Sweet plot: the story of murderous scientific errors

Robert Lustig (Robert Lustig) - children's endocrinologist at the University of California, specializing in the treatment of childhood obesity. In a lecture in 2009, "Sugar: The bitter truth," he emphatically states: fructose, widely used in modern health food, is guilty of the American obesity epidemic.

About a year before the placement of the video Lustig said a similar speech at the conference on biochemistry Adelaide (Australia), after which came up to him and one of the scientists asked whether Lustig read works Yudkina. Lustig shook his head. "John Yudkin, - continued the scientist - the British professor of nutrition, which is still in 1972, he spoke about the dangers of sugar in his book" Clean, white, deadly '. "

If even a small part of what we know about the impact of sugar on the body belonged to another food additive, it would be immediately banned.

John Yudkin, scientist

The book was a success, but Yudkin paid dearly for it: prominent nutritionists, teaming up with food manufacturers, destroyed his reputation and career. He died in 1995, frustrated and forgotten by all.

Perhaps a scientist in Australia ran a friendly warning Lustig that he was endangering its reputation as a scientist, began loudly campaign against sugar. But, unlike Yudkina, Lustig caught a tailwind: almost every week out fresh studies on the harmful effects of sugar on our bodies. In the United States are beginning to recommend to limit the consumption of sugar in the UK Chancellor George Osborne (George Osborne) announced the introduction of a new tax on sugary drinks. Sugar becomes a dietary enemy number one.

We are seeing a significant shift of priorities. Yudkin when in 1960 his research on the effects of sugar, gaining momentum adherence to a diet low in fats - saturated fats were the main enemies. Yudkin headed constantly decreasing group of dissidents who believed that sugar, not fat - more than likely cause of diseases such as obesity, heart disease and diabetes. But, by the time he finished the book, strategic heights were captured supporters of food with low fat content. Yudkin tried to resist, but was defeated.

Not only defeated, but in fact buried. Returning to California, Lustig was looking for the book "Clean, white, deadly"In bookstores and on the Internet, but to no avail. In the end he got a copy of it by submitting an application to the university library. Read the introduction to the book, Lustig was shocked: "Damn, this guy thought of everything 35 years ago."

The beginning of the era of low-fat diet

In 1980, after lengthy consultations with respected American scientists and nutritionists, the US government issued its first "Dietary Guidelines". Leaders set the trends in food for hundreds of millions of people. Doctors have based it on their prescriptions, food companies have developed products to meet the specified diet. The impact of management spread beyond the United States: in 1983, following the American example, such recommendations released UK.

The main advice was to reduce the consumption of saturated fats and cholesterol - the first time people have recommended something less. Consumers dutifully obeyed and replaced steaks and sausages on pasta and rice, butter - by margarine, vegetable oil, eggs - muesli and milk - milk with low-fat or Orange juice. But instead of becoming healthier, they became fat and sick.

Analyzing the change in weight of the statistics of people after the war, we can assume that something has changed since 1980. Only 12% of Americans were obese in 1950, 15% - in 1980 and over 35% - in 2000. In 1980, 6% of Britons were obese, but in 20 years, this number has increased more than 3 times. Today ⅔ Britons are obese or overweight, making the UK the most "large" country in the EU. Number of cases of diabetes Type II diabetes, which is closely linked to obesity, increased in both countries.

It can be concluded that, at best, formal recommendations have not reached your goal, at worst - have led to long-term medical catastrophe. Naturally, the search began for the guilty. Scientists traditionally apolitical, but then researchers in nutrition began to scribble articles and books that resemble brochures of political activists, who threw accusations towards large sugar industry players and fast food. Who would have thought, they said that food manufacturers respond to an order to reducing the amount of fat fat yogurt with a ton of sugar and a cake with trans fats, rodent liver.

Scientists, nutritionists are angry at the media for distorting their findings to politicians - for the fact that these conclusions have believed, and the rest - for overeating and lack of physical activity. In general, all are guilty: business, media, politics and consumers. All but the scientists themselves.

But how could not foresee that the discrediting of fat - a mistake? We get energy from fats, carbohydrates and proteins. Since the proportion of energy derived from protein, as a rule, remains stable regardless of diet, a diet with reduced fat actually means food high in carbohydrates. But the most versatile and affordable source of carbohydrates - sugar, which John Yudkin was already noted by a red cross.

Nevertheless, the results of research Yudkina considered baseless, simply because in 1980 an increasing number of scientists adhere to the hypothesis about the harmfulness of fat rather than sugar. We consider heretics who goes against all and defies the conventional point of view. However, sometimes a heretic - an outstanding thinker who remains true to himself, even if they all look the other way.

When in 1957 John Yudkin first put forward his hypothesis about the dangers of sugar for health, its perceived seriously as the author. But 14 years later, when Yudkin already retired, and the theory, and made fun of him. Only now, after his death, the work Yudkina back, becoming the scientific mainstream.

These changes in relation to the investigation Yudkina have nothing to do with scientific methods: here in all its ugliness emerged just unscientific approach that prevailed in many nutrition environment years. This story came to light only now, with thanks to the skeptical "outsiders" rather than the venerable nutritionists.

In his meticulously-designed book "Big fat surprise"Reporter Nina Teyholts (Nina Teicholz) traces the history of the hypothesis that saturated fat causes heart disease. It turns out that its development from controversial theory to absolute truth for the most part has not been made under the influence of new evidence, and under the influence of a number of distinguished personalities, especially Ansel Keyes (Ancel Keys).

In his book Teyholts describes how privileged circle of eminent scientists, nutritionists, jealously guarding its medical authority, constantly It exaggerates the importance of the arguments in favor of a low-fat diet, at the same time directing the strength to fight with anyone who dares to speak against. John Yudkin - only the first and most prominent victim.

Today, as nutritionists are struggling with the disaster, which they did not predict, and perhaps even accelerate, there comes a painful period of re-evaluation. Scientists back from bans on cholesterol and fat and begin to warn about the dangers of sugar, but has not yet given a sharp reversal. Teyholts found that the older members of the community still retain collective instinct and denigrate those who throw too loud challenge to their battered conventional wisdom.

To understand how we got to this point, let us return to the past, in the days when its infancy modern nutritional science. September 23, 1955, US President Dwight Eisenhower (Dwight Eisenhower) had a heart attack. Eisenhower insisted that this fact did not hide, but on the contrary, explained to the public the details of his illness.

The next day the doctor Eisenhower Dr. Paul Dudley White (Paul Dudley White) organized a press conference on which he instructed Americans to avoid heart disease: stop smoking and reduce intake of fat and cholesterol. In the article, the subsequent, White quoted a nutritionist from the University of Minnesota Ansel Keyes.

Cardiovascular disease, which is relatively rare in the 1920s, began to literally mow middle-aged men at an alarming rate, and the Americans in panic looking for the causes of these diseases and methods treatment. Ancel Keyes gave the answer: for the heart need a diet low in fat.

And we are all well acquainted with the theory of Ansel Keyes: an excess of saturated fats in the diet, derived from red meat, cheese, butter and eggs, raises cholesterol, which stiffens inside the coronary artery. Arteries lose their elasticity and becoming narrower until blood flow stops and the heart is not "jammed".

President Eisenhower, and his doctor Ancel Keys formed a credible chain of male authority, and belief that fatty foods are harmful to health, it was stronger among physicians and the public. Eisenhower himself also removed the saturated fats from your diet and stick to this diet until his death in 1969 from heart disease.

But many scientists, especially the British, remained skeptical. The most famous skeptic was John Yudkin, a leading nutritionist UK. After studying data on diseases of the heart, he was struck by these diseases have found a link to the consumption of sugar, not fat. He conducted a series of laboratory experiments on animals and humans and found, like others before him, that the sugar is processed in the liver, turning into fat, before you get into the bloodstream.

He also took into account that it is always the former carnivorous man began to eat carbohydrates only 10 thousand years ago, with the widespread emergence of agriculture. Sugar - a pure carbohydrate, completely cleansed of dietary fiber and other components, were trapped in the diet 300 years ago. On the scale of evolution, we tried it like a second ago. Saturated fats, on the other hand, recently included in our diet that are present in large quantities in breast milk. And Yudkin considered it most probable that this innovation brings us the disease rather than prehistoric main product.

Yudkin contrasted his theory hypothesis Ansel Keyes, who went to war: each publication Yudkina he pounded to the nines. Keyes called the theory Yudkina "mountain of nonsense" and accused John propaganda in favor of the meat and dairy industries.

A Yudkin never answered kizu same. He was a gentle man, ignorant of the art of the political struggle. This made it vulnerable not only to attacks Keyes: British Office of sugar (Sugar Bureau) called the results research Yudkina "emotional judgments", and the International Organization for the study of sugar - "scientific fiction. " In his memoirs, Yudkin remains precise and restrained as he was in personal contact. Only once did he hint at how felt when his life's tarnished. He appeals to the readers whether they can imagine how depressed person if he thinks, and whether it is worth trying to carry out scientific research in health.

In 1960 Keyes institutional concentrated power in his hands. He secured a place and its allies in the most influential institutions of American health care, including the American Heart Association and the National Institutes of Health. From these strongholds they have sent money for like-minded research and publish authoritative advice for Americans.

People need to know the facts. And if after that they will want to eat to death, that's their business.

Ancel Keys for the Times Magazine

The study "Seven Countries"

This solid confidence was not justified: even some supporters of the fat hypothesis admitted that her evidence is still inconclusive. But Keyes was a trump card. Since 1958 th and 1964 th he and his colleagues collected data on diet, lifestyle and health 12 770 middle-aged men from Italy, Greece, Yugoslavia, Finland, the Netherlands, Japan and the United States.

The study "Seven Countries" at 211 pages was published in 1970. It shows the relationship between the consumption of saturated fats and death from cardiovascular diseases, as predicted by Keyes. Libra scientific debate strongly bent towards the fat hypothesis.

Now every time Keyes theory questioned, he replied: "I have a 5000 case, and you have how many?"

The study "Seven Countries", which seemed monumental, and served as the basis for many subsequent articles of the authors, in fact, had a shaky foundation. for the study countries were selected Kizom subjective, and it is easy to assume that he specifically picked those that support his hypothesis. Why in the study included many European countries, but there is France and West Germany?

Because Keyes knew that in France and Germany relatively low rates of heart disease despite a diet rich in saturated fats.

The biggest drawback of the study was his method. Epidemiological study includes collection of data on the behavior and health, and search patterns. Keyes used the scenario developed for the study of infections, and adapted it for the study of chronic diseases, which, unlike the majority of infections are developed for decades. During this time, accumulated hundreds of factors that influence the diet and lifestyle, which are already impossible to separate.

In order to pinpoint the cause, it requires a higher level of evidence - controlled trial: dial group and half of the subjects assign a certain diet, say, 15 years, and at the end of the study to assess the health of the people of both subgroups. But this method is problematic: it is practically impossible to strictly control the diet of a large group of people. However, only spent properly test - the only way to reliably establish a causal relationship.

While Keyes showed a correlation between heart disease and consumption of saturated fat, it does not rule out the possibility that diseases were caused by something else. Years later, Alessandro Menotti (Alessandro Menotti), a leading Italian scientist who participated in the study, "Seven Countries", returned to collected data and found that the food, which was most often associated with heart disease, do not contain saturated fat, and sugar.

But it was too late. The study "Seven Countries" was canon, fat hypothesis has been fixed in the official recommendations. Committee of the Congress on the creation of "Dietary Guidelines" headed by Senator George McGovern (George McGovern). Most of the information he received from the American nutritionists from prestigious universities, most of whom knew each other and worked together, and they all agreed that the fat is a problem.

And McGovern and his fellow senators never seriously put it into question. Only once they have revised this hypothesis. In 1973, John Yudkin was summoned from London to testify before the committee and submitted an alternative theory of heart disease.

Stunned McGovern asked Yudkina whether he suggests that high fat intake was not a problem and that cholesterol is not dangerous.

"I believe in that, and in another," - said Yudkin.

"My doctor says quite the opposite," - said McGovern.

Science moving funeral

A new scientific truth does not triumph because its adversaries admit they were wrong, but because they die.

Max Planck (Max Planck), German physicist

In a series of articles and books, for example in the book "Why we get fat"Scholar and writer Gary Taubes (Gary Taubes) conducted a critical analysis of modern nutritional science, powerful enough to get to listen to it.

One of his contributions was the publication of studies conducted by German and Austrian scientists before World War II and lost by the Americans in 1950. Europeans were experts in fields related to metabolism. Americans were more epidemiologists, quite ignorant in the field of biochemistry and endocrinology. This led to a fundamental error in the modern diet.

Case in point - the fight against cholesterol. After he was found in the arteries of those who have suffered from heart attacks, public Health on the advice of the scientists added the egg yolk is rich in cholesterol, in the list of hazardous products.

But this is a mistake - to think that a man could not eaten is converted after it is swallowed. The human body is not a pan, which he fills, and a chemical plant that converts and distributes what gets outside.

The guiding principle of the body is homeostasis, or the maintenance of energy balance: when the body is warmed up by playing sports, it cools the sweat. Cholesterol is present in all our cells, produced in the liver, and biochemists have long known that the more cholesterol you eat, the less it makes your liver. It is not surprising that repeated attempts to prove the correlation between cholesterol in food and cholesterol in the blood have failed. The vast number of people will not happen significant increase in cholesterol levels, regardless of whether they are eating 2-3 or 25 eggs a day.

In fairness, we note that Ancel Keyes realized quickly that the cholesterol from food is not a problem. But in order to support the claim that cholesterol leads to heart disease, he had to identify what increases its level, and he focused on saturated fats. But many years later, after Eisenhower's heart attack in Kizu could not definitively prove the existence of those links, to which he pointed out in the study "Seven Countries".

But the scientific elite is not very embarrassing lack of definitive evidence, but was found in 1993, it is impossible to avoid another criticism: while the low-fat diet recommended for women, it has never been tested on them. The surprising fact for all but the scientists nutritionists.

National Heart, Lung and Blood decided to go for broke and spend the largest controlled trial of diet has ever undertaken. The study "Women's Health Initiative in the name» (Women's Health Initiative) was to cover the other half of the population and destroy all doubts about the negative effects of fat.

But nothing like that happened. At the end of the study, scientists found that women who adhered to a low-fat diet, were not less likely to develop cancer or heart disease than women in the control group who did not diet adhered to. The results caused consternation among researchers, they did not want to make their own conclusions. This study, carefully planned, generously funded by the spent under the supervision of the best specialists, it was pointless. nutrition science was to make progress, but still frozen in place.

In 2008, scientists at Oxford University conducted a pan-European research into the causes of heart disease. The data show an inverse relationship between saturated fat in the diet and cardiovascular disease. In France, the country with the highest consumption of saturated fat, has the lowest incidence of cardiovascular diseases. In Ukraine, at the lowest level of saturated fat consumption - the highest.

When the British researcher in the field of obesity Harkomb Zoe (Zoë Harcombe) analyzed data on the cholesterol level of the residents of 192 countries Worldwide, it is found that the lower the level of cholesterol correlates of cardiovascular with high mortality rates diseases.

Over the past 10 years, a theory that somehow survived without support for nearly half a century, has suffered greatly several studies with actual data. Although she still lives in the dietary advice and medical advice.

Food and Agriculture Organization of the United Nations, after analyzing data in the field of low-fat research in 2008 diet, not found "convincing or probable evidence" that a large amount of fat in the diet causes heart disease or cancer.

In another notable 2010 study conducted by the American Society for Nutrition, it was stated: "There is no substantial evidence, that the content of saturated fat in the diet is associated with increased risk of coronary heart disease or other cardiovascular diseases. "

Many nutritionists have refused to accept the findings. The magazine, published a study feared resentment readers, but because in the preface to the article wrote that the findings are contrary to all national and international dietary guidelines. Crowd logic tends to ignore the obvious, if it does not meet the generally accepted view.

The pre-war European explorers would laugh too simplified idea that obesity comes from the "calories". Biochemists and endocrinologists are likely to be presented obesity as a hormonal disorder caused by foods that we have replaced the forbidden fats: easily digestible starch and sugar.

In his new book, "always hungry" David Ludwig (David Ludwig), an endocrinologist and a professor of pediatrics at Harvard Medical School, calls this model of obesity "insulin-carb." In this model of obesity excess refined carbohydrates interferes with the metabolic system to balance itself.

Adipose tissue - is not an inert landfill for excess calories, it works as a backup source of energy for the body. Calories from her call for help when falling glucose level - that is, between meals, during fasting. Adipose tissue receives a signal via the insulin, the hormone responsible for regulating blood sugar levels.

Refined carbohydrates are quickly converted to glucose in the blood, causing the pancreas to secrete insulin. With increasing levels of insulin adipose tissue receives a signal that the energy can be taken from the blood and stops to give it. When insulin remains high for an unnaturally long time, a person gains weight, he is always hungry and feels tired. And we blame him for it. But, says Gary Taubes, people are not obese because they overeat and move a little. They overeat and move a little, because it is already thick.

And Ludwig, and Taubes emphasize that this is not a new theory. This theory of John Yudkin, complemented by fresh data. Only they do not mention the role played in the history of the supporters of the fat hypothesis, demoralized and deprived Yudkina authority.

Nutrition plays on the eternal rules of human social life: respect for charismatic personalities, following the majority, the penalty for deviation from the norm and the fear of making a mistake.

In the same 1972, when Yudkin published the book "Clean, white, deadly," cardiologist Robert Atkins Cornell (Robert Atkins) published a "revolutionary diet Atkins." Book ideas were similar (carbohydrates are more dangerous to our health than fat), different parts. Yudkin focused on the dangers of carbohydrates, but obviously not recommended diet high in fat. Atkins argued that the low-carbohydrate diet high in fat - the only safe way to lose weight.

Perhaps the most important difference between the two books was that what tone they are written. Yudkin - quiet, gentle, reasonable, which reflects his temperament and the fact that he saw himself first and foremost a scientist, and only then the practitioner. Atkins - a strong practitioner and not a scientist, unfamiliar with tact. He loudly indignant fraud nutritionists, and it is not surprising that this attack embittered elite hastened to heavy retaliation. Atkins was declared a fraud, and his diet - "fad". The campaign was a success: even today, on behalf of the Atkins blows quackery.

"Fad" was called all new. However, a diet low in carbohydrates and high in fat has been popular for centuries before the Atkins and approve scientists until the 1960s. With the advent of the 1970s, everything changed. When scientists studied the effects of sugar and complex carbohydrates to obesity, they saw what happened to Yudkin, they quickly realized: to continue to study for a career is very dangerous. Yudkina reputation was destroyed. He was not invited to the conference, scientific journals refused his works.

Yudkin was so discredited, ridiculed so badly that when someone dared to respond badly to sugar, about him saying he is just like Yudkin.

Raiser Sheldon (Sheldon Reiser), one of the few researchers continue to work on the study of the effect of sugar in 1970

If Yudkina ridiculed, hated the Atkins. Once it became possible to study the effect of the Atkins diet in the last few years. In 2014, in a study funded by the US National Institutes of Health, 150 men and women in During the year, a limited amount of fat, or amount of carbohydrates, leaving the same amount calories.

By year end, the subjects who ate few carbohydrates and high in fat, have lost an average of 4 kg more than the other group. And the weight of the left due to loss of adipose tissue. The group, which adhered to a low-fat diet also lost weight, but due to the loss of muscle tissue. This study, as well as 50 more similar to him, suggest that the low-carb diet more extent than low-fat, promotes weight loss and reduces the risk of diabetes second type. The results of research while not conclusive, but based on facts.

American edition "Dietary Guidelines" in 2015 (they are reviewed every five years) makes no reference to the new research, because the scientists who are involved in making recommendations, known nutritionists-connected, did not include this information in its report. It is a terrible omission, inexplicable from a scientific point of view, but perfectly understandable from the standpoint of nutrition policy. If you need to protect their power, why show what it can to undermine? Pull the string, and unravel the whole ball.

Although, maybe it's already been done. In December last year, the scientists responsible for the report, received a humiliating rebuke from Congress and the question of whether, on the basis of what data the report to develop recommendations. Scientists reacted violently, charging politicians in collusion with the meat and dairy industry. What would boldly, because funding for many research depends just on the food and pharmaceutical companies.

Noise in Congress rose partly because of Nina Teyholts. Her book was published in 2014, and Teyholts believe that we need to revise the dietary recommendations. It is nutritionally coalition, community, the purpose of which - to ensure that food policy is based on adequate research.

In September last year, she wrote an article for the "British Medical Journal» (BMJ), which referred to the inadequacy of scientific advice to underpin nutrition guidelines. The reaction of the scientific elite was fierce: 173 scholars - some of whom were in the advisory group "Recommendations", while others have criticized the book Teyholts - sent a letter to the magazine, demanding to refute article.

Publisher has refused, explaining that the article refuted only if they are given fraudulent information. Consultant of the National Health Center oncologist Santhanam Sundar (Santhanam Sundar), replied to the letter of scientists at the journal's website: "The scientific debate to help move forward. Calls for the reticence of eminent unscientific and frankly alarming scientists. "

The letter was a list of 11 errors in the article, which on closer inspection turned out to be insolvent. The scientists who signed the letter were happy to condemn an ​​article Teyholts in general, but could not name the specific facts wrong. One confessed that he did not read it. Another said that he had signed the letter, because the magazine published an article without review (although the review was). Meir Stampfer (Meir Stampfer), an epidemiologist at Harvard, argued that the work Teyholts "riddled with errors", but refused to discuss them.

Not wanting to disassemble the article essence, the scientists were filled with caustic remarks against its author. David Katz (David Katz) from Yale, a member of the advisory group and a tireless defender of orthodoxy, said work Teyholts "smacks of conflict of interest", without specifying what exactly interests (Dr. Katz - author of four books about diet).

Nina behave shockingly unprofessional... The meetings of scientists, nutritionists, I've never seen such unanimous disgust, as in the case when the name is mentioned Miss Teyholts.

David Katz

However, Dr. Katz can not cite a single example of her unprofessional conduct.

In March of this year, Nina Teyholts invited to take part in the discussion on the topic of nutrition at the conference of the National Food Policy in Washington, DC. However, the invitation very quickly canceled, as other participants in the debate have made clear they do not intend to dialogue with it. Instead Teyholts organizers invited the head of the Association of the Study of potatoes.

One of the scientists, who called for refutation of the article Nina Teyholts in the "British Medical Journal", a confidential He complained that the rise of social media has created a "credibility problem" for nutrition, "Even a madman could assert themselves. "

Znakomaya complaint. By opening the gates to all Internet blurs the hierarchy. We no longer live in a world where the accredited expert is able to dominate the elite complex or contentious issues. For the benefit of society whether it? For those areas where experts are sorely mistaken, of course. For nutrition such democracy is much more useful information autocracy.

In the past, we had only two authoritative source in the field of nutrition: the doctor and the government. This system works fine as long as the doctors and officials are fully aware of all scientific research. But what if you can not rely on them?

Community dietitians for many years has shown itself as a people, appealing to the senses, not the mind. It eloquently demonstrate their attempts to sink the Robert Lustig and Nina Teyholts as well as once they drowned John Yudkin. They can not accept and recognize that the promotion of a low-fat diet has been jealously guarded "quirk" which lasted 40 years and led to disastrous results.

Professor John Yudkin retired from his post at the Queen Elizabeth College in 1971 to write a book "Clean, white, deadly." College renounced this earlier promise to allow him to use their research centers. In place Yudkina hired a staunch supporter of the fat hypothesis, and it is unwise to keep the most ardent opponents in the same room. The person who created from scratch the department of nutrition at the College was forced to turn to a lawyer for help. In the end, for Yudkina it was found a small room in a separate building.

Lustig When asked why he was the first in many years, a researcher who began studying the harmfulness of sugar, he said, "John Yudkin. They are so trampled on him that no one wanted the same fate. "