Rise and Fall of The Low Fat Diet

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In the 1980’s the low fat diet dominated the American landscape for the go-to healthy diet.

Promoted by medical associations and propagated widely by the media, it was everywhere. You thought seeing gluten-free foods everywhere was annoying? Nothing compared to the scope and length of time, the low fat diet ruled for.

History of low-fat

The American culture of weight loss was well entrenched by the late 19th century, and by the 1920s, many women were losing weight to fit in with the fashionable, slimmer, and more revealing clothes of the era.

The preferred method of dieting at the time was counting calories, which is to simply minimize the total amount of calories consumed each and every day. The smarter dieters realized that fat had 9 calories per gram, while protein and carbohydrate had only 4.

Common sense would then suggest you focus on restricting the component with the highest calorie density, which would be fat. I mean, theres even ‘fat’ in the name! So obviously eating something called ‘fat’ would make you fat. Right?

So even before the low fat diet took hold in the mid to late 20th century, it seemed to make sense back then to restrict fat in one’s diet if you wanted to lose weight. But it isn’t easy to restrict fats, especially for the American people in the 20th century.

The American diet back then was full of saturated fats, rich, and flavorful foods, such as mashed potatoes and butter, Beef Stroganoff, meatloaf, other deliciously fatty cuts of meat, and rich creamy soups.

Desserts were even better, with pies, ice cream, cakes, and cookies of all types. I mean there were some weird things too like molded Jello salad… yikes.

Combine that with smoking being so much more prevalent back then, and It was not hard to see why coronary heart disease was the leading cause of death by 1940.

Research into low fat

The medical community sounded the alarms, and In 1948, the Framingham Study was initiated by the United States Public Health Service. It is currently a cohort study of the residents of the city of Framingham, Massachusetts to “identify common factors or characteristics that contribute to cardiovascular disease”. I say currently because the study is still ongoing, and is the longest cohort study on cardiovascular disease to this day.

Together with other cardiovascular studies, such as the Seven Countries study, researchers found that there were modifiable lifestyle characteristics that were strongly associated with cardiovascular disease, things like smoking.

The studies also found that diet, particularly diets high in saturated fats and cholesterol, were strongly correlated to coronary heart disease. Thus the diet-heart hypothesis was created, which held that diets high in saturated fats and cholesterol were a major cause of coronary heart disease.

It’s important to note that, although the studies found correlation, there was still no proof of causation.

So while high amounts of saturated fats and cholesterol were found in the diets of many people with coronary heart disease, it did not necessarily mean that these foods were CAUSING coronary heart disease in these people.

Nonetheless, researchers began promoting a low fat diet. And in 1961, the American Heart Association or AHA, an American non profit organization, recommended that reducing dietary fat was a way to lower the risk of coronary heart disease.

At first, the recommendation was more tentative, with the AHA recommending it only for people already at high risk for heart disease, but when a publication came out that found obesity as another independent risk factor, and with the prevailing belief that low fat diets were common sense for weight loss, low fat diets were starting to look real good to the medical community.

And it was about to look real good to the general community.

Rise and fall

The rise

In 1977, The USDA Food and Nutrition Service, which is tasked with providing nutrition education, published lower fat, and higher carbohydrate dietary recommendations, things such as switching from whole fat milk to nonfat milk.

However, there was pushback. Critics in the medical community argued that the diet-heart hypothesis was unproven. Critics in the food industry didn’t want people to stop buying their fatty foods.

So under pressure, the USDA revised their guidelines to use more open wording, things like “choose meats and fish that will reduce saturated fats” rather than simply “reduce meat consumption”.

But the march towards low fat was ultimately unstoppable. The National Cancer Institute made their own low fat dietary recommendations. Low fat diets could now reduce the risk of cancer as well.

By the end of the 1980s, both the Surgeon General and World Health Organization promoted low fat for pretty much everyone. The USDA published its first food pyramid shortly thereafter, putting fats as the least recommended food group.

These recommendations, however, were not exclusively low fat. What I mean by this, is that although these departments had a low fat dietary component as a part of their guidelines, it was only a small or moderate part of the whole dietary recommendation.

For example, the USDA 1977 Dietary Goals for the United States says the goals were “increasing consumption of complex carbohydrates and naturally occurring sugars; reducing consumption of refined and other processed sugars; reducing overall fat consumption, saturated fat consumption, and cholesterol consumption; and limiting intake of sodium.” Essentially to eat more fruits, whole grains, poultry and fish. And less meat, eggs, and processed foods.

It seems like pretty reasonable advice back then, and honestly sounds like pretty good advice now. It was only when the media took hold of the information, and began promoting and focusing solely on the low fat component of the recommendations, that the low fat ideology began to embed itself in the American psyche. Publishing articles in journals, advertising for low fat processed foods, and recipes for low fat meals, it was everywhere.

America had labelled its number one villain, and it wasn’t Hannibal Lecter or Agent Smith, it was fat. And low fat diets were the hero.

The riches

The food industry, originally concerned with the change, realized it could cater to consumer tastes by simply replacing the fat in their processed foods with sugar and slapping “low fat” or “no-fat” stickers all over it. Nabisco’s Snackwell cookie marketed itself as a reduced-fat “healthy” cookie, and quickly became the best selling cookie in America at the time, despite having about the same amount of calories and sugar as a regular cookie.

In 1995, sales reached about $490 million, and The craze became known as the Snackwell effect, which is the idea that people will go overboard if given a free pass.

The AHA, not to be outdone, introduced its “Heart Healthy” labelling. Food companies could pay to have their foods certified and receive the AHA “Heart Healthy” sticker of approval.

By 1997, over 600 products were certified and received the paid AHA seal of approval. The problem however, was that actual foods that were healthy for your heart, like fresh fruits, were not being labelled “Heart Healthy” in grocery stores. So you would have low fat processed foods such as sugary cereals, cookies and pies labelled as “heart healthy” and recommended by the AHA, and fresh fruits, nuts, and vegetables sitting there with no stickers recommending it.

This understandably confused a lot of consumers, and misled many into thinking the AHA approved Frosted Flakes were actually better for your heart than fresh salad.

Americans were obsessively counting fats. Counting calories fell by the wayside, and you could now eat as much as you wanted, as long as it was low fat.

The fall

So perhaps it wasn’t surprising that despite the well-meaning intentions of the low fat diet, the rates of heart disease and obesity in America continued to rise out of control.

Critics argued that it was the types of fat, rather than all fat, that were correlated with heart disease.

Dr. Jules Hirsch, a leading obesity researcher at Rockefeller University, found that once the dietary fat content of food got below 20%, the body would end up producing its own saturated fat anyways. The body needed dietary fat to function properly.

The landscape started to change as different new and old dietary ideas became more widely accepted.

Other researchers began to look into the efficacy of low-carbohydrate diets, and the media jumped on it. The low-carbohydate Atkins diet rose to prominence, along the other fad diets such as the South Beach diet. The early 2000s ushered in the low-carbohydrate craze, which is now being revived as the no-carb diet or ketogenic diet.

The food industry once again pivoted to consumer tastes, pumping out highly-processed, low-carbohydrate foods, and branded them as healthy and weight conscious. Low fat was out, and low carb was in.

Lessons learned

The low fat diet was borne out of research in the mid to late 20th century. While the research was sound, the evidence was still new, and needed refinement. Time to mature and really savor the flavours, to really understand the evidence. It highlights to us how important it is for the medical community to avoid drawing premature conclusions, especially when it comes to public health.

But I think another important lesson we can learn is that, even during the low fat craze, many of the official dietary recommendations from the USDA, NCI, and other governmental health departments, were pretty reasonable if you actually read them in their entirety.

When the media got a hold of the information, and maybe it was just oversimplification or miscommunication, it was boiled down to simply low fat. If it was low fat, it must be good.

The food industry simply followed consumer demand. Because everyone was now looking for low fat, they were more than willing to provide low fat snacks and foods. And thanks to some creative labelling, consumers readily devoured these highly processed snacks, and actually believed it to be helpful for heart health and weight loss.

I think, if most people had gone to the source, and read the dietary recommendations directly from the health departments, rather than getting them second hand, and heavily-filtered from the media and the food industry, there may have been a lot less confusion.

And this is where you can prevent yourself from being confused about public health matters. Understand that any and all social media, journalists, bloggers, myself, we’re all secondary sources of information. We may do our best to disseminate the information we receive from these health departments, but we’re not perfect. We oversimplify, we omit information, we make mistakes.

If you want accurate health information, don’t go to facebook, find out what your public health department says about it. If we’ve learned anything from the low fat craze, look for reliable sources of information. Together, we can avoid making the same mistakes in the past.

Learn more about

• Orlistat, a weight loss drug used with low fat diets
• Framingham Heart Study
• Other diets for weight loss

See also

• 
  The Glycemic Index Diet: an overview
  The Glycemic Index diet focuses on foods that are lower in glycemic index and load, which can help with diabetes and weight loss.
• 
  Low FODMAP Diet: an overview
  The low FODMAP diet aims to reduce certain types of carbs that can cause bloating and gas. It can sometimes help reduce symptoms of IBS.
• 
  Paleo diet: an overview
  The paleo diet replicates our ancestors diet with wild game, fish, fruits, vegetables, and nuts, while avoiding dairy, grains, and legumes.
• 
  Anti-inflammatory diet: an overview
  The anti-inflammatory diet focuses on eating foods that have anti-inflammatory properties, and avoiding pro-inflammatory foods.
• 
  Gastric Balloon Diet Plan
  Once you have a gastric balloon, properly transitioning from liquids on day 1 to 3, to solids by day 14, is key to success on your balloon.