How 'Settled' science nearly succeeded in destroying mother nature's most perfect food.
"I have high cholesterol," my mother sighed over the phone. "Just got back from my doctor, and my cholesterol reading was 523."
"Is that high?" I asked. I knew nothing about cholesterol to say nothing of medicine's ability to measure it. But I know my mother. If the doctor found something alarming, she would immediately go about and make any necessary changes to correct the problem.
Congressional hearings were held in 1976, where testimony was given that 98.9 percent of world nutrition researchers all agreed; heart disease was caused by foods high in fat and high in cholesterol. Having been manipulated by one of the oldest rhetorical tricks known, claiming the science was settled by an overwhelming consensus, the bipartisan committee agreed, and new dietary guidelines were published.
She proceeded to tell me everything she knew about high cholesterol, which is what the doctor told her and articles from dozens of magazines. Cholesterol and fat are responsible for heart disease and strokes. It's caused by eating fatty food and food high in dietary cholesterol like eggs. And with heart disease in the family and the leading cause of death among Americans, my mother immediately changed her diet. If she left any eggs in the refrigerator, they were for making cookies and cakes. Butter from cows milk fat- out. Whole milk- gone. Cheese, cottage cheese, and yogurt- to the back!
My mother was no longer eating eggs or whole milk or butter or most other dairy products. Unfortunately, that didn't do much for her cholesterol levels. "Still too high," she'd tell me. I could tell she was worried. Anxious even. Lurking in the back of her mind was her father, who died of a heart attack at the early age of 72. Playing a game of pool with his friends, he leaned against the pool table, crumpled to the ground, and died. Maybe her fate was sealed.
For her, worry came naturally. It was 1995. She was in her mid 60's, in great shape, and a breast cancer survivor. With dozens of grandchildren, my mother had a lot to live for.
Eventually, I, too, have my cholesterol levels checked. To my consternation, my triglycerides are a bit whacked. My grandfather dies young of a heart attack, and my mother has high cholesterol. It only stands to reason that I, too, would be afflicted. Individual cholesterol levels are largely a function of one's genetics. Soon, significant articles were appearing in Time, Newsweek, and other national publications. TV networks started devoting news time and specials to the health effects of eating what was now looking to be evil food high in cholesterol and fat. There might have been folks that disagreed with the science communities' conclusion, but we didn't see or hear much from them.
Eventually, my mother is prescribed a statin drug, and her high cholesterol count did come down a bit- but just a bit. I asked her if there were any side effects in taking these drugs. Sure, but that didn't make her any less of a believer. She committed herself to an egg-free low-fat diet, taking her statin meds and going for a brisk walk every morning.
During one of my many visits, I would open her kitchen cabinets in search of a bowl of cereal. I found one unopened and one half-eaten box of Special K next to the refrigerator. 'Heart Healthy' they claimed. The Kellogg folks had done some research and added a 'healthy heart' symbol from the American Heart Association to the corner of the box. Kelloggs paid the association thousands of dollars for the right to claim it 'heart-healthy.' A bowl of Special K would reduce my mother's cholesterol, the box implied. I'm sure she thought that to be true.
Being healthy and young, I could afford to be cavalier about what I ate. I recall a sense of optimism about what appeared to me was incredible advances in health science. With increasing rapidity, magazine and newspaper articles touted each discovery. If taken at face value, one had the sense that eventually, heart disease and a host of other conditions would soon be eradicated- and in my lifetime. Science was going to discover the fountain of youth- finally. I had nothing to fear because science was all over it. It would have been easy to believe that science was on the brink of knowing everything they needed to prevent death itself. Perhaps a pill with no side effects.
Dr. Ancel Keys
Good health sells. Glossy magazines touting all sorts of good health content piled up on my mother's kitchen table. She'd read these magazines and soon became a bit of an expert. At least she thought she was. An article would claim this, and soon she believed that. My mother read a book by Dr. Ancel Keys titled 'Eat Well and Stay Well.' Dr. Keys would claim the reason for writing the book was to declare war on cholesterol. Then he was featured on the cover of 'Time' magazine as the foremost authority on why atherosclerosis (heart disease) was killing so many. My mother believed all of this. She grew up in an age when you could believe what you read.
The sun was shining brightly one winter, Florida morning. My wife and I were visiting her grandfather, who was well into his 80's. His wife had faithfully made him a breakfast of a half grapefruit, one hard-boiled egg, and a strip of bacon every morning for years. After breakfast, he'd chow down on a crossword puzzle to keep the synapses firing. He may have not known it, but the egg he just consumed was keeping his synapses healthy too. I recall inquiring about his breakfast habits and his cholesterol level. If he knew and told me, I don't recall. But it didn't stop him from enjoying his regulation breakfast every morning. He lived to be 92 years old.
The human biological system is incredibly complex, made more so because each individual is a unique system. My mother is much different than my wife's grandfather. We each contain an infinite number of physiological variations. Throw in all the possible environmental differences such as obesity and exercise and the quality of healthcare, and we begin to understand how difficult research on human nutrition must be. Then consider how long some effects of our human diet can take to affect our health either positively or negatively—many years in most cases.
To understand how so many nutritional scientists bought into the high fat, high cholesterol argument, we need to examine the nature of early research. But equally important, we best understand what the rest of the world did with this information. I hope to shed some light on how we deviled the egg with shoddy science, sophisticated public relations, and the shameless use of fear and intimidation. The images of clogged arteries by fatty deposits and cholesterol traumatized a generation, including my mother.
The 'Deviling' of the Egg
In the early 1900s, science was making significant strides in understanding human systems. Heart disease had been around a long time. Since we're curious enough to poke around a corpse for clues, researchers in Germany found something interesting. The observations soon turned into a theory by esteemed German pathologist Rudolph Virchow when he posed that cholesterol in your blood became the 'plaque' in your veins.
Nikolaj Nikolajewitsch Anitschkow
Taking a different tack, the Russians were studying rabbits. Having fed rabbits food high in cholesterol, Nikolaj Nikolajewitsch Anitschkow from St. Petersburg, discovered that the rabbits soon suffered from arterial lesions. Ah-ha! More evidence that cholesterol leads to plaque buildup on the arteries. Eventually, someone took a closer look at this bit of research and suggested a possible flaw. Rabbits are herbivores and don't naturally eat things with cholesterol. Feeding rabbits high doses of something they never eat is like feeding us rotting food to examine why worms appear immune to salmonella. The same experiment was then conducted using the common dog. Dogs are carnivores with a diet more similar to humans. When fed a diet high in cholesterol, dogs did not develop arterial lesions as the rabbits did.
Sometimes research results appear so compelling we're tempted to go straight to a firm conclusion. And sometimes, the research, upon closer inspection, contains flaws and errors. The methods used did not always consider all factors or weigh them correctly. Such was the case with Dr. Ancel Keys, who in 1953 published the Seven Countries Studies. He collated data from seven countries known for their high consumption of dietary fats and a high incidence of heart disease and connected the two. Why he didn't include data from all 22 countries in which data was collected is still not known. Some have speculated that it did not support his hypothesis. Only later, when data from all 22 countries were eventually tallied, little to no correlation was found between the consumption of dietary fat and coronary heart disease when a variety of other factors were considered.
The next paper to hit the scientific community was called the Framingham Heart Study. This study started in 1948 and included a detailed assessment of 6000 individuals, all living in Framingham, Massachusetts. It also included other factors that might lead to heart diseases, such as obesity, smoking, and lack of exercise. It, too, found a link, albeit a weak relationship, between consumption of dietary cholesterol and heart disease. However, if you read carefully, you'll discover something of an anomaly. The research pointed out that the more dietary cholesterol and saturated fat an individual ate, the lower was their cholesterol level. One crucial piece of data that should have stopped them cold. But we don't always read things very carefully that we find inconvenient. What the science community and media ran with was the link between a diet high in dietary cholesterol and heart disease- albeit an extraordinarily weak one.
By 1995, it was too late to set the record straight. Government, industry, the science community, the media with their clickbait headlines, and my mother were all singing in unison- eggs are evil. But a former director of the Framingham Heart Study, Dr. William Castelli, may have sensed the studies' contribution to groupthink and had second thoughts. He tried to save the integrity of the research and possibly the beleaguered egg as well when he stated, "In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum cholesterol. The opposite of what Keys et al. would predict. "We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least, and were the most physically active." Finally, being 'physically active' and in good physical shape was given some weight. But they had yet to discover the strong genetic component to individual cholesterol levels.
Yet, these research papers, however flawed, started a revolution. Billions of words, thousands of dubious products, millions of medical tests, billions of statin drugs, and an anxious mother was the result. It was all settled. For the egg industry, the fallout was simple. The weakest producers went bankrupt. For the dairy industry with its complicated government controls, unmarketable milk was turned into cheese. Eventually, so much cheese was stockpiled, it was given to schools to be fed to the kids not yet worried about their cholesterol levels.
Such is the nature of research. A hypothesis is posited, research results in observations, theories are developed, papers are written, media attempts to explain it, and science is advanced. It's a wonderful rational process and nearly always benefits humankind. But even scientists are human and subject to making errors, holding strong biases, and some have even been caught fudging a bit to prop up a wished-for narrative. But as we'll see, our natural world is immensely complicated, and human behavior is somewhat predictable. Humans are prone to 'confirmation bias' and 'groupthink,' which contributes to the confusion. Sometimes, a perfect storm gathers that obfuscates the truth, which leads all of humanity to follow a rabbit down the hole.
The Answer is Faux Food
In free-market systems, innovators and risk-takers are always looking for opportunities. That is nearly always a good thing. If sugar is bad for you, then we'll figure out a way to make our sugary sodas sugar-free. With gifted marketing folks given budgets rivaling that of the GNP of mid-tier nations, soda companies can convince the world that a can of soda is the equivalent of a glass of water. Zero everything!
So it must have been with some delight when the processed food folks realized that Humpty-dumpty had been pushed from the wall and needed to be replaced- pronto. Soon grocery store shelves were full of products that addressed the evils of fatty cholesterol-laden food.
Since we insist on spreading something on our bread, the magicians of industrial food came up with a product called 'margarine.' So good was margarine, they claimed you couldn't tell the difference between it and butter. How pleased the butter-eating public must have been to enjoy something that tastes like butter, looked like butter, spread like butter, and sat in the cooled butter display case. The package boldly stated as fact, as good as butter without all the nasty dietary cholesterol. "Don't fool with mother nature," they lectured. In a most memorable TV advertisement, Mother Nature herself, played by a stern-looking woman, was seen having been entirely fooled by an industrial food concoction called 'I Can't Believe It's Not Butter' margarine product. She was not happy haven been duped, but she loved the trans-fat-laden margarine. Out with nature's natural food and in with highly processed foods.
Soon, concoctions of chemicals cleverly stirred together without the bad stuff yet providing our senses the idea that we are still enjoying the old stuff. We didn't much notice or care that many of the ingredients were there for presentation value. Stuff to make it stick together like butter and be smooth and creamy to spread like butter and taste just like butter without any actual dairy product in the brew. Only later would we come to understand that this new butter substitute, margarine, typically contained a heaping of heart-damaging trans fats. Eventually, the makers of these products would be called out for all the trans fats. Until then, my mother was spreading nothing but margarine on her lunch sandwiches.
Food companies, startups, and Wall Street soon grew to see the size of the opportunity. They hired bright chemical and biological researchers and gave them white coats and high-powered electron scopes, and told them to develop substitutes.
I imagine a scene where the director of research walks into a meeting carrying a single ordinary egg. The chief demonstrably lays it on a sterile stainless steel table and slowly addresses her team. "Ladies and Gentlemen. Today we embark on a new journey- a journey so critical that the well-being of all humankind is at stake. Men and women are dying of heart disease at alarming rates because of cholesterol and fat in their diet. We all know the likelihood of the average person voluntarily changing their diet (a few snickers could be heard.) Since that is unlikely, we must offer substitutes."
The chief continued, "Research has discovered a link between this egg (she points with disgust at the lonely egg on the table) and plaque buildup on the arteries of men and women leading to atherosclerosis." She pulls out a visual that shows a blood vessel clogged like a kitchen sink. "Just this morning, the CEO gave us the go-ahead and a three million dollar budget to develop a new product. A substitute egg." Several researchers looked at each other with slightly tilted eyebrows. The chief continues, "Our substitute egg must look like an egg, taste like an egg, and cook like an egg. In every regard, the egg-loving public shall enjoy our egg as much as any egg nature has ever provided. Any questions?" she asks. One small hand emerged with a question. "Mam, what about the nutrients of this new product. Does it need to reflect that of an egg from nature?" she asked. "Good question. Marketing believes that if we include an industry solution of your standard off-the-shelf synthetic vitamin pack. They will plaster 'fortified' on the packaging; we'll have a product that will sell like hotcakes," the chief concluded as she closed the meeting. "We've already paid the AHA for the right to place Healthy Heart on the packaging. Let's get to work."
Today, we have the dubious benefit of eating an egg substitute with something like 30 different chemicals carefully co-joined to resemble an egg, albeit somewhat poorly. The scientist did their best, but an egg is hard to replicate. But Humpty Dumpty had fallen, well pushed actually, and couldn't get up. My mother walks right past the egg cooler at the grocery store to the display right next to it. That's where she'll find the substitutes.
Pharmaceutical Companies Smell Blood
The pharmaceutical companies were not going to let industrial food folks get all the spoils. They, too, started to stir some ingredients together and came up with various medications to reduce the cholesterol count of those with high cholesterol.
With heart disease being the leading cause of death in America, the pharmaceutical industry was already pumping out drugs to treat coronary disease and prevent heart attacks. But it wasn't until cholesterol was accused as the rotten egg that they went to work on developing anti-cholesterol preventive medicines. The most successful being a class of drugs known as 'Statins.' Statins would become the most prescribed and most profitable category of drugs in all of history. Thirty-four billion dollars are spent annually in the US for statins.
In 1972, a Japanese biochemist discovered a chemical found in a particular type of mushroom that would inhibit certain microorganisms from forming into other organisms. These 'inhibitors' prevented the maintenance of cell walls, therefore, inhibiting their formation. In 1976, the Brits had stumbled upon essentially the same mechanism, which resulted in a compound called Mevastatin. Fortunately, Mevastatin was never marketed because it caused muscle deterioration, tumors, and even death of laboratory dogs. Since some researchers were about ready to give Humpty Dumpty the big push, let's get to know the focus of their ire. A Brief History of the Egg
Historians believe it was the Chinese that first domesticated the chicken for purposes of enjoying their eggs around 6000 BC. Some records exist that the Egyptians and Romans used eggs for baking, having discovered the eggs' ability to act as a binding agent in bread and cakes. Domesticated chickens didn't arrive with Columbus, but they did come on the very next boat.
There is something about the shape of the egg, its conical sphere wider at the bottom, slowly tapering towards the top, which makes it so compelling. Similar to a round sphere or a ball but just different enough to make it interesting. So also thought the ancients. The cultural significance of the egg over all of recorded history is perhaps without equal in the category of food.
I recall a story out of the Midwest and reported on CNN. A junk dealer made a bid of $14,000 for someone's entire pile of junk. This particular dealer would typically take the trinkets that contained gold or silver and have them melted down to reclaim the precious metals to make a few bucks. Just before he was to box up a collection of trinkets to be melted, he carefully examined one final time an item that looked like an ornamental mantelpiece complete with three very ornate legs suspending an object shaped like an egg. In a long shot, the junk dealer 'googled' 'egg' and the name of "Vacheron Constantin," which he had found inscribed on the object.
One link led to another, which finally led him to the conclusion that he might possess something rare and precious. It turns out that he owned an original Russian Faberge. These beautiful eggs were not just any Faberge. This particular trinket was the 'Third Imperial Easter Egg' made by Faberge for the Russian Royal Family. One of only 50 made for the Royal family; this particular one was number three and worth nearly 33 million dollars. And that is how an unsophisticated junk dealer from the Midwest came into possession of a piece of art created to represent the observance of Easter and a love token. That's one very expensive Easter egg.
The very first Easter Eggs are thought to have been painted by early Christians in Mesopotamia (modern-day Iraq). They painted them red to signify the blood of Christ. The tradition expanded and involved to where today, the Easter Egg is a significant component of celebrations across the globe. So strong is the Easter Egg, even attempts to de-sanctify it as a healthy food source have not diminished its symbolic power. Americans consumed $16.4 billion of multicolored plastic eggs filled with candy, chocolate bunnies, marshmallow Peeps, and other Easter holiday staples in 2015, according to the National Food Federation. In contrast, the egg industry sold 9.4 billion dollars worth of production in 2019. Fill a plastic shell resembling an egg with candy and chocolate and other sugary morsels, sell billions of dollars of them, and no one raises an eyebrow.
An Easter Egg is just one symbolic use of the egg recorded in history. Many cultures saw the eggs as a symbol of fertility. Several went so far as hanging eggs from temple doorways as an offering to the fertility gods. In ancient Iran, brides and grooms exchanged eggs, and in France, the bride would crack an egg before entering her new home. Ancient Chinese would use eggs to divine the future. They would paint eggs, boil them, break them, and carefully read the 'cracks' to reveal the unknown.
The Egg as a Food Source
The egg is unique in all of nature. The nutrient profile is profound in its completeness and complexity. One little ole egg contains 75 calories, 7 grams of high-quality protein, 5 grams of fat, and 1.6 grams of saturated fat and a large variety of vitamins, minerals, carotenoids, and 187mg of dietary cholesterol per large egg. Carotenoids are known for reducing the risk of macular degeneration and the disease-fighting attributes of lutein and zeaxanthins. You can legitimately call an egg 'brain' food in that brain development and memory may be enhanced by the choline content of the humble egg. The egg contains no carbohydrates, no sugar, and no gluten.
Just after World War II, annual egg consumption stood at around 422 eggs per American. Egg prices were relatively low, and farm and breeding practices were substantially improving egg production. Americans were also dying of cardiovascular disease. The leading cause of death at the time.
There is no other food source with a history as rich as the lowly egg. Yet, within just a few years, the egg became unwelcomed in American kitchens even at Easter. Between 1950 and 2011, egg consumption in America decreased by nearly 40%. Had not the continued falling of egg prices and rising income, the decline in consumption likely would have been worse. Most food experts agree that the consumer's concern about the egg's contribution to heart disease was the major contributor to declining consumption.
So over several decades, the mighty egg with a history of thousands of years providing human sustenance, to say nothing of its rich cultural heritage, fell and cracked into a sort of science purgatory. That might have been a just end to a proud legacy if we had gotten the science right. But we didn't. Like a rouge jury, Humpty-dumpty was found guilty on the equivalent of a rumor. Like many rumors which started with a morsel of truth, the humble egg soon morphed into a ruthless killer. Poorly conducted research that took on a life of its own. Soon, many were invested in a particular outcome; the food industry, the AHA, the National Institute of Health, the pharmaceutical giants, nothing could stop a guilty verdict.
The role of government in the pushing of Humpty Dumpty
Humpty Dumpty sat on the wall Humpty Dumpty had a big fall And all the Kings horses And all the Kingsmen Couldn't put Humpty Dumpty together again.
To convince Americans of anything, it’s best to start with a freshly baked apple pie. Whatever stands next to the apple pie will sell. When something as apple pie as the American Health Association and the National Institute of Health team up to publish nutritional guidelines, we best pay attention. The guidelines relied heavily on Dr. Ancel Keys and his infamous Seven Countries Studies. That was the study that took the eating habits from seven countries and claimed a correlation between a diet high in saturated fats and cholesterol with heart disease. It was possibly the most extensive study conducted to date on eating habits.
With the AHA new dietary guidelines, the smoking gun was clear for all to see. Food high in dietary cholesterol and fat is to be avoided. Carrying the weight of the Ten Commandments presented to Moses by God himself, the AHA, the National Institute of Health and the Senate Committee on Nutrition changed the way Americans relate to their food.
Congressional hearings were held in 1976, where testimony was given that 98.9 percent of world nutrition researchers had all agreed; heart disease was caused by foods high in fat and high in cholesterol. Having been manipulated by one of the oldest rhetorical tricks known, claiming the science was settled by an overwhelming consensus, the bipartisan committee agreed, and new dietary guidelines were published. Increase your carbohydrate intake and decrease your fat intake. Soon my mother was told that nine of ten doctors also agreed. Cut out the eggs, the dairy, the red meat, and you'll never die from heart disease.
The train was rolling so smoothly that by 1984, the AHA and the National Institute of Health produced a slick national campaign called "National Cholesterol Education Program." The goal was simple; convince Americans to reduce their cholesterol consumption. Millions of dollars were spent. So convinced of these substantial efforts, the then AHA president claimed that if the dietary guidelines were followed, atherosclerosis would be "conquered" by 2000. We were one step closer to the fountain of youth.
Nearly every food package soon claimed how healthy it was based on two criteria; low fat and no or low cholesterol. And if you were an egg- well, so sorry. Some politicians even considered forcing the egg industry to warn egg eaters of the dangers by placing images of clogged arteries on the egg carton as if it were as dangerous a killer as cigarettes. In their opinion, what was needed was more fear.
Would anything put Humpty Dumpty back together again? A resurrection seemed unlikely. Nary a word was uttered in support of the poor defenseless egg. Who dared? A few tried. Some did suggest that human health was more complicated than just blaming eggs and consuming highly processed food and swallowing a statin pill a day. Dr. Atkins, a New York physician, tried by suggesting that we look at carbohydrates a bit closer. And if weight loss was your goal, then consider removing some of the carbohydrates from your diet. But he was quickly labeled a 'quack.' Other 'charlatans' would come and go. Today, we'd call them 'deniers.' In some cases, their contributions to science are finding a more receptive audience today.
Except for bankrupt egg producers, few lamented the plight of the mighty egg. My mother, adjusted by reaching for margarine full of trans fats, Special K with a paid-for AHA healthy heart sticker, vitamin D fortified skim milk that tasted worse than water, and egg beaters fortified with a few vitamins instead. Despite the 'settled' nature of things, a few rubes kept eating eggs despite the overwhelming evidence. But the 'smart' folks believed it hook, line, and sinker. With near unanimity of belief possibly the result of the most successful PR campaign ever choreographed, one big question still hung out there like a pinprick to a balloon. Does a low-fat diet prevent heart disease?' Sadly, there was simply no evidence to suggest that it does.
Eventually, new dietary guidelines were produced in response to better research. The dietary guidelines didn't completely exonerate the egg- but it came close. Humpty-Dumpty is back on the wall.
So what went wrong?
Just how does nine of ten doctors come to agree with a very steamy dog pile of science? Or what about the 98.9 percent of the world's nutrition researchers who claim to all sing in perfect harmony? Suffice to say that I know neither the exact question they all allegedly agreed to or who tallied up the results. But it's in the congressional record that the sheer overwhelming nature of peer agreement was so persuasive that it resulted in a bi-partisan consensus that kept the ruse going and the money moving.
How Human Behavior Contributed
Groupthink "Groupthink," said social psychologist Irving Janis, the man who coined the term, "occurs when a group makes faulty decisions because group pressures lead to a deterioration of "mental efficiency, reality testing, and moral judgment." There- he insulted every one of us. In a group, any group, the pressure from that group can lead us astray. We are likely to act differently, less independently, than if we're outside of the group. I've seen it on the playground, in churches, on Twitter, and in TV newsrooms. We can all become corrupted. Our desire to be liked, to get along, and to stay safe in the fold becomes, perhaps, more important than personal integrity and independence. Perhaps. There is something to be said by 'go along to get along.'
Unfortunately, the side effects of groupthink are serious. Groupthink will ignore alternatives and quickly, collectively, dehumani