Birth of a Fat Nation

Manabout to bite into a big hamburger.

What has been the cause of America becoming a fat nation? Could it be that we are just a land of gluttons? Or is it that our population of today really has little understanding of health and nutrition.  I surmise that the paradox is a combination of both factors, in that we have become a nation of gluttons who have little knowledge of nutrition. I also believe the lack of knowledge is not entirely the fault of Americans being as there has been far too much conflicting data which comes from our government.

We have a problem where valid, yet conflicting studies are at odds with each other, with one side of the issue winning out as settled science. My friends, there is no such thing as settled science, no matter the subject. Good science involves scientists not just proving theories, but also trying to disprove the same theories they have proven. The problem with our nutritional health is that one side has been deemed proven science. And the other equal theory has been neglected as a cause. It is we the people who pay the price as a fat nation when our own government is not ensuring we receive proper education on nutrition.

The Seven Countries Study

The Seven Countries Study was conceived by Ancel Keys, a Minnesota physiologist, who in the mid-20th century brought together researchers from all over the world. It became a collective effort to study their joint questions about heart and vascular diseases among countries having varied traditional eating patterns and lifestyles.(1)

The main hypothesis was that the rate of coronary disease in populations and individuals would vary in relation to their physical characteristics and lifestyle, particularly in fat composition of the diet and serum cholesterol levels. (1)

Who was Ancel Keys?

Ancel Keys is the man who pioneered the field of quantitative human biology. In his studies and work, he combined his research into a conglomeration of physiology, nutrition, and public health. Mr. Keys proved that through good nutritional habits, we do not have to suffer from ailments that at one time were accepted as genetically unavoidable.  He proved that we can control our cholesterol levels, blood pressure, body weight, and our responses to stress through good nutrition.

Beginning in the early 1950’s, Keys began the landmark Seven Countries Study. This study involved 12,000 healthy middle-aged men living in Italy, Greece, Yugoslavia, the Netherlands, Finland, Japan, and the United States. Keys hypothesis for his study was based on the increase of heart attacks and poor cardiovascular health in Americans following World War II. He did not subscribe to the common medical wisdom of the day that atherosclerosis was an inevitable consequence of aging. Through studies of foreign populations, he concluded there had to be a means of mitigating the risk of people dying from heart attacks and heart disease.

Keys found that a diet  rich in fruits, vegetables, pasta, and olive oil, with small portions of meat, fish, and dairy products — appeared to be protective against heart disease.  In his studies and research, he found that Japan, where vegetables, rice, and fish were the mainstays, also had a very low rate of heart disease. But in the United States and Finland, diets rich in saturated fats were associated with heart attack rates 10-fold higher.

Keys was right in his findings, and a large amount of his findings are the basis for many of our governmental policies on nutrition. However, the problem is that his findings are only one side of the story and the other side of the story has been largely left out and ignored.

Sugar, especially fructose, are the cause of heart disease as well!

Ancel Keys was mostly correct about his theories. But the implementation of his findings in governmental nutritional policies has not stopped us from becoming a fat nation with preventable heart disease. This is part and parcel to the error of taking one side of an issue as an absolute. When we do this, we often neglect to see other equally important factors. In this case, the role of sugar has been greatly overlooked as a cause of cardiovascular health problems too.

Enter John Yudkin

John Yudkin wrote the book “Pure, White, and Deadly” in 1972. He argued the point that dietary and saturated fats were harmless which caused a rebuke from Ancel Keys. Yudkin’s theory was that sugar, especially fructose, are the cause of heart disease as well as cavities, obesity, liver disease, and some forms of cancer. He was just as correct in his findings as Keys was in his, but Keys won out. As a result the food industry successfully manufactured a huge market for its own processed foods, which contained little saturated fat but lots of sugar. The consequences of our government taking only one side of this nutritional and health issue is we now have an obesity epidemic such as we have never seen before in our history.

John Yudkin was born in London in 1910, earned a degree in chemistry and a Ph. D in biochemistry, and later studied medicine in London. As the Chair of Physiology at London University at Queen Elizabeth College, he persuaded the university to institute a Department of Nutrition in 1954, the first department in Europe devoted to undergraduate and postgraduate teaching and research in nutrition. In 1954 Yudkin became the Chair of Nutrition for Queen Elizabeth College. In the 1960s, he grew increasingly concerned with the role of nutrition in western afflictions like obesity and diabetes, and spoke of the problem of “the malnutrition of affluence.” Yudkin retired from Queen Elizabeth College in 1971, and became Emeritus Professor of Nutrition. (2)

John Yudkin believed that sugar is an important cause of coronary heart disease, and that saturated fat and cholesterol are not. There is much debate as to if his beliefs about saturated fat and cholesterol are valid, but this does not cancel the validity of his arguments against sugar. Yudkin conducted a study in 1957, in which the death rate from coronary disease in fifteen countries was correlated in relation to the average intake of sugar. The study concluded that men consuming relatively large amounts of sugar faced far greater odds of developing heart disease in the age range of 45 to 65, than did those who did not ingest as much sugar. Only in recent years are Yudkin’s studies beginning to be taken seriously as we have become fat as a nation.

Obesity, Heart Disease, Diabetes and Carbohydrates

In the early 1960’s, a gentleman named George Campbell began working on his book “Diabetes, Coronary Thrombosis, and the Saccharine Disease” with another gentleman named Peter Cleave. In this publication, they argued that all the common chronic diseases of Western societies constituted the manifestations of a single, primary disorder that could be called “refined carbohydrate disease. Because sugar was the primary carbohydrate involved, and the starch in white flour and rice is converted into blood sugar, they ultimately chose the name Saccharine Disease. Note, saccharine in this case means “related to sugar.”

Unfortunately, the medical community at the time did not take this work seriously. This was largely because Peter Cleave was an outsider without the proper pedigree or credentials. It didn’t matter that he was correct even without the expected bonafides. His career in the British Royal Navy as a surgeon who had first hand experience in multiple nations was deemed irrelevant despite his experience in noting how the chronic disease incidence differs between nations.

In the decades following WWII

Peter Cleave began corresponding with hundreds of physicians from around the world. He was seeking information on disease rates, along with the occurrence and appearance of specific diseases. He published a book on peptic ulcers in 1962 that contained detailed testimony from hundreds of doctors who confirmed the absence of ulcers in populations where sugar, white flour, and white rice were difficult to obtain.

Cleave believed in simplifying the way forward to reduce the problems of nutrition and western diets. He believed the problem was the incorporation of sugar, refined flour, and white rice to the western diet causing health issues. His belief was based on the fact that many chronic diseases did not occur until after we began consuming large amounts of these carbohydrates. He had a theory that if sugar, refined flour, and white rice were added to even the healthiest of diets, chronic diseases would soon follow. He knew from his travels and studies that indigenous peoples from around the world who lived almost exclusively on animal products, as well as agrarian diets, did not develop chronic diseases of western societies until the addition of those particular carbohydrates.

Because Cleave believed that all chronic diseases of western cultures had the consumption of simple carbohydrates as a primary cause, he was disparaged by the medical community of the time. He considered dental cavities as being the canary in the coal mine. If cavities are caused by primarily eating sugar and simple carbohydrates,  followed by obesity, diabetes and heart disease, then the assumption until otherwise proved, should be the diseases were also caused by simple carbohydrates.

Diabetes, obesity, coronary heart disease, gall stones, and gall bladder diseases, along with cavities and periodontal diseases are intimately linked!

It was known and reported by physicians as far back as 1929, that one fourth of their heart disease patients also suffered from diabetes. Diabetics, as it became clear, were especially prone to atherosclerosis.  This became even more evident after the discovery of insulin.

Studies conducted in the 1940’s revealed that diabetic men were twice as likely to die from heart disease as men who were not diabetic. Unfortunately for diabetic women, you are three times more likely to die from heart disease. It was also fund that diabetics had and exceptionally high rate of gall stones, and the obese had an exceptionally high rate of gall-bladder disease.

The Law of Adaptation.

Peter Cleaves believed in keeping things simple,  which led to his theory that any cluster of diseases which are associated with each other must have a single underlying cause. He theorized that endemic, chronic diseases are caused by a rapid change in our environment. He referred to this theory as the Law of Adaptation.  In this, he theorizes that any species needs adequate time to adapt to changes in the environment. The refining of carbohydrates represented the most significant change in nutrition since the introduction of agriculture. We had been cooking foods for about 200,000 years before we began consuming simple carbohydrates. If Cleaves is correct, we have not yet adapted to these carbs. The refinement of sugar and simple carbs has only been in existence for a little more than a century. In evolutionary terms, this is a mere blip in time.

The refining of carbohydrates has done it’s damage in a couple of ways. 

The first problem with the refining of carbohydrates is it has led to overconsumption.  Our appetite control apparatus is deceived by the concentration and density of refined carbohydrates.  There is roughly a teaspoon of sugar in an apple. You probably never have a great desire to consume multiple apples in one sitting as you would teaspoons of sugar added to other foods. How many teaspoons of sugar do you find just in one serving of any soft drink or sweet treat?

The next part of the equation is that refined carbohydrates cause an onrush of sugar to the pancreas. After some time, this results in diabetes. The pancreas gets overwhelmed by the amount of work thrown on it in a short amount of time, and not so  much the amount of work required from it. When we eat refined carbohydrates, the pancreas gets stressed to it’s maximum all at once. You probably do not like it when your boss does this to you at work no more than your pancreas likes it when you overwhelm it. At some point, there is going to either be a push back, or an altogether failure.

When we eat refined carbohydrates, there is little to nothing to meter the flow of blood sugar to the pancreas, as opposed to when we eat potatoes. When we consume potatoes, the conversion of starch into sugar, and the absorption of this sugar into the blood stream is a slower and gentler process than the rapid one that follows the consumption of any mass of concentrated sugar.

The link between sugar and disease has been obscured over the years.

Sugar as a cause of disease had been overlooked while fat had been the key focus over the years. When carbohydrates as a cause of disease has been studied, there has been a great error in not distinguishing the difference between refined and non-refined carbohydrates. Cleave made a point of this in 1956 when he countered the argument that the increase in diagnosis’s of diabetes was unrelated to the increase in the consumption of sugar and refined carbohydrates.

One of the fundamental flaws identified by Cleaves was the theories being promoted that the increase of meat consumption and fats were a result of affluence. The thought was, since people were eating more meats and fewer carbohydrates, this would be the cause of chronic ailments such as heart disease as a result of eating saturated fats. The problem with this thinking is the disregard, that although people were consuming fewer complex carbs, they were eating more and more refined carbohydrates. White rice replaced brown, white flour replaced whole meal. Sugary beverages and candy were also driving up the consumption of refined carbohydrates.

A result of this flawed thinking is the belief that chronic disease was  caused by high fat intake with a decrease in the intake of complex carbohydrates. The fact that the increased consumption of simple carbohydrates had actually become a part of the equation was overlooked.

A fat nation and flawed observations.

The changing American diet led Ancel Keys to insist that the consumption of fat caused heart disease. Because of his beliefs, he insisted that we needed to begin consuming a low fat, high carbohydrate diet. And as obvious, Keys was able to convince our government of his ideas too.  He theorized that since there was an increase in heart disease with the consumption of more fat and less carbohydrates, we were placing our health at risk. He theories were based on the increase of fat by Americans from 100 pounds per year to 130 pounds per year. But he overlooked the fact that there was also a spectacular increase in sugar consumption from the mid 19th century onward.  In the 1830’s the average yearly consumption of sugar was 13 pounds for American citizens. By the 1920’s this number increased to 100 pounds annually, and then upwards to 150 pounds annually by the end of the 20th century. Is it any wonder we are a fat nation?

It was not until the 1990’s that epidemiologists began to acknowledge the difference between complex and simple carbohydrates in their dietary analyses. Even in 1989, when the National Academy of Sciences published their “Diet and Health” report, there was no differentiation between complex and simple carbohydrates.

When Keys linked the low fat, high carbohydrate diet of the Japanese to their low incidence of heart disease, he had overlooked their low consumption of sugar and refined simple carbohydrates. His assumption was that since fat consumption was low, and the rate of heart disease was also low, then it must be solely because of the low fat diet of the Japanese. The same can be said of the people of Crete and Corfu who had also been in Key’s research. All of these populations also had a correlating low intake of sugar along with their low intake of fat. We have grown into a fat nation as a result of this one sided thinking which government has based nutritional guidelines upon.

The problem with limiting analyses and over interpretation of limited and unreliable data.

John Yudkin took Ancel Keys to task for the limitations of his analysis, and his overthinking of very limited and unreliable data.  Yudkin understood that there are actually many factors that contribute to heart disease deaths. As we can see from all of the obesity of today despite the availability of zero and low fat foods, Key’s theories were not absolutely correct. We are fatter as a nation than we have ever been.

Yudkin paid attention to the trends of diet and disease in developed nations, and to heart disease and obesity, rather than the slew of chronic diseases. Yudkin came to the conclusion it was sugar that was the culprit, not the fat in our diets. You can test Yudkin’s theory out for yourself by eliminating sugar and refined carbohydrates entirely from your diet and see how your health and weight respond. You do not have to contribute to us being fat as a nation.

Research scientists can be ego driven, government can be stupid.

In the 1970’s, the medical community began taking John Yudkin serious. However, the theories of Ancel Keys had taken precedence in governmental nutrition policy. It was thought that if one was right, the other must be wrong. Could we get any more stupid? At least researchers in Europe recognized this flawed analogy.  They recognized that there was a problem with saturated fats and sugar in the diet. The researchers in Europe knew  through their research that there sugars and fats have a common metabolic pathway. Disturbances in carbohydrate metabolism may be responsible for abnormal fat metabolism. This is a causative factor in the development of atherosclerosis and of coronary disease and how we have become fat as a nation.

As a nation, we have become fatter each year. While we are each responsible for our own health, it is no wonder that people have such little understanding of how our nutrition affects our health. Ego and ignorance have led to marketing and policies that have made us a fat nation.

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Good Calories Bad Calories, Gary Taubes

(1) Seven Countries Study

(2) The Pauling Blog

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