by Mark Hyman
POINT SCALE
0 = Never or almost never have the symptom
1 = Occasionally have it; effect is not severe
2 = Occasionally have it; effect is severe
3 = Frequently have it; effect is not severe
4 = Frequently have it; effect is severe
DIGESTIVE TRACT
____ Nausea or vomiting
____ Diarrhea
____ Constipation
____ Bloated feeling
____ Belching or passing gas
____ Heartburn
____ Intestinal or stomach pain
Total before _________
Total after _________
EARS
____ Itchy ears
____ Earaches, ear infections
____ Drainage from ear
____ Ringing in ears, hearing loss
Total before _________
Total after _________
EMOTIONS
____ Mood swings
____ Anxiety, fear, or nervousness
____ Anger, irritability, or aggressiveness
____ Depression
Total before _________
Total after _________
ENERGY/ACTIVITY
____ Fatigue, sluggishness
____ Apathy, lethargy
____ Hyperactivity
____ Restlessness
Total before _________
Total after _________
EYES
____ Watery or itchy eyes
____ Swollen, reddened, or sticky eyelids
____ Bags or dark circles under eyes
____ Blurred or tunnel vision (does not include near- or farsightedness)
Total before _________
Total after _________
HEAD
____ Headaches
____ Faintness
____ Dizziness
____ Insomnia
Total before _________
Total after _________
HEART
____ Irregular or skipped heartbeat
____ Rapid or pounding heartbeat
____ Chest pain
Total before _________
Total after _________
JOINTS/MUSCLES
____ Pain or aches in joints
____ Arthritis
____ Stiffness or limitation of movement
____ Pain or aches in muscles
____ Feeling of weakness or tiredness
Total before _________
Total after _________
LUNGS
____ Chest congestion
____ Asthma, bronchitis
____ Shortness of breath
____ Difficulty breathing
Total before _________
Total after _________
MIND
____ Poor memory
____ Confusion, poor comprehension
____ Poor concentration
____ Poor physical coordination
____ Difficulty in making decisions
____ Stuttering or stammering
____ Slurred speech
____ Learning disabilities
Total before _________
Total after _________
MOUTH/THROAT
____ Chronic coughing
____ Gagging, frequent need to clear throat
____ Sore throat, hoarseness, loss of voice
____ Swollen or discolored tongue, gums, or lips
____ Canker sores
Total before _________
Total after _________
NOSE
____ Stuffy nose
____ Sinus problems
____ Hay fever
____ Excessive mucus formation
____ Sneezing attacks
Total before _________
Total after _________
SKIN
____ Acne
____ Hives, rashes, or dry skin
____ Hair loss
____ Flushing or hot flushes
____ Excessive sweating
Total before _________
Total after _________
WEIGHT
____ Binge eating or drinking
____ Craving certain foods
____ Excessive weight
____ Compulsive eating
____ Water retention
____ Underweight
Total before _________
Total after _________
OTHER
____ Frequent illness
____ Frequent or urgent urination
____ Genital itch or discharge
Total before _________
Total after _________
GRAND TOTAL BEFORE _________
GRAND TOTAL AFTER _________
Key to Questionnaire
Optimal health: less than 10 points
Mild toxicity: 10 to 50 points
Moderate toxicity: 50 to 100 points
Severe toxicity: more than 100 points
If you scored not so great on either of these quizzes, don’t panic. Here’s the good news: You can reverse diabesity. You can get over FLC syndrome. And you can do all of that while delighting in the abundance of whole, rich foods. With the Eat Fat, Get Thin Plan, you will not be suffering or deprived. The promise of this book is that if you eat more of the right fats, you will feel good, get thin, look better, and get healthier than you’ve ever been, while enjoying delicious, savory, mouthwatering food.
2
Fleshing Out Our Fear of Fat
A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.
—Max Planck
Science is a veritable graveyard of closely held beliefs that once seemed obvious and completely in line with common sense. Certain ideas become so entrenched that they seem to be natural laws. That is, until they are proven false. Before Columbus, everyone believed the world was flat. It was true… until it wasn’t. In the early seventeenth century, Galileo’s idea that the sun did not revolve around the earth was so heretical that he was thrown in jail. But of course, he was right. Darwin postulated that species did not arise in their current form as spontaneous creations of God, but evolved through natural selection. Even today, 150 years later, many still debate the theory of evolution.
And so it has been with fat. We’ve been told lots of falsehoods about fat over the past 50 years that have shaped what we eat, what we buy, how we diet—all of which has had huge and disastrous consequences for our health.
It all began with two big ideas about fat that have turned out to be wrong. Dead wrong, in fact. These two ideas seemed consistent with common sense, just like the earth looking flat. The first was that all calories operate the same way in your body. Since fat has more than twice as many calories as carbs or protein per gram, the natural conclusion was that if you ate less fat you would lose weight. That, in effect, the fat you ate turned to fat in your body.
The second idea was that since fatty cholesterol deposits caused heart disease, and dietary fat, especially saturated fat, raised cholesterol, then the fat we ate caused heart disease. Seems to make sense, except the body is more complex than this simplistic conclusion would suggest. Whole scientific careers and industries have been devoted to these false notions, based as they are on incorrect assumptions. Once people adopt a worldview, it is very hard to change.
In this chapter we’ll examine how these two ideas became accepted facts in the scientific community—and why they are wrong. I’ll explain how the government and the food industry jumped on the bandwagon to create a maelstrom of bad advice. It was the perfect storm of overzealous scientists leaping to premature conclusions, anxious government agencies eager to do something to stem the tide of obesity and heart disease, and a profit-hungry food industry that raced in to capitalize on the low-fat mania, leading, in fact, to a rise in obesity, heart disease, and diabetes.
This is the story
of how fat became public enemy number one and triggered the biggest health crisis in human history: obesity and chronic disease caused by eating the wrong foods.
UNTANGLING THE RESEARCH ON FOOD
With literally millions of studies (more than 8 million in the National Library of Medicine database) performed over many decades on obesity, metabolism, type 2 diabetes, and heart disease, how could the scientific community have gotten this so very wrong, for so long?
Science is driven by hypotheses, ideas, and concepts that need to be proven or disproven. It should be simple. And in some cases, it is. But even in the face of clear evidence to the contrary, scientists get pretty stuck in their worldview. Edwin Friedman, a twentieth-century rabbi and family therapist, said, “The risk-averse are rarely emboldened by data.”
For example, doctors long believed that stress caused stomach ulcers, even though they’d consistently find bacteria in patients with stomach ulcers; they’d dismiss the bacteria as insignificant. Even after Dr. Barry Marshall, a gastroenterologist from Australia, proved he could cure ulcers with antibiotics to kill the bacteria (called Helicobacter pylori), his theory was still dismissed for more than a decade. It was only after he drank a beaker full of bacteria, caused an ulcer in himself, and cured it with antibiotics that his theory was accepted. Dr. Marshall won the Nobel Prize for his discovery.
But biology (and human biology in particular) is infinitely complex. It’s a web of genetic, hormonal, and biochemical reactions that vary dynamically under the influence of the environment. And food is the biggest “environmental” regulator of that complex system we call our bodies. Food, it turns out, is not just calories, but information that radically influences our genes, hormones, immune system, brain chemistry, and even gut flora with every single bite.
Yet there’s an even bigger factor contributing to our confusion about food: the tricky business of nutritional research. How is it that we come to know what we know, and how can we determine what is accurate?
The first thing to understand is that all evidence, and all studies, are not created equal. As a young medical student and doctor, I believed in the infallibility of science. Science was objective and independent of bias and gave us clear answers to the questions we asked. But over time I learned to analyze data more carefully, to dissect the studies and look at methods and actual data to see what questions were actually asked, how the study was designed and if it was well done or not, and to dig into who funded the study to root out any conflicts of interest.
Dr. John Ioannidis, from the Stanford Research Prevention Center, has challenged the validity of most nutrition studies. Most studies that make conclusions from looking at diet in populations have been later proven in experimental trials to be wrong. Dr. Ioannidis writes, “Critics have focused on the poor track record of observational claims when tested in subsequent randomized trials (0/52 success rate in one review) and perpetuated fallacies.”1 Wait! Zero out of fifty-two population (observational) studies validated previous notions about what you should eat when those notions or hypotheses were subjected to actual human experiments! There are different types of studies (for instance, observational studies vs. randomized controlled trials vs. animal studies), and the conclusions that can be drawn from each type are different: some prove cause and effect while others show only associations. Each type of study has its benefits and drawbacks, and it is impossible to draw definitive conclusions from any one study. It is important to look at the weight of all the evidence and how each type of study was done. For example, was it a study that asked people to eat a certain diet and hoped they would, or did the researchers supply food in their homes and expect they wouldn’t cheat with ice cream? Clinical trials that simply provide participants with advice and guidelines about what to eat are also different from “metabolic ward studies,” where people are locked in a hospital for a long period of time and have all their food provided and their metabolism directly measured.
It is also important to know what population was studied. Were they all white males who weighed 180 pounds, or was it a group of African American females or Asian children? There are tremendous differences in how populations with different genetics respond to different diets. If studies show an effect for one population, it might not be valid for another.
Another problem is that most nutritional research relies on large studies of populations and their dietary patterns, obtained mostly through dietary questionnaires or twenty-four-hour dietary recall. Do you really remember every single thing you ate over the last seven days or thirty days? And how closely does that represent what you have been eating over the last five years, or even 30 years? It is well described in the research that people often under- or overreport their habits depending on the recommendations of the day. For instance, if you think that eating meat is bad, you will likely underreport how much meat you actually eat.
Here’s another piece we need to consider: Who is funding the study? Is there any conflict of interest? More than most doctors would like to admit, science is for sale. Researchers’ work has to be funded, and it is often expensive (we’re talking millions of dollars here). The funding generally comes from two sources: the government through the National Institutes of Health (NIH) and private industry (Big Pharma, or the food industry in this case).
We know that if a study is funded by a food company, it is eight times more likely to turn up positive findings for that food company’s product.2 If the National Dairy Council funds studies on milk, milk is more likely to be found beneficial. If Coca-Cola funds studies on soft drinks, they are likely to be found not linked to obesity and disease. It is very hard to find clean, clear, objective research in those cases, since the study was either designed to show a specific outcome or the data selection and emphasis were “spun” to get the desired impact. It gives a whole new meaning to the phrase “spin doctors.”
You can see how this can get very confusing!
It’s not easy to know for sure what is the “truth.” Vegan diet studies show they help with weight loss, reverse diabetes, and lower cholesterol. Diets high in fat and animal protein seem to do the same thing. So should you be shunning animal foods and eating only beans, grains, and veggies, or should you eat meat and fat without guilt and give up all grains and beans? One respected scientist condemns saturated fat, while another equally esteemed scientist vindicates saturated fat. Whom should we believe?
Essentially, each scientist (or even each person reading the research) with a point of view adheres to his or her position with near religious fervor. And each can point to studies validating his or her perspective. We call this cherry picking. After reading thousands of studies on human nutrition over 30 years, even I get confused. But I can find my way through the headlines because I read between the lines. I read the methods and analyze the actual data to learn what the studies actually demonstrate—or, sometimes, what they don’t demonstrate.
For instance, the first study linking saturated fats to heart disease, by Ancel Keys (on which 50 years of dietary policy to eat low-fat was based), looked at only about thirty men from Crete and their previous day’s diet, and linked that to the fact that they had fewer heart attacks than people from countries where more saturated fat was consumed. Skimpy evidence at best!
It is very hard to tease out the factors that matter in population studies that are not real experiments. If I did a study on the link between your waking up and the sunrise, I would find 100 percent correlation. But that doesn’t mean that your waking up caused the sun to rise. For example, when Asians move from Asia to the United States, they eat more meat and have more heart disease and cancer, but they also consume far more sugar. So it is the meat or is it the sugar? Hard to know. These types of population studies can show only correlation, not cause and effect. Yet, the media and consumers overinterpret the results and take them as gospel.
Many experimental nutrition studies often have only small numbers of people in them, making it hard to draw firm conclusions. Even wor
se: The diets they use for comparison (the control group) are not ideal alternative diets. Comparing a toxic vegan diet of chips, Coke, bagels, and pasta to a high-fat, whole-foods diet of healthy veggies, olive oil, nuts, and grass-fed meat won’t be very helpful, nor would comparing a toxic, processed diet of feedlot meat, foods with trans fats, and no fresh veggies or fruit to a whole-foods, low-glycemic plant-based or vegan diet.
So how do you make sense of the contradictory, oftentimes confusing information, break past the unnecessary polarization in nutrition science, and find a path that forges an ideal weight and optimal health? You put all the pieces together like a puzzle, consider all the potential issues and conflicts, and see the story the data tells. I have spent hundreds if not thousands of hours combing through the research, reviewing thousands of scientific papers, and talking to dozens of experts. I have seen tens of thousands of patients, reviewed their blood work, and seen how they’ve responded to different dietary and nutritional interventions. I have spent the time wading through and deciphering all the geeky science so you don’t have to do the hard work. I have done the homework for you to develop this program that gets you out of the dangerous fear of fat and into a sane, sustainable diet to rev up your metabolism and optimize your health.
I love this program. The fats keep me full and remove cravings and eating real food is delicious. It doesn’t feel like a diet; it feels like my new normal life.