The paradox of Europe’s high-fat, low heart-disease diets

I am always fascinated by the way science occasionally comes up with ‘insoluble questions’ or ‘paradoxes’. After a while, these tricky queries go away because, it turns out, everybody was barking up a tree to which they had been led by an expert whose ideas had captured peer and public attention.

The Rue de Lafayette one night in 2004

Photo I took of the Rue de Lafayette in central Paris. I scoffed as much high-fat French cuisine as I could get down this boulevard. And it was delicious.

The big one, these days, is the link between high cholesterol and heart disease.  This has been dogma for decades. After the Second World War, US scientists theorised that saturated fats contributed to high cholesterol, hence clogged arteries, and therefore caused heart disease. The idea was enshrined in a US Department of Agriculture guideline in 1980.

Low fat, it seemed, was the way ahead – and it was embraced by the food industry in the US, followed by large parts of the rest of the western world.

Except Europe. They didn’t much change – and traditional French, German and Italian cuisine is awash with saturated fats and high-cholesterol foods. Yet they suffer less heart disease and are less obese than Americans. What’s more, since 1980 obesity has become a major issue in the United States and other countries that have followed the US low-fat lead, such as New Zealand.

A paradox! Something science can’t explain. Or is it?

The problem is that research often tests only what can be funded, something often framed by commercial priorities. This framework is further shaped by one of the philosophical flaws of western rational thinking; the notion that complex questions can be eventually reduced to single-cause questions and answers.

Reality is far less co-operative. The real world isn’t black-and-white. It’s not even shades of grey. It’s filled with mathematically complex systems that can sometimes settle into states of meta-stability, or which appear to present superficial patterns to initial human observation. An observation framed by the innate human tendency to see patterns in the first instance.

For me, from my philosophical perspective, it’s intriguing that recent research suggests that the link between saturated fat and ischemic (blood-flow related) heart disease is more tenuous than thought. Certainly it’s been well accepted – and was, even fifty years ago when the low-fat message was being developed – that types of cholesterol are utterly vital. If you had none at all in your system, you’d die, because it plays a crucial role in human biochemistry on a number of levels. Cholesterol even makes it possible for you to synthesise Vitamin D when exposed to sunlight. It’s one of the things humans can produce – your liver actually makes it, for these reasons.

As I understand it, recent studies suggest that the effort to diagnose and fix the problem of ‘heart attacks’ based on a simplistic mid-twentieth century premise – something picked up by much of western society as dogma – has been one of the factors implicated in a new epidemic of health problems. There is evidence that the current epidemic of diabetes (especially Type 2) and other diseases is one symptom of the way carbohydrates were substituted for fatty foods a generation ago, and of the way food manufacturers also compensated for a reduction in saturated fats by adding sugar or artificial sweeteners. Use of corn syrup in the US, for example, is up by 198 percent on 1970 figures.

I’m not a medical doctor. And from the scientific perspective all this demands testing. But the intellectual mechanisms behind this picture seem obvious to me from the principles of logic and philosophy – I learned the latter, incidentally, at post-grad level from Peter Munz, one of only two students of both Karl Popper (the inventor of modern scientific method) and Ludwig Wittgenstein (who theorised that language distorts understanding). I am in no doubt that language alone cannot convey pure concept; and I think the onus is on us to extend our understanding through careful reason – which includes being reasonable.

What am I getting at? Start with a premise and an if-then chain of reasoning, and you can build a compelling argument that is watertight of itself – but it doesn’t mean the answer is right. Data may be incomplete; or the interplay of possibilities may not be fully considered.

What follows? A human failing – self-evident smugness, pride in the ‘discovery’, followed by over-compensation that reverses the old thinking without properly considering the lateral issues. Why? Because very few people are equipped to think ‘sideways’, and scientists aren’t exceptions.

Which would be fine if it was confined to academic papers. But it isn’t. Is it.

Copyright © Matthew Wright 2014

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8 comments on “The paradox of Europe’s high-fat, low heart-disease diets

  1. Charles says:

    If you aren’t a medical doc you sure sound like one. Good read! What about portion distortion? Our portion sizes are huge compared to Europe, but I’m no doctor either.

    • I started in the sciences – specifically, physics; but I can read science papers and have a working knowledge of the other fields. Yeah, the portion size issue is a major one too – it’s not just the type of foods we eat, it’s the volume of them. I believe it’s bad in the US, but it’s also true in NZ. Back in the ’80s we went for ‘nouvelle cuisine’ – tiny fragments of ridiculously overpriced food that left you with both empty wallet and stomach afterwards. These days it’s all about ‘value for money’. Unfortunately…a happy medium seems elusive.

      • Charles says:

        Physics? Well, you are no dummy. When we do the “fast” food thing I can feed mine with about half the meals for the number of people. Food still sucks but there is your value. But even in a “nicer” place the wife and I split an entree and have plenty. (This saves the $ for an extra glass of wine.)

  2. EagleAye says:

    Yeah, this is a holdover from early, proto, pre-chaos-theory science, from back when we believed in a magic pill that would cure everything and when we thought you simply have to take something apart to understand it. This was before we learned that our environment, and even the human body, was more of a “system” with a complex set of interactions rather than a collection of pieces.

    Something that modern medical science isn’t giving enough credence to is the American lifestyle which is: buy everything in sight to prove that you’re “monied” to the Jones’ and then work and stress yourself to death trying to pay for all the gizmos you barely understand and rarely use. That stress can cause obesity as quickly as eating fat. Europeans may eat fatty foods, but they don’t eat gargantuan gobs of it at every meal. They don’t put sugar in positively everything they eat like Americans do to keep the highly-subsidized sugar industry going. And Europeans have a glass of red wine with dinner (known to combat heart disease), while Americans put away a six-pack of Bud Light. We do a bunch of things wrong, and medical science isn’t helping by still stupidly promising a magic cure-all pill.

    • You’re spot on with this. It’s all to do with profit, of course, and vested interests. And, of course, from this also emerges an equally lucrative ‘diet’ industry, an equally lucrative ‘medical cure’ industry and so on. A nicely circular system in which everybody wins, except the poor schmucks being sold cures for the incorrect food they’ve also been sold. Alas, New Zealand has been following on US coat-tails with this – as has Australia. You can buy ‘Lite’ this, ‘Low Fat’ that and so forth – all of jammed to the hilt with sugar and various processing chemicals.

  3. Very thought-provoking post! As a health writer (and let’s face it, research-aholic), it seems to me that the “plan” that works always has–whole foods as part of a balanced diet, moderate (not low) in fat and limited in low-nutrient processed fare. The problem is, that’s not a marketable diet.

    Gluten-free, low-carb seems the biggest fad of late, which–like other plans–leads to weight gain over time. (Gluten avoidance is, of course, vital for people with celiac disease, etc.)

    I’m so with you on being reasonable!

    • I agree with your thoughts on a proper eating plan. A balanced diet of unprocessed, whole foods is best. Fresh vegetables, fruit, grains, meat etc. It doesn’t mean going ‘cave’ – but does mean being sensible. To me, the test is ‘did our grandparents eat this?’. If they did – it’s probably OK. And yes, that included whole fat butter, fatty steaks etc. But not in vast quantity. Moderation in everything! (Possibly including moderation, sometimes… :-))

      It’s bizarre; NZ is one of the world’s main dairy producers. Not the largest, but the quality of our stuff is among the best on the planet – thanks in part to our pasture quality. And yet the supermarket shelves are jammed with processed low-fat substitutes. I think a lot of the problem has come about in the last 30 years, broadly at the hands of a profit motive. These days the pressure is on to make profit from processed food – which means making them cheap – which means chemicals.

      I think fads feed into that – and ‘gluten free’ is one of them. Absolutely essential for people who are truly intolerant, of course. But I think many people end up going ‘gluten free’ not because they have an issue, but because it’s supposed to be healthier. Yet, in order to make ‘gluten free’ food – especially industrially – the recipe has to include such an incredible quantity of exotic chemicals that I’d be dubious about any health benefits.

      Reason – reasonable – and reasonableness…all virtues that go a very long way!

  4. Reblogged this on quirkywritingcorner and commented:
    We need a lot less additives to be healthy. Cholesterol certainly plays a roll, but I have never believed it was worst culprit in our diet.

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