Monday, August 11, 2008

Wifezilla vs. Dr. Isadore Rosenfeld

Doctor Isadore Rosenfeld is a frequent guest on Fox New Sunday. According to his Fox News bio, "With nine best-selling books to his credit (as well as a textbook for doctors), Dr. Rosenfeld is one of the leading and most effective proponents of the medical enlightenment of the American public. He is a contributing editor of Parade Magazine, with 82 million readers.",2933,34772,00.html

I find him to be very likable, and I enjoy his news segments. Fortunately I have learned to take his recommendations with a grain of salt. Sunday morning, for example, he had an interesting segment on eggs. Once believe to be a contributor to heart disease, Dr. Rosenfeld pointed out a study that showed eating eggs did not raise cholesterol and can actually contribute to weight loss. No big surprise to us low carb fans, but it was sure nice to hear that reported in the main stream. However, a few seconds later he uttered this little sentence..."Saturated fat raises cholesterol levels."

This is a widely held belief, and it is something that is a cherished view of vegetarian activists.

"Saturated fat raises the level of cholesterol in the blood. Cholesterol is present in animal foods but not plant foods. It is essential for metabolism but is not needed in the diet as our bodies can produce all that is needed. Raised blood cholesterol is associated with an increased risk of heart disease."

"Well-planned vegetarian diets provide us with all the nutrients that we need, minus all the saturated fat, cholesterol, and contaminants found in animal flesh, eggs, and dairy products."

The whole animal fats bad/plant oils good idea ignores the reality that not only are animal fats NOT bad for you, not all animal fats are even saturated. "The reality is that both animal and vegetable fats and oils are composed of many different kinds of fats, each with it's own chain length and degree of saturation, and each with a different effect on cholesterol. Half the fat in beef, for instance, is unsaturated, and most of that fat in the same monounsaturated fat as in olive oil. Lard is 60% unsaturated; most of the fat in chicken is unsaturated as well." - Gary Taubes, "Good Calories, Bad Calories"

But before you drive yourself crazy trying to figure out what percentage of each animal product is unsaturated, you should realize, that despite spending millions trying to prove that animal fats, saturated or otherwise, as well as plant based saturated fats like coconut and palm oils are bad for you, the evidence just doesn't pan out.

"The longest, most prestigious and widely quoted long-term study on CHD (coronary heart disease), the Framingham study, clearly shows that those who eat the most saturated fat have the lowest cholesterol levels."

"Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization." - Gary Taubes, "Good Calories, Bad Calories"

So, despite popular wisdom and the words of kindly but misguided Dr. Rosenfeld, saturated fats, though they may or may not raise cholesterol, aren't even bad for you. At worst, they are neutral. At best, they may even be protective.

"We have all been brainwashed into believing that eating foods with any type of fat is a heart attack on a plate, despite the fact that saturated and mono-unsaturated fats have never been shown to cause heart disease, but have been shown to protect against this and many other serious diseases...

Before the twentieth century, most of the fatty acids in the diet were either saturated or monounsaturated, primarily from animal fats such as butter, lard and beef and mutton dripping. In those days, fewer than one in twenty-seven people got cancer and heart disease was so rare that very few doctors had even heard of it, let alone seen a case. At the beginning of the twenty-first century, most of the fats in the diet are polyunsaturated from vegetable oils, and cancer now affects one person in two and heart disease is a major killer." - Barry Groves, "Eat Fat Get Thin"

Dr. Rosenfeld is a great example of why people need to do their own research. Despite what we are often told in the media, the evidence is out there that saturated fats aren't bad for us, cholesterol isn't the cause of heart disease, and people who do intentionally lower their cholesterol don't necessarily live longer. The culprit in the whole heart disease issue is, instead of saturated fat, carbohydrates. I will leave it up to you to dig up the carbohydrate information on your own. Getting a copy of "Good Calories, Bad Calories" will give you a good start.

The funniest thing about the Doctor Rosenfeld segment wasn't his obviously wrong interpretation of what constitutes a bad fat, but what happened later in the segment. Someone had written in about cocoa butter and wondered if she should stop eating it for health reasons. Doctor Rosenfeld said there was no reason to stop since cocoa butter was really good for you and he spent quite a bit of time singing its praises. While I agree that cocoa butter is good for you, obviously Doctor R. didn't realize that cocoa butter is comprised primarily guessed it...saturated fat. Yet, saturated fat is the very thing he warned against just minutes earlier.

This story is a good illustration of why your shouldn't let a kindly face and an authoritative voice on TV, or even a blogger like myself, sway you too much when it comes to something as important as your health. Take everything you hear or see with a large grain of salt and do your own investigation.


Anna said...

Absolutely! I find health information in the media to extremely unreliable, usually generated from PR machines or Drs who haven't really examined the original data or contrary evidence, and often not based on *rigorous* scientific research (there's lots of weak and even bogus "scientific" research out there mainly meant to sell products and agendas). Your description with Dr. Rosenfeld is a perfect example of how the mainstream, even supposedly enlightened medical profession gets it wrong, too, because they accept and disseminate the conventional wisdom without a true understanding and exhaustive review of the data (most only read the summaries, if even that - but the data is where one finds the real value of a study). Any many studies aren't well-designed, are designed to support a particular conclusion (which isn't scientific at all), or are epidemiological, which only shows correlation, not causation (this is often confused by the lay public as well as by medical practitioners).

I have found most people tend to think of MDs as scientists. Guess what? Most aren't scientists at all, not even in the most general sense. Typically, MDs are "practitioners", not scientists. There is a critical difference and patients need to understand this.

Practitioners put into practice the protocols developed by others, usually based on some sort of scientific research, but surprisingly often, the research is NOT peer-reviewed research with well-designed studies (or it is research designed to sell products, like drugs, tests, or procedures, so it doesn't consider alternatives or prevention).

In fact, medicine is a very s-l-o-w moving body, that is very "risk-averse" and tends to do "what they've always done" unless sanctioned by a governing medical authority. Anyone who studies the history of medicine quickly learns that medicine is fraught with bad practices (lobotomy, anyone?). Proponents of theories of bacteria and infectious diseases, etc., were laughed at, scoffed, prosecuted, and worse, for example. Early surgeons had to work in secrecy to study anatomy and surgical technique. Much of the surgical advances in the last 150 years came during warfare, but many surgical techniques still remain quite crude (read detailed descriptions of female pelvic "repair" - it has changed very little in 100 years). A primary theme of medical education is about avoiding risk, only doing what is legally and professional sanctioned by the medical boards, and not sticking one's neck out.

Science, on the other hand, is all about taking risks, finding out "what if", developing and testing hypotheses to see how they hold up, and pushing the boundaries of knowledge. The training of a scientist is nearly opposite that of a medical doctor. A scientist is (or should be) trained to test and retest, even prove his (or the current) theories wrong, to expand knowledge, not rest on what we think we already know. It is about challenging the status quo.

We do need both kinds of thinking, because medicine cannot be experimenting on patients all the time (think about Dr. Frankenstein and the Nazi medical experiments) and it is generally useful to put into practice what the best scientific research has shown to be effective and useful (otherwise we would still have doctors with dirty hands who bleed patients to get rid of "bad humors".

But where I think many things go wrong is when medicine, and poorly executed science meet, especially where profit intersects as well (public health bureaucracies and politics could be added to this mix too), creating a perfect storm of bad info and practice for everyone. I think that is what has happened with the diet-lipid/cholesterol-CVD-statin-Big Pharma intersection. A good review of this situation is detailed extremely well in Gary Taubes' Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease.

The media health machine is a really bad source of information, in my opinion. Most of it is the same old drivel wired all over to newspapers, TV & radio stations, magazines, and internet sites, with little editing and even less review. Worse yet, there is a PR machine that actively reports research info that isn't peer reviewed, isn't well documented (who paid for the study, how large was the study, was it on humans or animals, what were alternative outcomes, are the results repeatable, is it peer-reviewed,etc?). Often the "study" that is reported in the media is just a student or trainee poster session at a meeting, which is preliminary at best, and meant to be used to develop a hypothesis to be further tested, not advice for the public.

Like you say, more than ever, people need to do a lot of their own investigating to see what the contrary views are, too, and then make more informed decisions and choices. Getting one's health info through the popular media could be a dangerous practice. It is easier than ever to learn with the internet (a critical mind is especially important on the Internet, though) and doesn't require a visit to a medical school library anymore. We can't be "sheeple" and just blindly accept what even our medical heroes offer up anymore. There's too much evidence that even they are sold "the wrong goods" on some issues.

Jennifer said...

I couldn't agree more. We all need to be proactive in our own health matters. To rely only on a busy doctor who has 15 to 20 minutes per patient is folly.

Anonymous said...

It is difficult to take health advice from a Dr. who is grossly overweight.

Linda said...

I just saw him on Fox news this weekend. He does appear to have packed on some pounds recently.