The Big Fat SurpriseI recently finished reading Nina Teicholz’s excellent book “The Big Fat Surprise” which further demolishes the low fat diet as a reasonable recommendation for the health of most Americans. She has made the discussion of the relevant studies, personalities and basic science fascinating, and I recommend the book to anyone interested in nutrition science, preventive medicine or simply their own health as it relates to diet. My intent in this series is to review the book in more detail and give a primer on dietary fat. First, however, I thought it would give context to briefly review my own history as a family doctor dealing with chronic disease brought on by our highly processed and often toxic food supply.

Medical school at UT Memphis and residency training in Houston, TX prepared me well to care for the common medical needs of newborns through the elderly. Traditional methods of chronic disease management, however proved to be not only inadequate but in my opinion harmful. I’ll use the treatment of diabetes as an example. In treating diabetic patients, we were taught to recommend a standard lower calorie and low fat diet. We then aggressively treated their “numbers” (cholesterol, blood pressure, blood sugar) with an ever growing arsenal of medications without direct attention to the root cause of the disease. It was like trying to get rid of weeds in the grass with a lawn mower. Everything looks great for a while, but the roots remain and the weeds come back with a vengeance. To effectively treat diabetes, you must aggressively deal with insulin resistance which requires significant lowering of carbohydrates. Successfully lowering carbs yet maintaining a diet which is palatable and satisfying and in the long run healthy requires a significant raising of fat. Thus the importance of “The Big Fat Surprise”. How did I come to this insight over 20 years ago? The credit goes to one of my favorite patients. I will explain next time.