A couple of years ago, a symposium was presented at the American Dietetic Association (now called the Academy of Nutrition and Dietetics) conference that was called “ The Great Fat Debate: Is There Validity In the Age-Old Dietary Guidance?” Four leading experts suggested at that time that low fat diets may be less healthy than once thought and that diets with moderate amounts of certain fats may be healthier. Recently, dietary cholesterol has been questioned as to whether it has much influence on blood cholesterol in healthy people. Where did it begin at least in contemporary times? This timeline presents the major events that led up to the fat and cholesterol phobia that beset Americans in the last century and continued into the early part of the current century.
1930’s to 2012
Columbia University biochemists David Rittenberg & Rudolph Schoenheimer demonstrated that dietary cholesterol had very little effect on blood cholesterol. Little was known then about the role of lipids on much of anything, let alone health and disease.
University of California medical scientist John Gofman discovered several fat-like substances called lipoproteins circulating in the blood, including LDL and VLDL. He also reported that total cholesterol (TC) was a “dangerously poor predictor” of heart disease.
Ancel Keys, a professor at the University of Minnesota, hypothesized that dietary fat is the cause of heart disease and published his Seven Countries Study, suggesting an association between dietary fat and mortality from heart disease. Critics pointed out that Keys had data for 22 countries, but selected data from just seven. He excluded France with a low rate of heart disease and a relatively high intake of saturated fat.
President Eisenhower suffers a first heart attack at age 64. Over the next six weeks, twice daily press conferences were held on the president’s condition. He was told to follow a low-fat, low-cholesterol diet. Eisenhower had several more heart attacks and eventually died of heart disease.
American Heart Association (AHA) urges Americans to reduce their intake of total fat, saturated fat, and cholesterol.
Margarine outsold butter for the first time and became the spread of choice. Consumption of margarine had grown to 9 pounds per capita. Little attention was paid to its hydrogenated oil and trans fat content at the time.
American Heart Association raised $35 million dollars and officially adopts AHA board member Ancel Keys’ low fat diet. In January 1961, he appears on the cover of Time Magazine with the accompanying cover story: “Medicine: The Fat of the Land”.
Data from the Framingham Heart Study (started in the 1940’s) first suggested that men under 50 were at greater risk of heart disease when their cholesterol levels were high. However, they had other risk factors like smoking, were overweight and had little exercise. Later data reported no association with heart disease risk when the men reached 50 years and older. The “experts” largely ignored this latter finding.
Obesity levels in the US had remained between 12 to 14 percent from 1960 to 1980. After 1980 – and especially after 1990 – obesity rates grew dramatically. The low-fat diet craze had begun in earnest, and low-fat diet books and programs multiplied and thrived for the next decade.
U.S. Department of Agriculture releases the official first ever low fat Dietary Guidelines for Americans. On the cover: “EAT LESS FAT, SATURATED FAT, AND CHOLESTEROL.”
The National Cholesterol Education Program was started by the NIH and the American Heart Association. Cereal companies, vegetable oil interests, and the American Medical Association eagerly join the long-awaited “War on Cholesterol.” Food products soon began to display the proud words – NO CHOLESTEROL. Plants have no cholesterol but labels on products like peanut better and raw potatoes (personal observation) boasted the claim.
The anti-fat “craze” continues. Fat has become the pariah of nutrients and many people tried to avoid it like the plague. Some counted fat grams, switched to skim milk and eagerly bought and consumed food with “low fat” or “fat-free” on the labels. Snackwell cookies and cakes were introduced in 1992 and consumers were delighted with the claim of “low fat”, not realizing they contributed calories and sugar when consumed in excess.
Obesity level in the U.S.: Over 30 percent.
Butter is making a comeback! For the first time since 1957, butter outsells margarine.
2010 – 2012
The low diet is questioned with the return of the low carb diet and research that did not seem to support the original hypothesis of Keys – that high fat diets cause heart disease. The new mantra began to emphasize the type of fat rather than the amount.
Carbohydrate intake mainly in the form of refined sugars and starches is currently on the center stage of the causes of obesity and new research is beginning to compare its effects on chronic diseases including heart disease.
Is the low fat craze finally coming to an end? Has this national experiment failed? Stay tuned for the “Fall of the Low Fat Diet” and more on the low-carb diet coming soon.