover, while dietary fat (unsaturated, polyunsaturated and saturated) is critical for physical repair, it is the food, and not the macronutrient, that is the soul of healing.
Being Emotional About Food is Optimal for Human Health
Hospitality is expressed through the sharing of food. Connection to kin and family is reinforced through the sharing of food. We extend our care, consideration, kindness and fairness through the sharing of food.
“ohhh butter.... how yummy it is on popcorn... and potatoes.... REAL FREAKIN BUTTER!! (i just had like half a stick:p) but it makes baked potatoes from ehhh to foodgasm!!! i hope no one else is avoiding butter because i regret restricting it for so long... NOTHING IS LIKE THE REAL thing!! NOTHING!”
Behavioural Eating
After the 2008 financial meltdown a new kind of economist gained favor: the behavioral economist. Dan Ariely, author of Predictable Irrationality, is a wonderful spokesperson for how ridiculous it was to once assume that any human system could somehow be devoid of emotion and be “perfectly rational”. Yet we were eager and willing to believe that human-made financial markets were rational.
The same is true for the dominant school of thought that posits eating healthfully is a matter of learning to recognize and suppress those occasions when we might eat emotionally. Emotional eating is a bad thing. We are to treat food as fuel and learn to recognize and tabulate correctly our sensations of hunger and fullness. Eating a tub of ice cream after your boyfriend dumps you is a failure to apply correct hunger and satiation rules. More than a failure in logic, it is a moral failure. You are weak.
“Satiation signals the completion of a feeding experience. It is a physical, emotional, and subjective sense of comfort, satisfaction, and well-being, of a need appropriately met. Satiation is self-care at its most refined; it requires the ability to discern and appropriately label bodily communications, and ultimately concerns trusting and accepting them.”
“A feeding experience”—exactly! You can be sure that eating a tub of ice cream after your boyfriend dumps you is an experience. Just because it is not an unequivocally positive experience (not the ice cream, the loss of a partnership), does not mean that it must be banned from your behaviors. In fact, in order to trust and accept your bodily communications, you must allow for the fact that your body has to respond to, and accommodate, both negative and positive emotions in your world.
“That eating should be foremost about bodily health is a relatively new and, I think, destructive idea—destructive not just of the pleasure of eating, which would be bad enough, but paradoxically of our health as well.”
We Should Not Be Fat…Or Should We?
Michael Pollan, quoted above, and I differ on our observations and understandings of fatness in developed societies around the globe, but I do not fault him on his understanding of the necessity of the pleasure of eating for overall mental and physical health and wellbeing.
Whether we had truly aquatic, inter-tidal or shore-dwelling ancestors, we are the chubbiest of the primates for a reason: our brains. And our brains became big energy sucking generators thanks to various fortuitous environmental happenings—most likely the constant availability of essential fatty acid-laden foods in the water and our ability to cook food.
In real terms teens are on average 1% taller and about 6% heavier than 30 years ago. [8] For the past 20 years, weight for adults in developed nations has on average crept up by less than 1 lb. per year. [9] However, since about 2000 in most developed nations, the rate is flat and anticipated to fall. [10]
We are heavier and taller than at the turn of the 20th century, but we need to ask:
Does it require intervention?
Do we even understand what intervention may be suitable or not?
We can be sure that one intervention is not only useless but also dangerous, and it may even contribute to excess weight over time as well. That intervention is weight loss.
Bernstein AM, Treyzon L, Li Z. Are high-protein, vegetable-based diets safe for kidney function? A review of the literature. Journal of the American Dietetic Association. 2007 Apr 1;107(4):644-50.
Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S, Kuller LH, LaCroix AZ, Langer RD, Lasser NL, Lewis CE. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Jama. 2006 Feb 8;295(6):655-66.
Chahoud G, Aude YW, Mehta JL. Dietary recommendations in the prevention and treatment of coronary heart disease: do we have the ideal diet yet?. The American journal of cardiology. 2004 Nov 15;94(10):1260-7.
Eaton SB, Eaton III SB, Cordain L. Evolution, diet, and health. Human diet: Its origin and evolution. 2002:7-18.
Kaplan H, Hill K, Lancaster J, Hurtado AM. A theory of human life history evolution: Diet, intelligence, and longevity. Evolutionary Anthropology: Issues, News, and Reviews: Issues, News, and Reviews. 2000;9(4):156-85.
Carol Bloom CS, Gitter A, Susan Gutwill CS, Kogel L, Zaphiropoulos AC. The truth about dieting: A feminist view. Eating disorders: A reference sourcebook. 1999:61.
Pollan M. In defense of food: An eater's manifesto. Penguin; 2009 Apr 28.
Smith SM, Craig LC, Raja AE, McNeill G, Turner SW. Growing up before growing out: secular trends in height, weight and obesity in 5–6-year-old children born between 1970 and 2006. Archives of disease in childhood. 2013 Apr 1;98(4):269-73.
Gaesser GA. Is it necessary to be thin to be healthy. Harvard Health Policy Review. 2003;4(2):40-7.
Koliaki C, Dalamaga M, Liatis S. Update on the obesity epidemic: after the sudden rise, is the upward trajectory beginning to flatten?. Current Obesity Reports. 2023 Dec;12(4):514-27.
Koliaki C, Dalamaga M, Liatis S. Update on the obesity epidemic: after the sudden rise, is the upward trajectory beginning to flatten?. Current Obesity Reports. 2023 Dec;12(4):514-27.
