Wednesday, March 13, 2019

Book Review: The Big Fat Surprise

“If saturated fat is healthy, why doesn’t xxxx say so?” The Big Fat Surprise provides the answer to that question, whether xxxx is “my doctor,” “the government,” or “the American Heart Association.” Author Nina Teicholz provides a detailed explanation of how a weak hypothesis has led to low-fat diets dominating nutrition discourse in the American public, government, and academia for the last several decades. She details the confluence of factors that helped demonize historically prized saturated fats such as those found in dairy foods and beef. These factors include cherry-picked data, charismatic and bullheaded scientists, vegetarian leanings, industry financial influence, groupthink, institutional inertia, and the well-intentioned act now attitude of a politician and his team.

America’s fear of animal fats started in the early 1950s with the work of scientist Ancel Keys. Using epidemiological data from just six countries, he published a paper showing an association between dietary fat intake and heart disease. With that, the diet-heart hypothesis (alleging that dietary fat causes heart disease) was born. There were many problems with the study and it was only powered only to show correlation (not causation). Nevertheless, Keys promoted his hypothesis strongly. Keys had a strong and persuasive personality, and he responded to critics with vigor. Despite many scientists’ disagreements, Keys’ hypothesis persisted. Despite twenty-two countries showing an at-best nebulous link between fat intake and heart disease, Keys’ hypothesis persisted. Despite ample evidence of healthy populations (Inuit, Masai, and Navajo) eating high-fat diets, Keys’ hypothesis persisted.

The American Heart Association (AHA) got its first big infusion of finances in 1948, so it saw a great deal of growth in the 1950s. This coincided with the timing of Keys’ popularization of his fat-fearing hypothesis. Keys was close to leaders in the AHA and the organization adopted this diet-heart hypothesis as a guiding truth. Over time, the hypothesis evolved to include concern about serum cholesterol levels, which are often elevated by saturated fat consumption. By 1961, the AHA recommended polyunsaturated fats (PUFAs) from industrially processed seed oils as part of its otherwise-low-fat “prudent diet” because of their cholesterol-lowering tendencies. Despite evidence that high triglycerides were more indicative of cardiovascular issues than high cholesterol, the AHA promoted the prudent diet. Despite evidence that high HDL cholesterol (raised by saturated fat) was actually protective, the AHA promoted the prudent diet. Despite a 1967 Indian study showing Southern Indians getting heart disease at 7 times the rate of Northern Indians while Northerners ate 8-19 times more fat, the AHA promoted the prudent diet.

The diet-heart hypothesis remained entrenched in the AHA’s recommendations and in the minds of the American public. In 1977, a small government committee led by Senator George McGovern met to investigate the link between diet and heart disease. McGovern’s team issued Dietary Goals for America that were in line with the AHA’s prudent diet. The central diet-heart hypothesis remained unproven, but the well-intentioned report stated that its authors “cannot afford to await the ultimate proof”. Three years later, those goals were built into the Dietary Guidelines for Americans. Similar logic (“What are the risks associated with eating less meat, less fat, less cholesterol?”) was used to dismiss criticism from a nutrition task force prior to issuance. The idea that saturated fat could be replaced by something worse was not considered realistic. The low-fat diet was assumed right (for everybody) until proven wrong. By 1980, this assumption suddenly had the backing of the AHA, the processed food industry, and the American government. Despite a growing chronic disease epidemic, these same groups continue to promote a similar diet today.

On top of going into detail on the history of America’s dietary guidelines, Teicholz covers many interesting topics, including:
  • the history of American red meat consumption
  • a fascinating comparison of animal-food-eating Masai vs. geographically similar plant-based Akikuyu
  • the dangers of PUFA consumption 
  • cases of the AHA historically supporting and promoting foods now known to be harmful
    • trans fats
    • hard candy, sugar, syrup
    • breakfast cereals getting stamped with AHA "heart-healthy" sticker (for a fee) 
    • PUFA-laden industrial seed oils (the AHA still recommends these) 
  • potential impacts of low-fat diets for children
  • the misleadingly-defined Mediterranean Diet
  • a history of trans fats
  • science and history showing the healthfulness of low-carbohydrate, high-fat diets

Readers of The Big Fat Surprise will learn a great deal about the history, the personalities, and the organizations that shaped America’s dietary guidelines. By spending a decade of her life investigating the issue from every angle, Teicholz masterfully shows that the diet-heart hypothesis emperor has no clothes. Her passionate work demonstrates that saturated fat has been wrongly vilified for the last fifty years. Above all, The Big Fat Surprise teaches that an idea can become widely accepted for a diverse set of reasons that does not include truth.

Thursday, February 14, 2019

Clinical Experience Using Low Carb (Part 1)

A lot of what is written about in this blog probably seems a little abstract. But real, effective results trump all. And real, effective results are what many doctors are getting by using low-carbohydrate, ketogenic, and even all-meat diets for their patients.

This approach can be effective enough to reverse things as seemingly different as diabetes, joint pain, anxiety, and gout.

Here are some brief notes from a recent podcast with Dr. Ken Berry where he describes the results his patients have from adopting a ketogenic way of eating:

Friday, February 8, 2019

Book Review: The Alzheimer's Antidote

Alzheimer’s Disease (AD) is generally viewed as an unstoppable disease with a cause that is too complex to understand or prevent. Amy Berger, author of The Alzheimer’s Antidote, counters that AD may not be as enigmatic as commonly believed. Medical literature often refers to AD as “Type 3 Diabetes” and like most chronic diseases, it is related to chronically elevated insulin. Berger is far too nuanced and too practical to claim bulletproof treatment or prevention of this dignity-robbing disease. However, her approach of using a ketogenic diet and other lifestyle modifications is an important step towards improving cognition in AD-afflicted people. Some of the same tactics can also mitigate the risk of developing AD in the first place.

This is the only way I could make the review any more glowing.

Berger postulates that the defining factor of AD is the brain’s inability to properly fuel itself via glucose. The good news is that brains unable to properly metabolize glucose can still metabolize ketones. Ketones are produced by the liver when one eats a very-low-carbohydrate diet, so Berger promotes this ketogenic way of eating (along with other ketone-boosting interventions) to improve cognition in a person suffering from AD.

The book highlights the work of Dr. Dale Bredesen. In contrast to the disappointing results from drug-based AD treatments, Bredesen’s work has been largely successful. His ketogenic approach has allowed many of his severely AD-impaired patients to go back to work and lead their normal lives. Berger shares his quote: “AD is not a mysterious, untreatable brain disease-- it is a reversible, metabolic/toxic, usually systemic illness with a relatively large window for treatment.

Berger discusses brain health from many angles, and she spends lots of time underscoring the value of cholesterol for a healthy brain. She is highly critical of the idea of cholesterol-lowering medications (statins) and calls out the fact that people who take them have increased risk of brain fog, cognitive impairment, depression, hormonal imbalances, diabetes, low libido, infertility, and memory loss. Furthermore, antacids (e.g. Pepto-Bismol) and proton pump inhibitors (e.g. Prilosec) can lead to brain-atrophying vitamin B12 deficiency. With common usage of these drugs and with common diets being nutrient-poor and insulin-spiking, it is no wonder that we are seeing cognitive decline in people earlier than we used to.

The Alzheimer’s Antidote pushes back against a common idea that beta-amyloid plaques are a driving factor in Alzheimer’s. Rather than disease causes, these plaques are effects: the plaques build up when an enzyme that could degrade them instead is too busy degrading excessive insulin. Long before beta-amyloid plaques show up in the brain, decreased brain glucose metabolism can be detected in PET scans (including in people just in their 30s and 40s). Berger also downplays common concern about the APoE4 gene variant. While APoE4 carriers do have an increased AD risk, focusing on genetics distracts from the root cause of elevated insulin levels.

For AD sufferers, for AD caregivers, and for anyone who cares about maintaining cognitive health, this book is a terrific resource. In a a practical, compassionate, and realistic manner, it teaches the reader how to implement a low-carb diet to improve cognition. It also makes the case for lifestyle practices like exercise and intermittent fasting. Berger’s work gives plenty of “why” and lots of "how" but it ultimately provides something else even more important: hope.

If you want to see a heartwarming real-life example of Berger's approach, see here. That video is what inspired me to finally read this book.

While you will find Berger's name in several of my favorite podcasts, I think one of her best interviews is here on the Peak Human podcast.

Tuesday, January 15, 2019

The Power of Nutrition

For anyone wondering why someone would become interested in, fascinated by, or obsessed with nutrition, check out this Tweet:

Things like this are why people like me are so passionate about nutrition. And about the potential of keto. 😃😃😃

Monday, January 14, 2019

This is Your Health on Keto

A well-formulated ketogenic diet (WFKD) improves insulin resistance. Insulin resistance is the condition connected to nearly every chronic disease: from type 2 diabetes to cancer to heart disease to Alzheimer’s and more. Most American adults today are insulin resistant. About 9 out of 10. Therefore nearly everybody could benefit from eating a ketogenic diet. A full description of a WFKD is beyond the scope of this post, but at its essence, a WFKD is a low-carbohydrate diet consisting of whole foods (=/= 50 grams of carbohydrate or less per day, eat until full, no calorie counting).

To highlight what happens to real people when they go on a ketogenic diet, it is helpful to look at a couple interesting cases: (1) the Virta Health study, and (2) dual lab values between twins: one eats the standard American diet, one eats a ketogenic diet.

Virta Health Study

In one year, using the ketogenic diet, the Virta Health program reversed Type 2 Diabetes in 60% of its patients. Yes, that’s right: type 2 diabetes, commonly thought to be chronic and progressive, can be reversed. In the same peer-reviewed study, 94% of patients reduced or eliminated their usage of injected insulin.

Nearly all health markers improved for the patients treated with the ketogenic diet. This includes reduced inflammation, weight loss, improved blood pressure, improved liver function, and improved cardiovascular health markers. (Despite the common belief that saturated fat is unhealthy, it turns out that a low-carbohydrate diet with a significant amount of saturated fats is likely very good for heart health.)

That all sounds abstract, but the Virta ketogenic intervention was performed on 218 real people who greatly improved their health by modifying their diet. Many of these people reversed their diabetes and greatly improved their quality of life. That is the power of nutrition; and specifically, that is the potential of a well-formulated ketogenic diet. You can read some of their testimonials here.

Lab Values of Twins (One Keto, One Standard American Diet)

This video details the lab value differences between two 16-year-old twin sisters. One twin eats a ketogenic diet. The other eats something akin to the standard American diet (some meals are ketogenic because the meals eaten with her family are low-carb). They share the same genetics but different diets.

The twins have remarkably similar lab values for most health biomarkers. Even their blood glucose levels were nearly identical. However, the standard American diet twin is significantly more insulin resistant. The keto twin’s fasting insulin is significantly lower than the other twin’s. Likewise, the keto twin’s C-peptide measurement (a proxy for insulin resistance) is significantly lower. As discussed in this post on insulin resistance, elevated insulin levels are an indicator of impending health problems. These elevated insulin levels may appear decades before blood glucose levels rise to prediabetic or diabetic levels.

MeasurementStandard American Diet TwinKeto Diet TwinNote
LDL Cholesterol (mg/dL)6198For more on proper context for interpreting LDL-C results on keto diet, visit
HDL Cholesterol (mg/dL)5357
Triglycerides (mg/dL)3842Both excellent
Glucose (mg/dL)8788
Hemoglobin A1C4.90%4.80%
hsCRP (mg/L)0.250.17This is a marker of inflammation. Both have excellent results, extremely low inflammation.
C-peptide (ng/mL)2.61.3Significant difference-- and generally, the higher the C-peptide, the greater the insulin resistance.
Insulin (uIU/mL)13.44.6Wow, what a difference. And in the (arguably) most important health marker measurement of the lab results.


  • Most modern people are insulin resistant, which is likely at the heart of most chronic diseases.
  • A well-formulated ketogenic diet improves insulin resistance.
  • Therefore, eating a WFKD is likely a good way for most people to improve existing conditions related to insulin resistance and to reduce the risk of developing such conditions.
  • On a related note, eating a WKFD is likely to lower an individual's inflammation, improve cardiovascular health, and improve liver function.
This post looks at lab values to utilize common objective measurements. However, in real life, subjective experiences are what count. In other words, I don't care if my triglycerides look great on a lab sheet if I feel like crap. For the keto dieters with improved insulin resistance markers, what do you think happened to their moods and energy levels? (If you want a hint, try Googling "keto mood")

The results listed here are a small sample size; they are just from one study and one twin vs. twin comparison. The sample size is small but meaningful. (And remember, you yourself are a small but damn important sample size.) The Virta info is peer-reviewed science carried out in the real world. The twin comparison is a look at two teenagers sharing common genetics but different diets in the real world. I showcase them because they reflect broader truths about what typically happens when people in the real world adopt ketogenic diets. Ketogenic diets improve insulin resistance and therefore they improve people's health, often to an incredible degree.

*Disclaimer: I am not guaranteeing that a ketogenic diet is appropriate for every person, nor that it is the only way to improve insulin resistance. However, the ketogenic diet is so reliable at improving health for the vast majority of the population that it is more appropriate to get that message across as opposed to discussing every rare exception. Focusing on rare exceptions would be missing the forest for the trees. For what it’s worth, Virta Health medical director Dr. Sarah Hallberg says the only type of person she has found that is not a good candidate for a ketogenic diet is someone who has hyperchylomicronemia (1 in 1-2 million people). Regardless, if considering a change, do your own research and always consult a medical professional where appropriate.

References that Dig Deeper

The Ketogenic Diet as a Treatment for Metabolic Syndrome

Tuesday, December 4, 2018

Vegetable Oils are Bad: Tucker Goodrich, Peak Human listening companion (Part 3)

Part 1 of this post (overview)

The Peak Human podcast with host Brian Sanders and guest Tucker Goodrich is my favorite health podcast episode of 2018. This podcast is about the idea that vegetable (seed) oils are at the root of the diseases of civilization (diabetes, heart disease, autoimmune disease, cancer).

Here are some notes and citations you may find helpful as you listen to the podcast.

[1:55] Tucker’s technical background as a problem solver

[2:45] Tucker had a stroke-like event at 38 (went partially blind, couldn’t talk for hours)

[3:15] Tucker had acute diverticulitis

[3:45] Despite trying to eat healthy, exercise, Tucker was progressively getting a little less healthy. Despite trying to eat healthy and even giving himself the nickname “Mr. Whole Wheat”. (This tells me that the current guidelines do matter, are harmful.) Exercise didn’t help him lose weight. Despite lots of exercise, he was still putting on about a pound a year (common thing that happens to many Americans)

[4:25] Tucker found Stephan Guyenet’s blog

[4:50] Despite being sick with it for 16 years, he cured his own chronic diarrhea in two days via diet. He had had surgery for diverticulitis. At the time of surgery, doctors didn’t even know if the surgery would help with his diarrhea. Now he feels that surgery was unnecessary.

[6:30] Tucker made connections through his own research (and in large part thanks to Guyenet’s work) that wheat intolerance is tied to chronic diarrhea.

[7:30] Diseases of civilization can’t be genetic because they set in within a single generation, and because they traveled all around the world.

[8:15] Tucker helped with book Story of the Human Body to help author Daniel Lieberman get feedback from the “ancestral health”/”paleo” community. Lieberman and other anthropologists’ research gets used to form basis of Paleo diets, but many of them do not want it to be used in that way. Goodrich unsure why. Sanders mentions that Lieberman buys into needing lots of fiber, whole grains, etc. Anyway, ancient genes don’t match current environment

[11:00] Humans evolve based on food shortages

[12:05] Diseases of civilization - started with agriculture

[12:45] Agriculture led to cavities, malocclusions, lower health, stunted height, worse bone structure, but higher population (reminds me of idea from Sapiens: agriculture great for growth/spreading of our species, horrible for individual members of our species. Harari may even have gotten the idea from reading Jared Diamond’s work.)

Dutch, just in 20th century, the tallest population on the planet, finally got back to height of Paleolithic ancestors.

Paleolithic people were probably more physically fit than our elite athletes, bigger brains, stronger bones, longer femurs.

References for bone strength, height, comparisons between Paleolithic ancestors and modern humans:

Jared Diamond article on agriculture: The Worst Mistake in the History of the Human Race

[14:45] Agricultural people also began to get diseases of civilization (but very rarely)

[15:00] Cancer, heart disease, diabetes used to be very rare until the 19th and 20th centuries.
These are all new diseases as new eating pattern has traveled around the world.
Goodrich mentions the Joslin Diabetes Center. At the start of Joslin’s career, diabetes was rare, and it was a certain death sentence. Dr. Elliott P. Joslin started to treat it in late 1800s but it was very rare. He treated it with prescriptions of strict calorie-restricted diet (borderline starvation) and exercise. Then after discovery of insulin, he incorporated that too. See more here

Side note: from the CDC’s numbers, diabetes went from being diagnosed in less than 1% of the U.S. population in 1958, to 7.4% in 2015).

Joslin found 172 cases of diabetes over 60 years in the Massachusetts Hospital (as found in the Boston Medical and Surgical Journal, Volume 139, page 179, it is actually 172 over an even longer timeframe: 74 years). That shows that diabetes was very rare.

[16:00] Tucker references Otto Warburg’s work on cancer (I’ve briefly written about this in a review of the book Tripping Over the Truth). Warburg found that cancer is primarily a metabolic disease. Hitler let Otto Warburg, a Jewish person, stay in Germany because he was so concerned about cancer.

[16:45] From 1920 to 1955, heart disease in England went up by 70-fold. Tucker has discussed this on Twitter here and here. The validity of the increase being “seventy-fold” is debated, but it is clear that, regardless, there is a major increase in heart disease during this timeframe.

[17:00] Tucker applies his RTFM (Read the Flipping Manual) problem solving approach to the cause of the diseases of civilization:
  • Diseases of civilization are not genetic because they set in within a single generation, and because they traveled all around the world.
  • Diseases of civilization are not primarily caused by pollution because even people on islands get very obese, and they get these diseases.
  • Diseases of civilization are not caused by lack of exercise because many industrialized people exercise just as much as hunter gatherers (There is conflicting data on this. But there is some data to indicate that industrial peoples expend the same amount of energy per day as hunter gatherers. Found here and here. For counter-balance, here is an article indicating that hunter gatherers expended 800-1200 more calories per day than modern sedentary folks. Regardless of whether hunter-gatherers exercised more or not, whether their bodies adapt and expend the same amount of energy or not, I agree with Goodrich’s point that it is not exercise. I think Weston A. Price’s work (which I’ve discussed here and here) showing the changes within a single generation show this. Goodrich and Sanders go on to discuss Price’s work at the 18:55 mark.)
So if it’s not genes, exercise, pollution, environment. . . what’s new? Diet. Something new in food in last 150 years. Diseases of civilization become prevalent when Western food spreads to new groups (including in other species: dogs, cats, monkeys, rats, racoons we feed, etc. If humans feed them, they start getting diabetes, obesity, heart disease. Ahem. There is a website named

[18:55] Brian and Tucker bring up Weston A Price’s work. All over the world, when Western foods were adopted, diseases of civilization came with them. It happened in a single generation. Parents had perfect teeth, children had cavities and malocclusions, bad teeth (among many other new health problems). This even happened sometimes between older and younger siblings. (Seriously, Weston A Price’s work is the most impactful reading I’ve ever done; I can’t recommend anyone’s work more. Read his work online here and/or buy his book here.)

[19:45] The Western foods Price identified are highly processed wheat flour, refined sugar, and refined vegetable fats (AKA vegetable oils or seed oils). Price also mentions canned vegetables and preserved meats.

[20:30] Guyenet, checking to see if Price’s work had scientific backing (largely, it does), wrote a lot about cancer incidence and seed oils. Upon reading about this, Tucker finally cut seed oils out of his diet and cured his 16-year irritable bowel disease in two days. It had not been cured previously by a low-carb diet.

[22:00] Tucker mentions that cutting seed oils eliminated his carb cravings. Also, he found out he had a wheat problem. Seed oils caused his irritable bowel disease; wheat caused his diverticulitis. Removing them led to quick cures.

[23:30] Vegetable oils are in basically every processed food.

[24:00] Exercise didn’t help him lose weight; diet did.

[25:00] Amazed at Guyenet’s work and the dramatic effects in his own life, Tucker began researching health and nutrition very seriously. On top of Guyenet, he read a lot from Mark Sisson

[25:45] What’s the mechanism behind seed oils being bad?

[26:15] SL Malhotra giant epidemiological study:
Northern (lots of dairy fat, meat) vs. Southern India (seed oils, low saturated fat, essentially following our modern food pyramid)
7-15x heart disease for the Southern Indians.
This is at about the same time as the aforementioned huge coronary heart disease increase in England.
What’s the biggest change during this time? Goodrich says it’s seed oils, and references that intake of soybean oil went up 1000-fold.
Still, there are always confounders. Epidemiology is still not trustworthy without mechanism.

[28:15] Okinawans are the poster child for Blue Zones
Longest-lived society in the world in latter half of 20th century
American people popularized “Blue zone” stuff (and said Okinawans were plant-based), but when you read Japanese sources, you get a very different perspective on what happened in Okinawa. After WW2, Okinawa had highest meat intake of anywhere in Japan (one of only places in Japan that did not become Buddhist, vegetarian. They believed pork to be longevity food.)
Still, they ate a lot of carbs. Tucker says 74% carbs. Diet mainly rice and yams, some pork. (This source concurs that 1949 Okinawans ate high carb. It says 85% carb.)

First American fast food in Japan was in Okinawa, 9 years before any opened in Tokyo
Lifespan in Okinawa went from longest-in-Japan to shortest-in-Japan in one generation (their environment did not change, their genes didn’t change, pollution didn’t change-- they were already industrialized, it wasn’t carbs-- they already ate high carb) after American junk food introduced.

So Harumi Okuyama studied this and published the paper titled Excess Linoleic Acid. This paper strongly calls out excess linoleic acid from vegetable oils as a driver of cancer, allergies, autoimmune disease, ADHD, behavioral issues, and heart disease.

America was recommending people eat vegetable oils. Saturated fat was demonized. This spread to Okinawa.

In Okinawa, parents were burying children. Diabetes, cancer, heart disease went way up in their population.

So. . . now that linoleic acid has been postulated by Okuyama as the problem, is it plausible? Is there a mechanism?

[32:15] Harvard recommends seed oils, saying industrialized countries eating seed oils have slightly lower rates of heart disease (but are they only looking at industrialized countries that are already eating too many seed oils, where seed oil consumption has already gone above the threshold needed to do damage?). And if seed oils lower heart disease, why do we see rising rates of heart disease in England, in India, in Japan, and in U.S. throughout the 20th century alongside increased seed oils?

[34:15] Weston Price was able to go around and look at people’s mouths and determine what was wrong. Westernized foods.

[34:30] “As an engineer, if you have a complicated system, and it stops working, your first question is ‘What changed?’ It worked yesterday, it’s not working today. What changed?”

In Computer Science, either the code changed, or there’s bad data that got put into the system. In this case, we know the code didn’t change. It’s not genetic, it happened too fast. It has to be a change in the input. It happened across species so it’s not a bacteria or virus. (And no one has ever found such a virus)

[35:45] High-carb societies: Japan, Okinawa, United States. . . all ate high-carb. And were healthy. Before seed oils.

[36:30] Japan still skinny, probably the skinniest industrialized population. Approximately 3.5% obesity rate. (3.5% in 2009 OECD data, 3.7% in 2015 OECD data)

[37:00] India’s diabetes and obesity rates are skyrocketing. Indian diet is low fat, high carb, their main fat source is seed oils.

Japan and China have decreasing carb consumption but increasing disease rate. (For this, the best references I found were discussions Tucker has had on Twitter in relation to this:

Tsimane and Kitavans ate high-carb, healthy, no diabetes.
Tsimane and Kitavans and other high-carb societies avoided diabetes, so carbs must not be the cause. So what is the cause?

[38:00] Carbohydrates still “Plan B” diet. Feed Japanese/Chinese cultures more meat, they get taller

[39:30] “Eat like a human should. . . “ That doesn’t mean you need to be a carnivore, although that works. . . ”

[40:00] Indians switched from ghee to seed oils -> diabetes explodes

[40:15] Warburg -> metabolic disease. No interventional studies in humans on diet and cancer interaction. But there is interventional study for heart disease: the 1994 Diet Heart Trial (Lyon).

In this trial, one diet reduced secondary heart attacks (study conducted on people who had heart attacks previously) by 70%. The diet that achieved this lowered omega-6 fats to 3.6% (Americans eat 7-8% of their calories from omega-6 fats) and raised omega-3 fats.

[42:00] Epidemiology very flawed. Harvard School of Public Health relies on it a lot, despite epidemiology’s flaws. For a look at how foolish epidemiology can be, see this article from Dr. Georgia Ede

William Lands, a researcher who studied fatty acid metabolism for 50 years, found no mechanism by which saturated fats can kill somebody

Lands: “Fifty years later, I still cannot cite a definite mechanism or mediator by which saturated
fat is shown to kill people.”

[42:30] Goodrich: “Theory’s got to work with all the facts. . . we’ve been eating saturated animal fats for millions of years; it’s been a primary food of ours. They didn’t overnight start causing heart disease. It’s just not plausible.”

[43:00] The lower-omega-6 diet had a relative risk reduction of 70% in that trial.

[43:15] “They sell billions of dollars worth of statins based off of a 20-30% relative risk reduction.” (and for a look at why that “20-30%” sounds way more impressive than it is, check out this terrific presentation from Dr. David Diamond)

[43:40] The American Heart Association had to change their recommendation from the prudent diet, which had just been demonstrated to be outright harmful. But no one seems to recognize the mechanism by which the Mediterranean diet (the one that lowered omega-6 and increased omega-3 fats) worked in Lyon

[44:00] Brown and Goldstein got a Nobel Prize for discovering the LDL receptor. Here is their paper

They initially thought that if you feed LDL to a macrophage, it becomes a foam cell, and atherosclerosis would follow. But it turned out LDL on its own doesn’t do it, it takes a modification (“...native LDL is not taken up by macrophages in vitro but has to be modified to promote foam cell formation. Oxidative modification converts LDL into atherogenic particles that initiate inflammatory responses. Uptake and accumulation of oxidatively modified LDL (oxLDL) by macrophages initiates a wide range of bioactivities that may drive development of atherosclerotic lesions.” Of course, this same paper immediately goes on to say that statins reduce risk for cardiovascular events, which would likely be a point of contention for Goodrich (and me))

Tucker references the work of Steinberg and Witztum, who did the rabbit study referenced below. Also, more recently, they published this about the role of LDL in atherogenesis.

[46:00] Polyunsaturated fats (PUFAs) are easily oxidized. If you oxidize LDL, the omega-6 fats are altered, and if you put that in vat with macrophages, they will get hoovered up and turned to foam cells. (But the non-oxidized LDL do not get hoovered up and turned to foam cells.)

[46:30] Rabbit study finding from Steinberg and Witztum that olive oil (a monounsaturated fat (MUFA), not a PUFA) did not oxidize LDL but PUFAs did oxidize it:

And another similar rabbit study here

A Witztum and Steinberg paper saying: “These data strongly support the conclusion that at least a portion of the LDL found in atherosclerotic lesions has undergone oxidative modification. That conclusion is further supported by the previously reported occurrence, both in rabbits and in man, of autoantibodies that bind to MDA-LDL and 4-HNE-LDL (18). Finally, that antioxidant therapy inhibits lesion formation in the WHHL rabbit (15, 16) strongly attests to the importance of oxidized LDL to the atherogenic process.”

Witztum and Steinberg, human LDL study: “The extent of LDL oxidation, regardless of whether the LDL was isolated from normo- or hypercholesterolemic subjects, was strongly influenced by the percent of 18:2 (linoleic acid, an omega-6 PUFA) in LDL.”

[48:30] To give rats cancer, they must be given a carcinogen and an omega-6 fat

In this study, control diet (including safflower oil) = no cancer. High heme + safflower oil = cancer. High heme + olive oil instead of safflower oil = no cancer. Mark Sisson comments here: “feeding heme iron to rats promoted colon cancer only when fed alongside high-PUFA safflower oil.”)

Another study: replacement of linoleic acid safflower acid with oleic acid safflower oil reduced promotion of colon carcinogenesis

[49:00] 4.4% omega-6 fat as amount of energy intake for rats = threshold to give them cancer. Above that, it doesn’t seem to make any difference

[49:30] Common mutation = p53 gene mutation. p53 = cancer suppression gene (“The p53 gene... is a tumor suppressor gene, i.e., its activity stops the formation of tumors.”). This is common in colon cancer, lung cancer, breast cancer

Asian women. Moved to United States, their rate of breast cancer increased sevenfold So this isn’t genetic; something about the input from the American environment must cause this.

[50:30] Random genetic damage (8-OHdG) present in all diseases of civilization

Goodrich: “Why is DNA damage happening in atherosclerosis? Why is it happening in obesity? . . . Mitochondrial dysfunction is a hallmark of every disease in the diseases of civilization. . . so what causes that? ”

[52:15] In 2004 rat study, it is shown that avoiding cooked seed oils isn’t enough. Just eating a high-PUFA diet made rats diabetic, and it made them susceptible to cardiolipin oxidation (in the mitochondria). Tucker breaks this study down here

Tucker says this means avoiding cooked seed oils is not good enough. The same thing happens inside the cardiolipin in your cells.

Another study related to cardiolipin and fatty acids, and Tucker’s selected quotes from the study

[53:15] Tucker references Thomas Seyfried’s work finding that there are no brain cancer cells without damaged cardiolipin and damaged mitochondria

[54:00] We know how to damage cardiolipin and therefore we know how to induce diseases of civilization: high-omega-6 diet plus high-carbohydrate diet.

[54:15] Tucker’s hypothesis is that seed oils are the main culprit behind the diseases of civilization.

[54:30] “ can practically cure diabetes by going on a low-carbohydrate diet.

Primary symptom of diabetes: insulin resistance

But places like India cannot switch to low-carb diet: not enough food. So we need to know if carbs are true cause. This study shows that moving people along the spectrum from high-omega-6 to low-omega-6 led to improvements in insulin resistance, even while eating a high-carb diet.

[56:00] Tucker explains that omega-6 PUFAs (omega-6 PUFAs are highly concentrated in seed oils) break down into toxins. p53 = aforementioned cancer suppression gene. The damage to p53 is caused by HNE, an omega-6 breakdown product.

[56:45] Non-Alcholic Fatty Liver Disease (NAFLD) being cleared in high-carb diet (with lowered omega-6 PUFAs) in 100% (12 patients)

Of course, insulin resistance improved in these patients as well, and their measured eicosanoids (PUFA breakdown products) decreased (referenced by Tucker on Twitter here)

Despite the possibility of fixing NAFLD while high-carb, Goodrich states that a ketogenic diet is the fastest way to get rid of NAFLD.

Cannot induce alchoholic fatty liver disease without omega-6 (might seem far-fetched until you click the link and see the paper’s title is Dietary linoleic acid is required for development of experimentally induced alcoholic liver injury.)

More on the different effects between saturated fat (protective) and unsaturated fat (harmful) for alcoholic liver disease found in this review

[58:00] Some populations have thrived on high-carb. Even high refined carbs (white rice, Japan). They got malnutrition and stunting, but largely avoided the diseases of civilization (heart disease, cancer, etc).

[1:00:15] Asian flush / Asian glow = common genetic mutation that causes faces to turn red upon drinking alcohol. Most common genetic mutation in the world (ALDH2*2). Controls the production of enzyme ALDH2. ALDH2 detoxifies alcohol and it detoxifies seed oils. Knockout model = people with ALDH2 mutation are more likely to get diseases of civilization.

Stated in this paper: “a higher susceptibility to various diseases such as Alzheimer’s, osteoporosis, and acute coronary syndrome has been associated with ALDH2*2 carriers.”

So, basically, when the seed oil detoxifier (ALDH) is impaired, chronic disease rates go up.

[1:01:45] Glutathione is a very important antioxidant. Primary antioxidant for seed oils.

Diseases often signified by lower levels of glutathione because body cannot produce it fast enough to deal with the omega-6-derived toxins.

Selenium is a precursor to glutathione. Where there is no selenium in soil, like in China, the body cannot produce glutathione. So places with low selenium have low antioxidant capability and increased disease.

Two sources discussing China having increased disease from low selenium

[1:03:30] If you put glucose and linoleic acid into a beaker, it causes the linoleic acid to oxidize. Same thing happens in your body when you have linoleic acid (the omega-6 PUFA) intake and you have hyperglycemia (which, essentially, is the modern American diet). The toxins produced by the oxidation of these omega-6 PUFAs cause health problems.

[1:04:15] Omega-6 fats are the driver of disease, but to fix it, go low carb and low omega-6 to hit both sides of the hyperglycemia/high-omega-6 coin. Sanders points out that America does the opposite by eating high carb and high omega-6.

[1:04:45] Oxidized omega-6 fats are problematic. Saturated fat is not. William Lands studied fatty acid metabolism for 50 years. He found no mechanism by which saturated fats can kill somebody.

(William Lands: “Fifty years later, I still cannot cite a definite mechanism or mediator by which saturated fat is shown to kill people.”)

[1:05:00] Scary Wikipedia pages for omega-6 PUFA breakdown products (oxidized metabolites):


[1:05:30] The same toxins in cigarette smoke are the ones that omega-6 fats turn into inside your body

[1:05:45] Cooking oils leading cause of lung cancer among Chinese non-smoking women

[1:06:15] Not a conspiracy! Although cottonseed oil was originally a toxic waste product, the producers initially thought it was healthy-- thought it had been detoxified.

The mitochondrial damage mechanism was not discovered until 2012 (upon Twitter clarification here it was actually a 2010/2011 paper)

[1:06:45] Crisco introduced in 1911. Cottonseed oil was being mixed with lard for 50 years before that. The problem is that it is not acutely toxic, so no one knows right away. Think about it... it took hundreds of years to determine cigarettes were toxic!

[1:07:30] Industry journals show that these seed oils become toxic. Linseed oil can burst into flames outside. Fast food uniforms become flammable

[1:08:15] Coconut oil vs. soybean oil: soybean oil caused obesity, coconut oil harmless

For reference, here is the information Goodrich and Sanders laugh at about coconut oil being harmful (“expert” assertion based on misguided epidemiology and assumption that saturated fat is harmful and that it is meaningful to have high LDL cholesterol. . . as opposed to having high oxidized LDL as discussed above)

[1:08:45] All nutrients (even water!) have a U-shaped curve. Basically, too little intake = high-risk. Too high intake = high-risk. Dose makes the poison. Example image of U-shaped curve

[1:09:15] You can’t completely eliminate omega-6 fats from your diet. Get it from whole food. And even be careful with grain-fed meat (note: This applies more to pork and chicken than to beef (thanks to cows being ruminants and having multiple stomachs). Grain-finished beef still has low absolute levels of omega-6, despite it not having as much omega-3 content as grass-finished beef.)

[1:10:00] Lower-omega-6 Plenish causing “less obesity” than regular soybean oil

[1:10:30] So, if not seed oils, what should we eat? Probably fats from meat and dairy.

Tucker speculates that there may be other essential fatty acids. For example, lack of heptadecanoic acid (a saturated fat) was found to lead to metabolic syndrome in dolphins (who do not eat carbs):

[1:12:00] Sanders and Goodrich agree that vegan diet is not recommendable, but you can make improvements on it, especially by virtue of eliminating “crap”. If you are so inclined to eat a vegan diet, Goodrich recommends checking out the work of Scott Jurek (plant-based ultra-marathoner:, book: Eat and Run)

Not recommended, but if you do it, make sure to supplement B12 and omega-3!

[1:13:30] Tucker not a low-carb zealot. References how healthy the Kitavans are, despite eating 75% carbs.

[1:14:00] Goodrich stopped eating sugar to avoid dental problems since he was 19 years old.

Goodrich cites Chinese and Indian populations eating low sugar but high diabetes and obesity. (References to China and India eating low sugar. Goodrich: two lowest sugar consumptions in the world. Chinese eat 1/10th of Americans’ sugar, Indians even less.)

Chinese and India getting diabetes now, not 50 years ago.

[1:15:00] Good overview from Sanders: Seed oils new in human history within about last 150 years. Evolutionarily, it doesn’t make sense. Not natural.

[1:15:45] Goodrich thinks seed oils driving disease makes the most sense to fit what we see throughout the world (and in his own personal experience).

[1:16:15] Tucker references thinking people at Mark’s Daily Apple were nutjobs for saying they had increased sun tolerance. Of course I have no idea what he was looking at specifically, but I thought I should link to a couple things sunburn-related from Mark’s Daily Apple:

[1:16:45] Tucker references Chris Kresser and his respect for Kresser but how he is very skeptical of Kresser’s background in Eastern medicine. Speaks to how much information is floating around out there and how difficult it can be to separate the wheat from the chaff

[1:17:30] March 2009 is when Tucker fixed his diet. Went skiing a few weeks later on a sunny day. Sun above and sun reflecting off the snow. That combo usually equals sunburn. This day he skied all day and didn’t get a sunburn. A few weeks later, he was standing in the sun for hours with his dark-complected wife. She loved going to the beach and he (fair complexion) hated it. But on this day, she burnt and he did not! After this experience, she changed her diet (and their whole family’s). Now, instead of burning in 45 minutes in the sun, it takes 5-6 hours for Tucker to burn. It’s not magic, but his tolerance has increased dramatically.

(My personal note: Earlier this year, I was inspired to learn about the potential for increased sun tolerance after removing seed oils from my diet. So when my wife and I honeymooned in Hawaii for a week in July 2018, I spent a lot of time outside in the mid-day sun and did not apply any sunscreen (except for one instance when I let my wife put a tiny bit on my face). I did not get any bad burns. My experience jibes with Tucker's; I wasn't magically able to completely not burn. But for the length of time I was outside in the July Hawaii sun without sunscreen, I think most people would have expected me to be a complete lobster. And I was not. I did not get many sunburns at all, and the very minor sunburns I got did not last long.)

[1:20:15] Tucker has collected dietary sunburn improvement anecdotes
Also, here is a blog post from Tucker on sunburn

[1:20:30] Tucker talks about man who tested X-ray safe exposure limits on himself, lived to be 102:

[1:21:30] Tucker talks about paper from 1950s that shows mechanism of why radiation causes radiation poisoning, and how the omega-6 breakdown products are involved:

[I read the paper, not understanding all of it. But the paper makes it very clear that autoxidized linoleic acid is toxic and is a necessary part of radiation toxicity.

Conclusion #4 from the paper: “4. On a basis of total peroxide content, autoxidized linoleic acid, unlike autoxidized squalene, was more toxic by intraperitoneal injection than any of the simple peroxides with which it was compared. Autoxidized methyl linoleate was less toxic than most of the simple peroxides.”

Conclusion #7 from the paper: “The evidence is consistent with the view that radiation toxicity is due to initiation of chain autoxidation of essential fatty acids producing lethal doses of peroxides in sites not reached by vitamin E.”]

Radiation causes omega-6 fats to break down and that is what poisons you. The oxidized linoleic acid killed the mice quickly.

Mouse study showing benefits of higher Omega-3 diet (compared to higher Omega-6 fat diet) for skin cancer

Another hairless mouse study showing the dangers of polyunsaturated fats (sunflower oil in this study): “The photocarcinogenic response was of increasing severity as the polyunsaturated content of the mixed dietary fat was increased, whether measured as tumour incidence, tumour multiplicity, progression of benign tumours to squamous cell carcinoma, or reduced survival.”

Another study: “When mice were given injections of 10(6) melanoma cells, the initiation time required for visible tumor growth in mice receiving the polyunsaturated fat (PUF) diet was significantly less than that in mice receiving the saturated fat (SF) diet.”

[1:23:15] After discussing mechanism, they bring it back to the common sense “evolutionary appropriateness” point: Essentially: Evolutionarily, the sun should not be dangerous; we evolved in it. We didn’t evolve to spend all day in caves.

[1:23:45] Omega 3: Omega 6 ratio = these things compete with one another. When high omega-6, it evaporates the omega-3 fats. Omega-3 fats depleted in grain-finished beef.

[1:24:15] Susan Allport, working with Jeff Volek, documents what happens in one month from high Omega-6: Omega-6 blood content immediately increased significantly, omega-3 dropped right away, resting metabolic rate dropped, fat increased, arteries stiffened. Other more subjective negative effects too.

Christopher Ramsden study: The title says it all: Dietary omega-6 fatty acid lowering increases bioavailability of omega-3 polyunsaturated fatty acids in human plasma lipid pools.
You can’t just add Omega-3s. You need to decrease Omega-6.

[1:25:00] Japan: don’t get obesity like we do (Goodrich implies that this may be because of omega-3s; animal model shows this). They are getting diabetes, heart disease, increased cancer rates.

[1:25:30] Ratios of omega-6 to omega-3 in human tissue. Traditionally, these have been in the range of 1:1 - 4:1. Today, thanks (but no thanks) to widespread seed oils, they are way, way more tilted towards omega-6. Tucker says that today it is like “15:1 is good”

[1:25:45] Study of increasing Omega-3 fats lessening aggressive behavior in prisoners
Study on Omega-3, Omega-6, hostility
Article on Omega-3, Omega-6, hostility
Stephan Guyenet on similar Omega ratio and behavorial consequences

Sanders talks about Weston A. Price and how he ascribed a lot of behavioral and moral troubles to malnourishment/changes in diet. Tucker agreed that anecdotally, changing his diet actually made him better to be around, slower to anger (he was cranky before, he was embarrassed to learn)

[1:27:15] High-level overview:
Wheat and seed oils cause autoimmune disease.
If overweight and have heart disease, definitely go on a low-carb diet. High-carb is a co-factor. Cutting carbs will accelerate recovery. If a lean athlete, probably more wiggle room to include carbs. Though lots of people have success avoiding carbs, not everyone has to. Tucker, after fixing his diet, can outperform people half his age athletically. And no more sunscreen to buy!

[1:29:00] Gabor Erdosi sent Tucker study on ground starch vs. unground starch: ground starch rodents got fat, others did not. Junk food bad.

The thread containing this discussion between Goodrich and Erdosi can be found here

(Before the last notes from the podcast, if you're interested in reading more of Goodrich's work, here are some of his best blog posts on seed oils:
Omega-6 fatty acids: the alternative hypothesis for diseases of civilization
What's Worse—Carbs or Seed Oils? Understanding a High-PUFA Diet.
"Hello, Can We Have Your Liver?": Understanding a High-PUFA Diet.
How To Prevent Oxidative Damage In Your Mitochondria
The Cause of Metabolic Syndrome: Excess Omega-6 Fats (Linoleic Acid) in Your Mitochondria

[1:30:15] Avoid seed oils.
His diet does not feel restrictive. He and his ex-wife refer to it as “cheating” diet.
Doesn’t like going to restaurants; can make it better at home (Sanders concurs)
Sanders mentions that it’s like he found a cheat code in life. Tucker says “That’s exactly how to put it” (and I have used the same phrase before!!)
You feel great after you eat it.

Tucker: out with guys, puts butter on his steak. Everyone looks at him like he’s crazy. He’s the skinniest guy at the table. “And it’s because I’m eating this way.”

Vegetable Oils are Bad: Tucker Goodrich, Peak Human podcast takeaways (Part 2)

Part 1 of this post (overview)
Part 3 of this post (podcast listening companion, notes)

The Peak Human podcast with host Brian Sanders and guest Tucker Goodrich is my favorite health podcast episode of 2018.

This episode spurred a million thoughts, but here are my takeaways from this podcast:
  • You are much more likely to heal chronic conditions by self-research than by relying on mainstream medicine
  • You can overcome ridiculous conditions (stroke-like event at age 38, decades of IBS, and diverticulitis, in Tucker’s example) and make yourself healthy again via dietary change
    • You will probably have to learn how on your own
    • For non-acute harms, mainstream medicine generally doesn’t touch root cause
  • Diseases of civilization are not genetic
    • Weston A. Price’s work shows diseases becoming prevalent in a single generation
    • Dramatic lifespan, healthspan decrease in a single generation in Okinawa upon adopting Western foods
  • Diseases of civilization are not environmental
    • People living in tropical (pristine) environments, eating Western foods, are unhealthy
  • Diseases of civilization are not due to lack of exercise
    • We expend about as much energy today as many hunter-gatherers
  • We know of lots of healthy populations that have eaten high-carbohydrate diets
    • Can even reverse NAFLD with high-carb diet
    • It does not work in combination with vegetable (seed) oils
  • We don’t know of any healthy populations with high seed oil consumption
  • Low-carb probably ideal, especially if one already has less than ideal metabolic health
    • Carbohydrates are bad for dental health
    • With seed oils, carbohydrates are a co-factor and an accelerant for causing diseases of civilization
    • Cutting carbs and vegetable oils is the quickest way to improve metabolic health
  • Increased consumption of seed oils corresponds with marked increase in heart disease and other diseases of civilization
  • Seed oils being healthy does not make sense from an evolutionary perspective
  • Saturated fat being unhealthy does not make sense from an evolutionary perspective
  • Eating healthy can be liberating
    • It's a "cheat code"
    • Now Tucker can athletically outperform people much younger than him
  • Epidemiology can be useful, but only within context
  • There are very plausible mechanisms for how seed oils are harmful
  • There are interventional trials showing seed oils to be harmful
  • There are lots of animal models showing seed oils to be harmful
  • You can increase your sun tolerance remarkably by cutting seed oils from your diet