The Melanie Avalon Biohacking Podcast Episode #234 - Nina Teicholz

TRANSCRIPT

(Note: This is generated by AI with 98% accuracy. However, any errors may cause unintended changes in meaning.)

Melanie Avalon:
Welcome back to the show. I am so incredibly excited about the guest that we have today. So the backstory on this conversation, back when it came out in 2014, I read a book called The Big Fat Surprise, Why Butter, Meat, and Cheese Belong in a Healthy Diet by Nina Teicholz.

Melanie Avalon:
And so when I read that book, it honestly blew my mind. It was the most extensive overview of what has led to today the potential misconceptions and demonization of things like saturated fat and cholesterol and how it relates to heart disease.

Melanie Avalon:
And in particular, the crazy different factors that went into why we have the dietary recommendations that we have today. It goes into the politics of everything, the studies, what has actually been found in a scientific literature.

Melanie Avalon:
So it's a real mind blower. And I've been dying to have Nina on this show, honestly, ever since I started it. So when our mutual friend Cynthia Thurlow mentioned that, I think you've been on Cynthia's show and that you guys are friends, I was just dying for an introduction.

Melanie Avalon:
And so then I was excited because then I was like, Oh, I get to reread The Big Fat Surprise now. I love seeing how my perceptions have changed and how it's kind of like a time capsule of sorts when you read a book at one point in your life and then reread it later.

Melanie Avalon:
So I reread it now. Again, blew my mind again. And it was exciting because a lot of the people that you talk about in the book, I've actually had on the show now. So like Gary Topps has been on the show, Marianne Nestle, who just is one of the most incredible people.

Melanie Avalon:
So it was really exciting to reread it now. But I have so many questions about the book, about the things that have happened since then, about stuff now. So Nina, thank you so much for being here.

Nina Teicholz:
Well, thank you, Melanie. And it's just such a lovely introduction. So yeah, I'm happy to be here.

Melanie Avalon:
Oh, and also, last night, I was randomly just doing some last -minute research. And so I was, what I was trying to find was the historical data on saturated fat intake from just like history until now.

Melanie Avalon:
And I started reading the first thing that came up and I was reading it and I was like, this really sounds like Nina. And then I looked at the top and it was you. It was your article. Oh, wow. That's great.

Melanie Avalon:
I'm delighted. I know. You were like the first hit. And I was like, oh, wow, this is so perfect. But actually, actually, actually, that relates, I didn't plan this, but that relates to a big question I actually had for you.

Melanie Avalon:
Because what I was trying to do with that Google moment, Google Scholar, was to find some literature outside of your book on everything. And then I was like, oh, wait, but now I'm actually, this is also from Nina.

Melanie Avalon:
And this relates to my question, which is, I'm sort of haunted. I think about this a lot. It's so confusing finding truth in especially dietary science and everything like I talked about in the introduction.

Melanie Avalon:
And I'm really haunted by how do we know, how do we know the truth when so much goes into telling the story of something? And especially when you do something like you do, where you write this incredible, beautiful, extensive, well -researched book, where you really are telling the history of everything that led to where we are today, even that is still a story from your perspective, which would happen with anybody who's writing a book.

Melanie Avalon:
So I guess my question is, how do we escape bias when we're tackling all of this? What do you do? How did you sit down and write the book?

Nina Teicholz:
That is an exceptionally hard question. When I started off my research, I was a vegetarian, and I really did not much understand nutrition science. It took me almost a decade to write my book, and I read thousands and thousands and thousands of scientific papers, and I just immersed myself in the scientific literature, and then I understood some of the technical issues of science, which I think are really just critical to being a smart observer of science.

Nina Teicholz:
We could talk about some of those, but what's the difference between epidemiology and a randomized controlled clinical trial, and what's the pyramid of evidence, better evidence, lesser evidence? That's one layer of trying to understand, but then you can't really rely on authorities, because even though now I've just received a PhD and have been published in the BMJ, which is a top medical journal and have maybe a dozen peer -reviewed articles to my name, I do not think that having a PhD or having anything in the peer -reviewed literature necessarily should be taken at face value, because as I discovered, almost all of the most powerful scientists had locked themselves into a dominant medical nutrition dogma, and that's basically like saturated fat is bad, a diet of more fruits, vegetables, whole grains, nuts, seeds, low -fat dairy, lean meat, that's the healthy diet, and vegetable oil is probably in there.

Nina Teicholz:
That narrative is so powerful, and if you go outside the narrative, then you're unlikely to get research grants. You will not get invited to expert panels or conferences, and I document a number of issues in my book about people who were trying to kind of butt up against the official narrative that, by the way, it goes back to the early...

Speaker 3
In the early 1960s, we've been living with this for decades now.

Nina Teicholz:
So, being a top authority makes it even harder to step outside and tell what I think is closer to the truth about the science, and, you know, one way, I mean, there are a myriad of ways you can understand that this, this kind of dominant idea about a healthy diet is probably not correct.

Nina Teicholz:
I mean, we could talk about the clinical trials that have tested that diet and shown that it doesn't improve health at all and really is, is been found to worsen it. We can talk about the fact that since America adopted this diet, starting really in the early 1960s, we have gotten, you know, we've seen an explosion of diet related diseases.

Nina Teicholz:
So there's sort of all these proof points, you know, now at a point where something like 700 ,000 people die every year from these diseases. So we know what we're doing, what we're telling people to do is not working.

Nina Teicholz:
I mean, how do you, how, I think that, you know, the best, I don't know what, it's really hard to figure out as an individual consumer what works. I think your audience is a bunch of biohacking people.

Nina Teicholz:
And in some ways, like we're really lucky that with diet, we can be our own n equals one experiments, right? We can do our own, it's, there's, there's some limitations to that. And we can talk about, you know, that, which is like, you don't immediately see nutritional deficiencies when you're doing your own, you know, those can take years to manifest.

Nina Teicholz:
But on the whole, we can do our own experiments in ourself, which is not something we can do, say, like, we can't all go and figure out environmental pollution, because we can't do experiments individually on what causes environmental pollution.

Nina Teicholz:
So, but we can all figure out ourselves and see, you know, which of the recommendations out there, be it carnivore, be it vegan, be whatever diet, you know, see what works for you. So, you know, because the other level of trying to understand science and really get to the bottom of it, just takes a lot of work and diligence, and not everybody really has the time to do that.

Nina Teicholz:
You know, that's what I do for a living. And it is, you know, it's, it's a tremendous amount of work, I maybe, if you'll permit, I'll just tell you about this, the column, the piece that I just published today.

Nina Teicholz:
And it kind of illustrates this point really well, that there was a study that came out recently called a, it was a twin study that was done out of Stanford by scientists named Christopher Gardner, very well known, very, very prominent scientist.

Nina Teicholz:
So one of the people you'd think, let's trust him, he's Stanford, he's on the US Dietary Guidelines Advisory Committee, the most powerful expert committee on nutrition in the United States. So this twin study, it turns out, turns out his whole center is funded by Beyond Meat, a meat replacement.

Nina Teicholz:
It turns out that the funding for this study was from a vegan advocacy group that just wanted to prove veganism. I mean, everything, they've given millions of dollars to vegan causes, they funded the movie The Game Changers, which promoted veganism by featuring vegan athletes.

Nina Teicholz:
Turns out Christopher Gardner has been vegan or mostly vegan for 40 years. Turns out they are, they did a Netflix docu -series on this study. And I think one could very well argue that the whole study, which compared twins on a vegan diet to twins on an omnivore diet, and the vegan twins came out looking better on a very selected criteria for heart disease, a highly selective criteria I meant to say.

Nina Teicholz:
It looks like the whole study was designed as a kind of public relations stunt to be a sort of fig leaf of science for a Netflix film that is designed, it's propaganda. It's designed to sell veganism, and the science is secondary.

Nina Teicholz:
It was not really the point. That's just the conclusion I'm forced to come to after looking at the science in the study, looking at all the funding behind it, the funding behind the center, looking at the center's goals and aims, which is all about advocacy.

Nina Teicholz:
It's just about how can we get more people to adopt a plant -based diet. There's really nothing about asking the scientific question, let's find out if this diet is really healthy to begin with. You can't be doing advocacy for an idea and also simultaneously say, well, we're not sure, you know, we're going to ask the scientific question, is this diet even healthy?

Nina Teicholz:
So that just gives you an example, like, well, I mean, here's one of the most respected scientists in nutrition in the country. So really, who do we trust? It is a really difficult question. At the column I did before was on the Harvard Department of Nutrition, which is a very similar story and really eye -opening, I have to say really, really eye -opening.

Melanie Avalon:
Yeah, I was actually reading last night, prepping for another show, and they were talking in the book about the origin of the concept of paradigm shifts, and I guess the guy who came up with it, and it was forever ago, I think it was like in the 1600s, am I making that up?

Melanie Avalon:
It was a while ago. But he basically said that in order for ideas to change, the people have to die. That's really the only way. Time is the only thing that can do that.

Nina Teicholz:
Yeah, I think that's Thomas Kuhn's idea to have paradigm shift. However, what I have observed in nutrition, and remember the original idea that fat, saturated fat are bad for health, so therefore we should cut back, and cholesterol.

Nina Teicholz:
So we should cut back on animal foods and eat more plant -based foods. That goes back to the early 1960s as official policy, and now we're 60 years later. Well, that's a couple generations in there, at least, right?

Nina Teicholz:
So what's happened in this field is that there are so many money interests. So you've got the food industry, the pharmaceutical industry, it's just a multi -trillion dollar set of interests behind our current advice.

Nina Teicholz:
You have institutions like the USDA and the American Heart Association that do not want to fundamentally change their advice because they would lose the trust of the public. What you see is that one generation of scientists simply passes on the idea to the next generation of scientists.

Nina Teicholz:
And they do that, in part, they select those scientists who are going to agree with their own ideas. I mean, I go through a number of stories in the 1970s and 80s about the scientists who disagreed with this prevailing hypothesis that it was saturated fat and cholesterol that caused heart disease.

Nina Teicholz:
The scientists who disagreed, they were maligned, like John Yudkin, who famously who proposed that it was sugar that caused heart disease, not fat, they were called names, they were accused of being financially motivated, they were disinvited from conferences, their papers were not published, all of these instances I document.

Nina Teicholz:
And so what do young scientists learn coming up? They learn not to stick their head above water, they learn not to go down an unpopular path because it will not result in the rewards of science, which is to be able to publish your work and get research grants.

Nina Teicholz:
And so that is also why I'm a journalist, Gary Taubes is a journalist, why some of the most independent thinkers and the people able to write and talk about this science are people who are truly independent.

Nina Teicholz:
I receive no money from any industry. I know, Gary, the same is true for Gary. We don't have brands, we don't sell things, we really, so we're independent, but we're also our careers are not dependent upon making nice to our senior scientists who is in control of either bringing along our career or bringing it to a grinding halt.

Nina Teicholz:
So yeah, so it's very hard for science, I think, and probably much harder in really in many fields, but especially in a field that is so suffused by money. And one could also say ideology because veganism for some truly is a religion.

Nina Teicholz:
For people of the Seventh -day Adventist Church, it is actually a religious belief. So, and other people feel like it's sort of a quasi -religious belief for some people because they feel like they wanna do good by not eating animals, by doing what they can for climate change, and they really believe that veganism is the way to do that.

Nina Teicholz:
So there's just so many vested interests involved that it's, I think that it's unlikely to change. In fact, I think it's less likely to change now than it was 20, 30 years ago because, yeah, just because the moneyed interests are much stronger now.

Melanie Avalon:
And this is so interesting because you predicted in your book an ultimate eventual ban on trans fats, which we've now seen happen. So even with changes happening like that, or like, and you mentioned like the Beyond brand, and I know, aren't they not doing as well as projected?

Melanie Avalon:
So even with things like that, so they aren't.

Nina Teicholz:
And so those are like, those are positive data points. I think also we could just mention more people are drinking whole milk. It looks like the bill to get whole milk back in schools is going to pass Congress in the upcoming weeks, which would be one

Melanie Avalon:
Is it just that milk right now? I haven't been to school.

Nina Teicholz:
While, it's only 1% are non -fat are allowed, and that is why so many kids have switched over to chocolate and strawberry milk, like thereby delivery, because 1% are non -fat milk really tastes terrible.

Nina Teicholz:
It's like water, watery. It is. Yeah, there are some positive data points. I mean, I wrote about trans fats looking at the ban, again, for my PhD thesis, and to explain why, yes, we had the ban on trans fats, so why is it so hard to get official policy to respond to the science on saturated fats, say?

Nina Teicholz:
Why is it so hard to get, or on a low carbohydrate diet? I mean, our officials barely recognize a low carbohydrate diet, which has a vast amount of scientific studies behind it now. And the answer is, I think, that trans fats, nobody really even knew about trans fats, so there was not really an official, there was not a whole set of scientists who were devoted to protecting their pro -trans fats careers.

Nina Teicholz:
There were not institutions invested in pro -trans fat recommendations, so there really wasn't a lot, there weren't a lot of interests threatened by a ban on trans fats. It's very different with saturated fats, where practically every nutrition university department in the country has come out against saturated fats.

Nina Teicholz:
And every institution, the American Heart Association and every public health institution has come out on the record saying that saturated fats are bad for health. So it's just a lot harder to change some of the more entrenched pieces of advice, I think, due to the fact that there's just institution and individual interests, so much cognitive dissonance in those areas.

Nina Teicholz:
Yeah, I mean, it's not to be completely pessimistic, because on the other side of the ledger, you have now huge amounts of money behind fake foods, which as you say, I mean, Beyond Meat is not doing that well, and neither is, say, some of the other fake replacement food companies, but they still have the entire, all the investors behind them, the United Nations wants to replace, they're going to use regulatory power, I think, taxes and other forms of regulation to really push these foods on us.

Nina Teicholz:
I mean, maybe that sounds like a little draconian, but I think their governments are so involved in trying to get rid of animal foods now for climate change, which they, there's just a sense of urgency around it that I think that these private companies, even though they haven't been successful in the marketplace, may get a boost from government regulations.

Nina Teicholz:
I don't know if that makes sense to you, but.

Melanie Avalon:
Rob wolf talks about that a lot actually which is like really scary i mean i've heard people talk about the concept of. Basically tying it into people's credit scores and stuff and having people that might relate to me to be going like really dark but basically like your habits and tying it into whether or not it's green or not and having some sort of scoring system i can see how it could become a power thing real quick.

Nina Teicholz:
Well, so that's sort of like the social credit score that they have been able to employ in China. And that's an authoritarian dictatorship. I mean, I hope we never see the likes of that in the United States or any Western country, but I think they can, and they have made meat much more expensive.

Nina Teicholz:
It's harder to afford, and they are forcibly taking farms, cattle ranchers out of production, whether through just taking land as in Ireland or the Netherlands or in creating so many regulations and rules that it's almost impossible to stay in business as a rancher.

Nina Teicholz:
So they are making meat more rare and more expensive. And I think, so I don't know if people are going to then move over into the fake food or the, you know, sector, or they'll just, or they'll just eat, I don't know, more soy.

Nina Teicholz:
I don't know what people will do. But then there's just like this Netflix film on the Stanford vegan twin study. They're just going, there's going to be, I think, a constant push to try to nudge people's behavior.

Nina Teicholz:
And in fact, Chris Gardner at Stanford has, I guess, what he calls, I think it's called the stealth nutrition effort that he's extremely proud of about basically how to change people's eating habits and nudge their behavior in a certain direction by kind of using non -health arguments.

Nina Teicholz:
Like how can we use climate change to change the way people eat? How can we use animal rights issues? How can we use labor issues? Like let's use all these other issues to, and conflate them with better health, which they aren't.

Nina Teicholz:
And, but let's try to nudge people towards eating less meat based on all these other issues. You know, we certainly see a lot of that in the press. So there's, so I guess there are, there are other means of trying to push to change people's behavior and to confuse them about what is healthy and what is not healthy.

Nina Teicholz:
So I don't mean to be too dark about where we're all going, but at the same time, just to add a positive note, I do see just maybe it's just my feed, but I see so many people interested in getting sugars and grains out of their diets and people just revolutionizing their health.

Nina Teicholz:
I mean, I see this on social media and I see, you know, I see that people who become healthy then become change agents in their communities and change the diets of people around them. So, you know, I'm not without hope.

Nina Teicholz:
I also think that the science is so incredibly strong that it's very hard to ignore at this point. You know, if you can reverse diabetes in a month by getting out, getting sugars and grains and other carbohydrates out of your diet.

Nina Teicholz:
I mean, that's, that's very powerful.

Melanie Avalon:
You answered one of the questions I had because I was going to ask you about, I found it so interesting why they pick things that they pick to focus on. So I was always like, why is like trans fast the thing that got labeled and focused on?

Melanie Avalon:
So I'm so glad that you address that. Honestly, it feels like the only way to have completely unbiased, well, even then it would be hard. But the way I see it would happen would be if there were independent journalists who aren't even invested in the ideology at all.

Melanie Avalon:
Like basically people who don't care about the subject writing about it, which would not happen because why would people who don't care about it write about it?

Nina Teicholz:
No, I was going to also say there are two problems with that. One is that people who don't know anything about it, it just takes a long time to really understand the field. So I've seen so many articles by pretty well -meaning journalists try to understand it, but it is a very complex set of subjects.

Nina Teicholz:
Not only study methodologies, things that can go wrong with studies and subtle ways that studies are influenced. And then your average reporter is going to have a hard time disregarding somebody from Tufts, Harvard, and Stanford, and believing some non -credential person instead.

Nina Teicholz:
That's just not what a normal reporter feels comfortable doing if they're not experts in the field. And then nutrition is also not an area advertisers want to see. So I've seen the amount of serious nutrition reporting even on sugar, which should be kind of a slam dunk.

Nina Teicholz:
It used to be that you would see investigative news sites in the New York Times, even. There was a lot of investigative work on sugar and how it was making its way into all of our food. And what were the forces pushing sugar?

Nina Teicholz:
And now there's almost nothing. And I think that's because there's now a lot of funding of news sites that comes from philanthropies. Like say Bill Gates spends a lot of money on journalists and invested journalism sites.

Nina Teicholz:
And so if he doesn't want sugar investigated, which he might not, I don't know, but you just won't see it being featured anymore. So that's when we have a lot of money flowing in. But even if it weren't from philanthropies, what do advertisers want?

Nina Teicholz:
They do not. We have a lot of pharma funding. We have a lot of food funding. They don't want to see stories about people getting ultra -processed junk food out of their diet and getting healthy. That's just not what they want to see in their pages.

Nina Teicholz:
And it's kind of fascinating with Wagovi and all these skinny shots coming out that you started to see articles that I never thought I would ever see, which is how Kellogg's hates trying to stop Wagovi because it cuts into...

Speaker 3
their profits. So yeah, you're starting to see revealed like

Nina Teicholz:
of the bare bones of the incentives that go into our news coverage, which is that big food and big pharma just do not want articles about how people can get healthy by avoiding drugs and eating well.

Melanie Avalon:
or what's even more ironic, I was reading something of it the other day. It was one of the big companies and they were responding to Ozimpic. And I don't know if you saw this, basically people losing weight on Ozimpic and not eating as much processed foods.

Melanie Avalon:
So it was basically them responding to the, having to tackle the issues of just people not eating the processed foods, but because of losing weight on that drug, which I thought was so, so interesting.

Nina Teicholz:
Yeah, I do too. That's the whole, yeah, it's very interesting. I think what you can see is there's sort of this concept called the Overton window, which is the window of conversations you can have in the mainstream.

Nina Teicholz:
Like what are the boundaries of what we can talk about? And for a long time, that Overton window did not really include obesity because it was considered fat shaming. And you can't talk about obese as being bad or even unhealthy because that would make overweight or obese people feel badly and it was shaming them.

Nina Teicholz:
That has completely shifted, right? With these new GLP -1 inhibitors, like Wegovi, that conversation we are now allowed to have. We can talk about how people want to get thin, how people crave having a nice body and how that matters to them.

Nina Teicholz:
That is that shift in this Overton window of the topics that we can discuss that happened with the introduction of these new drugs. And that happened because I think you can sort of hypothesize that who controls that Overton window of what we can and we cannot discuss, very powerful interests.

Nina Teicholz:
In this case, you would have to say the makers of pharmaceutical companies that make these weight loss drugs.

Melanie Avalon:
I've been so fascinated by the whole health at every size movement, especially because if you look at the factors of metabolic syndrome, and it's these list of factors, and it's the visceral fat factor of that one that was not okay to talk about health -wise.

Melanie Avalon:
Everything else, it's like, oh, if you have high blood pressure, that's a problem. Or if you have high blood sugar, that's a problem and we need to address it. But with the fat deposits on your body, it was like we couldn't talk about that.

Melanie Avalon:
Because then you weren't accepting yourself.

Nina Teicholz:
Right, which is completely absurd. I mean, being overweight, not, you know, a little overweight is not associated with increased risk, but being a lot overweight or obese increases your risk of every single other disease.

Nina Teicholz:
It is formerly the number one risk factor for diabetes, which is in turn the number one risk factor for heart disease, and it increases your risk of every kind of cancer. I mean, it's absurd to say that an obese person is as healthy as a slender person.

Nina Teicholz:
It's just not true. And there's so many statistics that bear it out, but our ability to have reason -based conversations about that or any number of topics in health and nutrition is limited, I think, by the fact that we don't, we don't particularly have a free media right now.

Nina Teicholz:
Not particularly, yeah, we simply don't.

Melanie Avalon:
That is so fascinating what you pointed out about the paradigm shift that we were able to have surrounding weight and health because of these pharmaceuticals that are weight loss drugs and then what you just said about just the funding behind everything.

Melanie Avalon:
So if you could flip a switch and have a paradigm shift, like a paradigm shift switch and you flip it and now it's all the science that you believe is accurate as far as the role of saturated fat and meat and everything and diet.

Melanie Avalon:
But the reason behind that is because it's funding on that side. Would you flip that switch?

Nina Teicholz:
You're saying, like, if I came out with a set of guidelines that I believed were evidence -based and based in good science, they would inevitably be aligned with some set of interests. I mean, if I said, I think there's no harm, and in fact, there's benefit in eating meat, especially as compared to some other protein sources, that would line up with the interests of the meat industry, but it doesn't mean that the meat industry funded my views or funded that science.

Nina Teicholz:
So maybe I'm not understanding your question.

Melanie Avalon:
So not you per se, but if you could flip the switch and the prevailing ideas would be these ideas that you believe and that you talk about in the book and then we're talking about now and that a lot of my listeners subscribe to as well.

Melanie Avalon:
If it was the same situation as it is now with funding from that side and maybe they are also trying to kind of have something similar to that. Still nutrition. And I get what you're saying that if it is the truth in a way it doesn't really matter because it would be supporting the accurate state of things and the accurate truth about the situation.

Melanie Avalon:
But if, yeah, I don't know if I'm asking this correctly.

Nina Teicholz:
Let me maybe reframe it in a slightly different way. If we were to say, okay, the current dietary guidelines are the healthiest, Kaylee, just to review, more fruits, vegetables, whole grains, nuts, seeds, low -fat, dairy, lean meat.

Nina Teicholz:
What is the rigorous clinical trial evidence to support that? I did a cover story for the BMJ magazine in 2015 in which I went through all the evidence. I mean, every single study that had been used to support and justify those current existing guidelines.

Nina Teicholz:
And I showed that there were zero clinical trials. That's what I read, I think, last night. Yeah, so there are zero clinical trials to support our current dietary guidelines. And in fact, if you look at clinical trials, like the largest nutrition trial ever undertaken in the history of science, what's called the Women's Health Initiative on some 49 ,000 women who followed, they were literally just given a copy of the dietary guidelines and told to follow it.

Nina Teicholz:
Lowered fat, lowered saturated fat, less meat, more fruits and vegetables for over seven years on average. And at the end of that experiment, which was powered for cancer, which not many studies are because it's hard to get actually outcomes on cancer.

Nina Teicholz:
It takes a long time to develop. There was no benefit of that diet for anything. For obesity, there was like a two pound difference, diabetes, heart disease, or any kind of cancer. And they looked at three or four different kinds of cancer.

Nina Teicholz:
No benefit from the dietary guidelines. A more recent experiment, which was more highly controlled and is totally fascinating to me, was where they compared the dietary guidelines to what we might call a junk food diet.

Nina Teicholz:
More fat, which I don't think is bad, but a lot more sugar, more desserts. You could have as many, you could snack on jelly beans all day long. There was more refined grains. Okay, so at the end of that experiment, which I'm not sure I can remember, six months or maybe a year, they found that there was no difference in health at all, except for one measure of blood pressure, which was slightly better for the women who had been given the dietary guidelines.

Nina Teicholz:
And they actually, sort of the people who were following the guidelines, it was all women, they had what is so -called dietary guidelines adherence score of 99. So they were totally following the guidelines versus what's called the typical American diet, which their score was in the 60s or something in terms of adherence.

Nina Teicholz:
So that was a good trial on the dietary guidelines. There is no support for the current guidelines. Okay, so let's just say, so that's the rigorous evidence in what it shows. Let's shift over to the vegan diet, which people think must be based on clinical trials because everybody is embracing a vegan diet.

Nina Teicholz:
Well, it turns out there are no long -term clinical trials on a vegan diet, showing that it's more healthy than another controlled diet. In fact, there have been experiments done, but they don't show any benefit.

Nina Teicholz:
And so there are precisely zero trials on a vegan diet, comparing it to a controlled diet. And now there's this vegan twin study, but that's only eight weeks long. It only, you know, it was very selective how it looked at outcome data, but really it's just eight weeks is too short.

Nina Teicholz:
Okay, so that's not evidence -based. What if we shifted over to a low carbohydrate diet? Is that evidence -based? So again, we're just, we're talking just about the evidence -based, not about whether or not this is aligned with this or that food interest.

Nina Teicholz:
The evidence -based for the low carbohydrate diet, there's probably some 200 clinical trials on the low carbohydrate diet. It has been shown to reverse diabetes, like 50% of the population in multiple clinical trials can reverse their diabetes within 10 weeks, more than 50%, and those results are maintained at two years.

Nina Teicholz:
It has been shown in every, almost every, you know, head -to -head trial of its low carb up against low fat, up against any other diet, the low carb diet always does better for weight loss. It may not do spectacularly better, but it does better.

Nina Teicholz:
And it improves in the trial that they did at the University of Indiana that was funded by Virta Health. It improved 22 out of 23 markers for cardiovascular disease, thereby, you know, very likely reducing somebody's risk for cardiovascular disease.

Nina Teicholz:
Okay, so do we have a 10 -year trial on the low carbohydrate diet? No. But... At the moment, it has more evidence with better outcomes than any other diet. But let's take the Mediterranean diet, which people also think, wow, the Mediterranean diet, everybody talks about that too, and that must be healthy.

Nina Teicholz:
There is one clinical trial on the Mediterranean diet that is long -term, conducted in Spain, called Pretty Med. That trial, it turns out, was retracted and then had to be reissued, and there are still serious doubts about whether it was properly randomized.

Nina Teicholz:
Its outcomes show that it reduced stroke, but it's really not clear the risk of stroke, but it's really not clear if it reduced any other outcome for cardiovascular disease. And even though we're told over and over, like a Mediterranean diet is low in meat, in that experiment, they did not reduce red meat, and the amount of fat that they ate was 40% of calories, which is way more than we're told to eat in our official recommendations, and they did not reduce saturated fats.

Nina Teicholz:
So that Mediterranean diet is not like the one that we're being told to follow by the American Heart Association, or the US Dietary Guidelines has one too. Their so -called Mediterranean diet style pattern.

Nina Teicholz:
So I mean, if you're just looking at the evidence, comparing different diets, and I understand, there's a lot of different ways to parse the evidence, people will say, but I know all the meta -analyses that have been done out there, and I can tell you that this is a fair rendering, what I'm now saying, of the state of the evidence on these various different diets.

Nina Teicholz:
So if I were to flip a switch, and make our guidelines, which are super powerful, because they're downloaded by all doctors, and nurses, and nutritionists, and dieticians, and everybody, and taught K through 12, and followed by the military, our guidelines are very powerful.

Nina Teicholz:
If I were to flip a switch on that, I would say it needs to be, currently there are over 55% of your calories, or sorry, 50 to 55% of the calories recommended are carbohydrates. I would way lower that.

Nina Teicholz:
For people with metabolic disease, it has to be low carbohydrates. So below 100 grams, and maybe below 20 grams per day, if you have a metabolic disease. And then, there's no reason to restrict red meat, the evidence just does not show that it's bad for health.

Nina Teicholz:
I would remove the caps on saturated fats. There are 25 systematic reviews of all the clinical trial literature on saturated fats showing they do not have an effect on cardiovascular or total mortality.

Nina Teicholz:
And the vast majority of those reviews, they show there's no effect on any cardiovascular events. And then, I would remove the limit on salt, than sodium, because that's also not evidence -based. And yeah, I think that would go a long, long ways towards fixing our problems, which is to say people with metabolic diseases, people who are not fully healthy, should lower carbohydrates, not restrict animal foods, not restrict fat, have medium amounts of salt, salt to taste, really your body can guide you on that.

Nina Teicholz:
And that, I think would just do a tremendous amount probably to improve, I mean, certainly would improve the health of the country.

Melanie Avalon:
It's just confusing because I hear that and I'm like, okay, yes. And then I also hear things, because when you were mentioning this stuff about no studies on veganism and these different outcomes that we're looking for, I had Dr.

Melanie Avalon:
Joel Kahn on the show who's a big vegan cardiologist, and he always says the low -fat, plant -based diet is the only diet shown to reverse heart disease, and I'm like, well, so that's just the complete opposite of what you're saying.

Melanie Avalon:
And I'm saying this because I get this from my audience all the time. They're like, who do I believe? You have this one person on the one hand and then this other person, and I'm like, listen to everything.

Nina Teicholz:
but that's I mean that's an excellent question and I'm glad you brought it up because the idea that it so first of all the vast majority of information of studies that support a plant -based diet are from observational or epidemiological studies that show association but not causation okay that means they can show one thing is associated without another but doesn't necessarily cause it I mean just quick example of why that can lead you astray umbrellas in the street are 100% associated with rain but it doesn't mean that the umbrellas are causing rain it can just be it could be the result of rain which is reverse causation and there are many other pitfalls of those kinds of studies so and in general I think it would be fair to say you know in today's world people following a plant -based diet are making a much greater effort to take care of their health than than most people who are still eating hamburgers and french fries and you know if you're eating hamburgers you're not following your doctor's advice and you're having the milkshakes that go with it and so and all of those other healthy things that a healthy kind of person does they exercise they smoke less there I mean vegetarians have been shown to weigh less not you know smoke less drink less I mean they're just healthier people and you really don't know if it's the diet that is making them look healthy or some one of these other behaviors that's what the majority of studies on vegetarian or vegan diets that's the kind of study they are but there was this one clinical trial I'm so glad you brought it up by Dean Ornish where he claimed to reverse heart disease and I totally recommend I mean I know this sounds like a sales pitch but I really was the first person who dissected that diet that study in tremendous detail really went through his work and discovered you know it was a total of 40 people all men no women the people who got the intervention of the vegan diet also got meditation yoga supplements you know they had this whole kind of multi -dimensional intervention that was not just diet it turned out that Dean Ornish he did this kind of images of the arteries that were supposed to show plaque buildup but it but it turns out that just the amount of plaque you have in your arteries is not what causes heart attacks it's the type of plaque that matters it's the unstable breakaway plaque that causes our heart attacks so just the amount of plaque is not a good outcome a reliable outcome measure and in his study although this so -called bad LDL cholesterol went down so did quite dramatically the so -called good HDL cholesterol so in all you know you could say that's kind of a mix really there as a wash you know it's he having having your HDL drop is a sign of worsening heart disease risk and then finally there were two deaths in the vegan group which is a lot like for only 40 people and there were no deaths in the other arm of the study and if you talked to Dean Ornish and I've been on some numerous

Speaker 3
times.

Nina Teicholz:
He will defend his study to the end, and he'll say things like, oh, well, that person died from something else, or they just became a maniacal exercise. Well, you have no way of knowing if the diet made it...

Nina Teicholz:
You just don't know. You still have to deal with what your outcomes are. That is that single trial for which Dean Ornish miraculously was able to get it published. He got it published in numerous different journals.

Nina Teicholz:
Weirdly, what you're not supposed to do, you're not supposed to do multiple publications of the same study, like the same results. And so he always refers to his having done studies, but really he did that one study, and it's that study that all those claims about reversing heart disease are based on.

Nina Teicholz:
And it's just a weak, small study that had very mixed outcomes in the end. So I think Joel Kahn, and I think I want to say in trying to understand Joel Kahn and some of the other vegan diet doctors, and this is true of a diet doctor from who has any set of beliefs, carnivore, vegan, whatever, they see their patients getting better.

Nina Teicholz:
A lot of people who are on terrible, typical American diets, they will look better if they go on a whole food plant -based diet, right? Because you tend to cut out sugar, you cut out white flour, you cut out processed food.

Nina Teicholz:
Everybody looks better doing that. So they see their patients get better. As I said before, the nutritional deficiencies inherent in a vegan diet don't show up until later in many people. And then if people fall off the diet, they don't come back to your medical practice.

Nina Teicholz:
So you don't even know about them. Like your world is filled, your patient world is full of people who've been successful. The people who are not successful tend just to drop out of sight. So that's true of that is, that's why you have to refer to, you have to rely on clinical trials where people, those clinical trials have to follow everybody and find out what happens to everyone.

Nina Teicholz:
Whereas, you know, a doctor's personal experience will be very powerful to them. They see it with their own eyes. And that's very compelling, but they don't know about the dropouts. So that's why we can't really use, I mean, anecdotal evidence is powerful.

Nina Teicholz:
And I think it can be used to inform decisions in a number of ways, but it just can't be used to inform population wide recommendations because it's not rigorous, it's not rigorous enough evidence.

Melanie Avalon:
Well, I think my closest experience to what you've experienced so many times was I had Dr. Neal Bernard on the show. He actually requested to come on for his study, which was looking at a vegan diet with soy to reduce menopause symptoms in women compared to a standard diet, I think.

Melanie Avalon:
But what was so interesting about it, and I will say in his defense, okay, actually, I'll circle back to that. What was so interesting about the study, this was so mind -blowing to me. I was like, I don't know how you can even draw this conclusion, and I really don't know how you're asking to go on all these podcasts and talk about it, because the conclusion was that it was the soy, that adding the soy is what reduced their menopause issues.

Melanie Avalon:
The only comparison was the vegan women with the soy and then the standard diet. So there was no vegan diet without soy. So how do you know it was the soy? Maybe the soy was making it worse. Maybe a vegan diet without soy would have performed better.

Melanie Avalon:
Literally, I don't even know how the conclusion was drawn. I asked him that when I was interviewing him. He basically said, and this is why I keep getting flashbacks from what you're saying, he said something about how some of the women before had been doing vegan.

Melanie Avalon:
Basically, he was saying that it kind of worked because some of the people before fit the parameter to test that, but I was like, but that wasn't even in the study. I don't know how you can make any of these, but then what I was going to say in his defense was that was a moment where I was like, I'm just going to try to lose all my biases and I'm just going to try to research soy and see what happens.

Melanie Avalon:
And I actually did not to soy, like GMO processed soy, but to whole soy added to diets. It warmed me up a little bit to it. And that also happened to me with grains when I was interviewing somebody else.

Melanie Avalon:
I don't remember who. That adding grains was helpful? Not adding grains, but I think it was when I was interviewing Dr. Bulsawitz. I think I did the same thing. I was like, I'm just going to research whole grains.

Melanie Avalon:
I'm not going to have any bias. I did find a lot of literature favorable. A lot of it was probably correlational epidemiology, but it did warm me up. And this is coming from me. I'm like, like anti -grains, but I did like warm up a little bit.

Nina Teicholz:
I mean, you know, I tried it. I remember when the movie maybe some your listeners remember the movie What the Health came out like 2015 or so and I thought

Melanie Avalon:
Oh, I did a massive, that was frustrating.

Nina Teicholz:
Well, I remember thinking, well, what are the studies on the vegan diet and vegetarian diet? And I went and I looked into the studies by Neil Barnard and Caswell Esselstyn and everything I could find because I had looked at the Dean Ornish studies but I hadn't really looked at everything else.

Nina Teicholz:
And I was really surprised how really poor studies were passed off as being more rigorous kinds of work. I mean, a little bit like what you're describing with Barnard, Barnard has done a number of studies on the vegan diet and he believes in it.

Nina Teicholz:
He has a center in Santa Rosa, completely committed to it but his studies just don't turn up benefits for that way of eating. And he's done at least one two year study and maybe more and it's all taken place in a very biased environment, because they're done at his Santa Rosa Center where presumably everybody's into plant -based eating because it's his center, but they don't produce positive health results.

Nina Teicholz:
Esselstyn, his study was not controlled, meaning had no control group, was published in a sort of very casual family medicine journal, did not follow up on everybody he even had in his study. It was barely a study.

Nina Teicholz:
So I was truly surprised by the lack of scientific evidence for this whole way of eating that had become so prominent in the media and in popular culture I was truly, I was pretty taken aback by that.

Nina Teicholz:
You can still find it if you search, but you have to go through quite a number of Google search pages. If you search my last name and what the health, I did a very, it was for the diet doctor platform.

Nina Teicholz:
I did a very extensive analysis of all the science in that film and I guess what the health was able to bury the search rankings on that, but which is something I've discovered since being in this field as a sort of non -narrative endorsing journalist is that Google rankings are quite, there are ways to manipulate them.

Nina Teicholz:
Well, I guess many people know that and maybe that just sounds very naive on my part, but I didn't realize that it could be done so completely and I've had that experience in just any number of ways, like terrible articles that no one would ever read that turn up on my first page.

Speaker 3
Google results like some letter to the editor in an obscure journal like why is that on that you know that page but anyway that's just good

Nina Teicholz:
to speak to the tremendous interest at work here and why it's, you know, again gets back to the point you made early on. It's very hard to understand and get to the bottom of, you know, what is truth truth and not what is sort of official truth.

Melanie Avalon:
Well, I will search and I'm fairly certain I will go find what you wrote about what the health and we'll put in the show notes and I'm pretty sure I read it and I'm pretty sure it helped me when I wrote my own post about that film as well.

Melanie Avalon:
So I will go find those, I'll put them in the show notes and I will say, like I said last night when I was googling saturated fat, you were like the first thing that came up I didn't even realize so that was you're still in.

Nina Teicholz:
still there. You're still there. Yeah, well, my book, I mean, just to put another little plug for my book, it was the very first publication. It was the very first publication to put together the arguments for why saturated fats had been unfairly villainized.

Nina Teicholz:
I mean, it was the very first place where all those arguments came together about small dense LDL and about I mean, just, it really was a, it's a, it's still a really comprehensive understanding of, if you're confused about saturated fats, it's a, I think, still a very good resource.

Nina Teicholz:
It was also the first place to tell the story of seed oils. I think I might have coined term seed oils, although I'm not sure, but you know, I was, I told the story of seed oils, you know, how they used to be machine lubricants and how they are actually, you know, they're subject to toxic oxidation or oxidation that results in toxic products that cause cancer and heart disease.

Nina Teicholz:
And, and I mean, that whole, that whole narrative, now there's like 100, you know, seed oil disruptors and scouts and, but that all started in my book. And I think I was also, I think it's still the only really complete thorough takedown of the Mediterranean diet, right?

Nina Teicholz:
Like, how do people really eat in the Mediterranean? And then how do we get the US version of the Mediterranean diet? And all the science behind that, which is an incredibly interesting story, also, because it tells how the Mediterranean diet was really sold on the back of a whole bunch of glamorous conferences all over the Mediterranean that were funded by the olive oil council in Europe.

Nina Teicholz:
And it was, you know, they invited chefs and scientists and particularly Harvard scientists to conjure up this idea of a Mediterranean diet and then sell it to the public in the late 1980s and early 1990s.

Nina Teicholz:
So that's really a good read. I mean, so it's still, yeah, I think those are still and then since then I've published some scientific papers and journals that have been able to bring those ideas into a more academic audience.

Melanie Avalon:
Listeners, read the book because what Nina was saying about the Mediterranean diet and the olive oil, I think that, I mean, that's like a page turner, all of that information. And you talk about so many studies in the book that like we've talked about now on the show, but where it's just shocking what was actually in the study compared to what they said.

Melanie Avalon:
Like one of the, I think one of the most shocking ones to me personally was the one that was on olive oil. And you said that they actually didn't measure the olive oil and the...

Nina Teicholz:
Oh my goodness, that was an incredible study published in the New England Journal of Medicine. This is a famous study that was in a top, top, top journal by Antonia Tricopoulos, now deceased, but she was like, she literally was called the mother of the Mediterranean diet, a Greek doctor.

Nina Teicholz:
She published a study based on observational studies, so data, which, so it's, you know, she's a Greek former data, but she was like, and the title in the New England Journal of Medicine was olive oil prevents heart disease.

Nina Teicholz:
And I start looking into this study and I'm looking and I'm looking and I'm looking and I cannot find any measurements of olive oil intake. Like, and I just don't understand it, like, how did this get, like, somebody, it must be there because it's in the New England Journal of Medicine.

Nina Teicholz:
So finally, I reach out to Dr. Tricopoulos and I said, you know, well,

Speaker 3
Where did you, how did you measure olive oil? I must have overlooked it. And she said, well.

Nina Teicholz:
we just asked them about dishes that they ate like you know you know moussaka or whatever any kind of cooked dish and we just assumed based on our recipes the amount of olive oil they must have used.

Nina Teicholz:
Like can you

Melanie Avalon:
Can you imagine? It's like mind -blowing. It's like, it's so upsetting.

Nina Teicholz:
That's not so unusual, actually, as a, you know, as a, I mean, I also discovered that, I guess, maybe it's now relatively well known, but that Ansel Keyes for his super famous seven country study, where he had gone to the island of Crete, where he studied all a total of 30 to 33 men, which who became like, the sole subjects that was the foundation of the Mediterranean diet, like it's based on their diets that he founded a Mediterranean diet concept.

Nina Teicholz:
He went there, one of the three periods he went there was during Lent, which is incredibly strict in Orthodox Christianity at the time in Greece, which was a total abstinence from all animal foods. And therefore he inevitably undercounted the amount of saturated fat that these men were eating, but things like that, you know, you just, you can't you can't sort of believe that the science is quite as bad as it is.

Nina Teicholz:
And also, I think there's an added layer of surprise that really, there are no referees in nutrition science that that the field itself does not recognize or try to correct its own mistakes. There's there are really good nutrition scientists, but as I have come to understand, they really are, those are not the people with the most power or influence.

Nina Teicholz:
And so the ability of the field to police itself and hold itself to higher, more rigorous standards is, is truly lacking in nutrition science, which is, which is part of why we all have such difficulty in getting good advice.

Melanie Avalon:
I totally forgot about this, okay? Because when you're talking about how you were the first person to talk about the saturated fat and even the seed oils, I self -published a book in 2014 or 15, and then I got an agent and published it in stores with WW Norton in 2017 or 2018.

Melanie Avalon:
So I was like, I'm pretty sure I talk about Nina's book in my book. So I just pulled it up on Kindle really quick and just searched your name, and it came up. Okay, I'm going to read you what I wrote, and then I'm going to tell you what happened.

Melanie Avalon:
So this section is called The Defamation of Fat. And so I say, there's a very complicated and twisted history to the vilification of dietary fat. If you want a fascinating perspective of the full story, consider reading The Big Fat Surprise, Why Butter Meat and Cheese Belong and Healthy Diet by Nina Teisels.

Melanie Avalon:
It is Teisels, right? Am I saying your last name? Yes, you are. I'm impressed. I'm having a moment where I'm like, oh, man, what if I'm saying it wrong? Or Good Calories, Bad Calories, Fat Carbs, and the Controversial Science of Diet and Health by Gary Topps.

Melanie Avalon:
So that was all I had in it originally. And now I totally forgot that when I sent it to my editor, actually, was it the editor or was it the legal department? It was one of the, it was somebody giving feedback.

Melanie Avalon:
They were like, you got to put in a disclaimer there about Topps. And I was like, oh, because they were saying that he's controversial or whatever. So then I had to put in in parentheses. Topps is an acclaimed science writer, though I will note that some critics disagree with this lengthy analysis as oft happens in the political health wars.

Melanie Avalon:
I came up with that sentence, but I was like, but I remember I totally forgot about that. Good thing is they didn't say that you were an issue. Not yet, I guess at that point. But yeah, they were not having it.

Nina Teicholz:
That's so unsurprising to me. But it's interesting. You know, I wrote a lot about Gary in my book, I wrote about I think, you know, his really pioneering work in this whole field. And I he was he's like a character in my book, because I believe he is the single most important thinker in the field of nutrition and has done more to create paradigm shift in so far as we have it than anybody else.

Nina Teicholz:
I think he's just just incredible. So I wrote about him as like a character in my book to kind of set his place in history. I think he's an incredibly important person. I mean, he's been doing this since I don't know, you have to be you have to be maybe like a little older because I think it was the the late 1980.

Nina Teicholz:
No, when did he was maybe was maybe it was 1989 or yeah, then he came out with what if it's all been a big fat lie in the cover the cover story of the New York Times magazine. And it the opening scene is about the people diet experts trying to imagine that Atkins, who is so vilified in his lifetime had been right.

Nina Teicholz:
And I remember reading that when it came out and thinking, oh, this is so alarming. And

Speaker 3
At that time, I was so religious, I was completely against fat of any kind.

Nina Teicholz:
Yeah, he's just been a hugely important person in all of this, and I recommend his books too. So, I mean, it's just like there's been, it's been now, I mean, he started really with that article and then I've been at this for researching and writing now for 20 years.

Nina Teicholz:
I don't know if we'll see real change in our lifetimes, but I think what is really fantastic about your work and people listening is that this idea of like biohacking and figuring out what's right for your body and doing your own experiment, I think is very important and powerful for people.

Nina Teicholz:
So, and again, I guess my one, like a big cautionary note is you just really don't know about if you're, if you're going heavily plant -based, you are not going to realize that you are starting to suffer from nutritional deficiencies until it's often quite a number of years before people see, I mean, they have problems with their teeth.

Nina Teicholz:
The way that people see it most often is they have problems with their teeth, their hair starts to thin or fall out or turn white if they're getting older. I think it shows, I think people age more quickly and then you lose muscle mass.

Nina Teicholz:
Yes, it's very hard to keep up with like the amount of complete proteins you need on a vegan diet because animal proteins really are, they're the only truly complete proteins and they come with zero glucose, so no sugar, whereas if you're having beans and rice, that's a lot of sugar you're also ingesting with that protein.

Nina Teicholz:
So yes, so you can't tell right away on that. The other issue that comes up for people is gastrointestinal issues that they start to have after, I don't know, six months, a year, maybe longer. Actually there's a really fascinating story, as I mentioned, the Seventh -day Adventist Church, they promote a vegan diet as a matter of faith that has to go, it goes back to their, like a vision that their founder Ellen G.

Nina Teicholz:
White had when she sort of fell down and envisioned everybody eating like they did in the Garden of Eden, which was only fruits and vegetables. So that's the source of their beliefs and I'm in the process of writing a story about how at the headquarters of the Seventh -day Adventist Church in San Sacramento, California, the incredible health issues that their leaders have suffered from, even though they believe in it, 100% how much they're suffering have suffered and the results of a health clinic that's opened up there, I think that might be interesting.

Melanie Avalon:
Wow, when are you publishing that? I don't know yet, TVD. No, I'm so glad you drew attention to all of that because I think it's so, so important, especially the protein piece. We talk about that on the Intermittent Fasting podcast all the time.

Melanie Avalon:
We're so passionate about that. I mean, it's hard enough with animal products for people to get enough proteins often. And I think it's such an issue with the plant base as well. And I should ask you really quickly, just because it's like reevaluated, like, you know, retracted or they had to reevaluate it.

Melanie Avalon:
Didn't they say that it was the same conclusions still? They did.

Nina Teicholz:
So, first of all, we have to point out how highly unusual it is to retract and republish a study in the same day. Usually a study... The same day? Yes. I think because that study was really the linchpin for the Mediterranean diet, which by that point, just to understand, okay, so pretty much came out in, I want to say 2013 maybe, but the Mediterranean diet had been launched in America in 1993.

Nina Teicholz:
So it had been a product of, it's been endorsed by Harvard for 20 years before a really decent study came out on the diet. So there was a lot riding on this study, right? And let's just also acknowledge that it was in part, maybe in large part, funded by various food industry groups in Spain that benefited like the tomato producers and I think maybe dairy also funded it and the potato producers.

Nina Teicholz:
But it came out, there were questions about its randomization, it was retracted and republished in the same day, which I've never heard of ever happening with any other study could have happened, I just don't know about it.

Nina Teicholz:
And they said, we came to the same conclusion, we tried to fix the randomization, but randomization is it, it's not like a statistical analysis, it's something that you do early on in the study. So it's...

Nina Teicholz:
It just wasn't randomized, right? They like... It was randomized by... Yeah, it wasn't randomized by individual, it was...

Melanie Avalon:
Do they think it would be easier for, like, people in the same families or something to... Exactly.

Nina Teicholz:
or in the same Eric neighborhoods, even, or villages. But then, John Ioannidis, who is a very famous professor at Stanford University, his team published an analysis of the new Pretty Med study, and they said, based on their analysis, there were lingering questions about the basic soundness of the Pretty Med findings.

Nina Teicholz:
And John Ioannidis is Greek, right? So he loves the Mediterranean diet. It's near and dear to his heart. But he said he thought that that study still had like significant lingering doubts around it. So, I mean, I think even if you take it on its face and accept it, the findings, the primary outcomes of that study was cardiovascular events as a group.

Nina Teicholz:
So that thing, you group together things like heart attacks and angina and strokes, but really the only difference, and it was really only seen in the first year, was in stroke. And there really was not a significant change in the rest of the cardiovascular events.

Nina Teicholz:
So it was just stroke. And so that's a smaller finding. But again, this is the sole study that is the foundation, the sole clinical trial that is the foundation for the entire American Heart Association's advice.

Nina Teicholz:
I mean, I went digging way down deep into all of their guidelines and discovered at the end of the day, all you could find, the only clinical trial they cite is Pretty Med. So there's just a lot writing on this study.

Nina Teicholz:
And it hasn't been replicated, which is also a problem for science.

Melanie Avalon:
That's something that's actually been haunting me for a long time because I hear, it's like multilayered. Like, you hear pridymed, and then you hear, well, it was retracted. So then it's like, okay, no.

Melanie Avalon:
But then you hear that they have the same conclusion. So then it's like, it's like every step you go, it's like, wait, it's like frustrating. So now, now I know that there's like another analysis. So yeah, it's like the endless background.

Nina Teicholz:
and forth. Like we could have, yeah, because you know, you understand on both sides, there are these huge, well, really, there's just these huge interests behind pretty meds. So letting that you know, if you are john ewenees, and you publish little study, I mean, there's gonna, there's gonna be every effort to sort of bury that.

Nina Teicholz:
But and again, like, pretty med does not represent it's not this American Heart Association diet, it did not promote. It did not promote vegetable oils, it was olive oil. It did not reduce red meat.

Speaker 3
It wasn't, it wasn't our

Nina Teicholz:
the US version of when we throw around the idea of the Mediterranean diet. We were talking about something very different than what was tested in that trial.

Melanie Avalon:
Again, for listeners, I can get the book. The Mediterranean diet stuff is just like fascinating, it'll just blow your mind. Maybe that's a good question just to end on. And thank you so much for your time, by the way, this has been absolutely so amazing.

Melanie Avalon:
A big question I had was, because you go through the very lengthy history of Ansel Keys and his role, and then also things like we just talked about with the Mediterranean diet and olive oil and all of that, do you think those were beneficial shifts in the fact that like he did create a paradigm shift on the importance of diet and how it relates to health.

Melanie Avalon:
And then like with the olive oil stuff and the Mediterranean diet, it's like that did create a paradigm shift bringing back in some sort of fat, even though it wasn't saturated fat. Yeah, so you feel like there were some benefits from those paradigm shifts or in a parallel universe could have just been a completely different way.

Nina Teicholz:
I think Ansel Keys' impact on nutrition has been 100% negative. I mean, and I say this when I say his study was his seven -country study was pioneering, ambitious. He was clearly a curious, brilliant man.

Nina Teicholz:
When he undertook that seven -country study, he was, they were on little dirt roads, traveling to places, trying, you know, getting there and setting up little units to measure people's cholesterol and trying to figure out their diets and what they were eating.

Nina Teicholz:
It was a pioneering, ambitious study, but he was not a scientist. He, just circling back to like Christopher Gardner at Stanford, Ansel Keys, like Christopher Gardner, has an idea about a healthy diet.

Nina Teicholz:
For Ansel Keys, it was reduced saturated fats, replace it with polyunsaturated vegetable oils, and lower your cholesterol. And he would not budge from that idea, no matter how much information to the contrary surfaced, which was a lot.

Nina Teicholz:
While in his lifetime, 67 ,000 people were tested on his idea. I mean, he should be honored. There is perhaps no person in the history of nutrition science who's had their idea tested in experiments all over the world.

Nina Teicholz:
And none of those experiments could show that his diet, that it reduced cardiovascular total mortality, or as I said, most of those, most of those studies showed no reduction in cardiovascular events at all.

Nina Teicholz:
So, you know, he had his day, but he never accepted any of the information to the contrary. He took an active part in blackballing people who opposed him or, you know, wrote scholarly articles with different points of view.

Nina Teicholz:
He was hugely aggressive about trying to snuff out the competition. And he was wrong. He was, you know, I mean, it's fine to be wrong. But then if you are a true scientist, and you see that multiple tests of your hypothesis cannot show it to be true, you just have to back down off of that hypothesis and say, you know, I guess I got it wrong.

Nina Teicholz:
And if he had done that, we would be in a much different world today.

Speaker 3
So, you know, that sh-

Nina Teicholz:
shift away from saturated fat and cholesterol, which effectively meant reducing meat, dairy, shellfish, eggs, and over to grains and vegetables has been, I would argue, really disastrous for health. So I can't see really any benefit to Ansel Keys having been such an important and prominent, probably the most influential nutrition science in the history of the field.

Nina Teicholz:
Sorry to disappoint you, Melanie.

Melanie Avalon:
No, no, no, no, no, no, not disappointing at all. I mean, and again, for listeners, read the book to get the whole history. And what's so interesting is I feel like now that's like common knowledge that we all know that about him.

Melanie Avalon:
And I really that was probably due to you and I mean, you and Gary's work. Yeah.

Nina Teicholz:
Yeah, I think I was basically the one who really put together a picture of his personality and also his bullying tactics. I document those and really talk about them. I think I would sort of paint that picture why my book is particularly disliked by his Aunt Keys' surviving colleagues on the seven -country study, they really dislike it.

Nina Teicholz:
But I think it's a fair explanation of his character. I encourage people to make their own decisions about whether or not I grew to be biased over the course of writing my book. Remember, I started as a vegetarian for 25 years, so it took a lot to convince me.

Melanie Avalon:
Oh, man. I love it. Well, thank you so much, Nina. I'm just so in gratitude for everything that you're doing, and you're changing so many lives, and I can't thank you enough for your work, and listeners, get the book now.

Melanie Avalon:
The last question I ask every single guest on the show, super easy, super quick, and it's just because I realize more and more each day how important mindset is. So what is something that you're grateful for?

Nina Teicholz:
I'm grateful for my ability to feel gratitude about small, small everyday things. Having a practice of just feeling gratitude helps enormously. So, yeah, I know that's a little tautological, but I think that's it for today.

Melanie Avalon:
I am. No, I love it. I'm the same way. Like there's just so many little things and you can be grateful for it. Like it doesn't have to be this like grand overarching, you know.

Nina Teicholz:
Yeah, I mean, I really practice that in a Buddhist way, like I'll be washing the dishes and either you can hate it or you can say, I'm just going to try to enjoy this in whatever way possible, or, you know, whatever.

Nina Teicholz:
It's just it's it just makes it just makes one feel better and happier. It's not always possible. Let's acknowledge but I do try.

Melanie Avalon:
No, I love that. I don't think anybody said that before. I love that. Well, thank you, Nina. This was everything. I hoped it could be a more, and I will eagerly be looking for all of your future work.

Melanie Avalon:
And just thank you. Thank you for what you're doing. Thank you so much. I really appreciate it.

Nina Teicholz:
Bye.