Let’s Ask Marion: Thumbs Up For Pollan’s “Manifesto”?

(With a click of her mouse, EatingLiberally’s kat corners Dr. Marion Nestle, NYU professor of nutrition and author of Food Politics and What to Eat:)

Kat: I just finished Michael Pollan’s new book, In Defense of Food, and found it to be a fairly scathing indictment of our corroded, corrupted food chain. Any book that calls on Americans to boycott CAFOs and support CSAs is A-OK with me.

But—and this is a big but—I was perplexed that he seems to embrace the “fat is a faux foe” school of thought, which purports that the link between saturated fat consumption and heart disease, diabetes, and obesity is some kind of medical myth. Pollan suggests other potential--and plausible--villains: excess consumption of carbs; insufficient exercise; round-the-clock snacking; the lack of diversity in the Western diet that deprives us of so many crucial nutrients, and so on.

According to this theory, fat is just a red herring (chock full of omega 3’s, presumably) and the connection between the cholesterol in our food and the cholesterol in our blood is another myth, a marketing ploy to sell margarine. So why does every doctor I know tell me to watch my borderline-high cholesterol and go easy on the cheese? Are they all suckers, Lipitor lemmings, co-conspirators in a big fat hoax?

Dr. Nestle: Cheers for Michael Pollan's new book and the great work he is doing to teach everyone about food systems. Of course I love his book. It says exactly what I did in What to Eat, and he is a journalist with a broader reach. I don't see his book as an exhortation to eat more fat, saturated fat, and cholesterol. On the contrary, his advice is crystal clear: "Eat food. Not too much. Mostly plants." This is just what I said in What to Eat: "Eat less, move more, eat plenty of fruits and vegetables, and don't eat too much junk food." It's also just what federal agencies have been advising for the last 30 years, although in code.

As I am constantly trying to explain, the science of nutrition is complicated. I am not aware of any disagreement that high blood cholesterol is a risk factor for coronary heart disease. But it's just a risk factor. That means that people with higher blood cholesterol levels have a greater chance of developing coronary heart disease. How much greater? It depends. Risk factors just mean that on average, across the population, the chance is greater, but for any one individual the specific risk is uncertain and depends on all the other dietary, behavioral, environmental, and genetic factors that also affect risk. As for saturated fat: Surely there is no disagreement that it raises the risk of higher blood cholesterol levels, almost as much as trans fats do. Here too, we are talking about risk, not inevitability.

In the late 1980s, at least three American and international health agencies (the Department of Health and Human Services, the Institute of Medicine, and the World Health Organization) issued enormous reports reviewing the evidence and concluding that people would have a lower risk of chronic diseases if they ate less fat. I was involved in the one from DHHS--the Surgeon General's Report on Nutrition and Health--so I know something about the thinking at that time.

Two factors were involved. The first was scientific: by reducing overall fat intake, people would automatically reduce their intake of both saturated fat and calories and, therefore, reduce their risk of heart disease and obesity-related diseases all at once. The second was political: the principal food sources of saturated fats are meat and dairy products. So advice to eat less saturated fat really means the politically impossible “eat less meat and dairy foods.” In this political context, “eat less total fat” was a euphemism for “eat less of foods of animal origin.”

What none of us could foresee was the food industry's response--to flood the market with low-fat products that contained just as many calories, this time from sugars (among them, high fructose corn syrup). "Low-fat," as we now know from Brian Wansink's work, is a signal to eat more calories. So it’s no surprise that people gained weight. One of the things I like most about Pollan's book is its emphasis on foods, not nutrients. We now understand that to focus on fat or carbohydrates outside of their food sources is to confuse the issues. So is a focus on nutrients without taking calories into consideration. Pollan’s book gives good advice about what to eat and is a great start to the new year.