Fats & Protein vs. Carbohydrates (Part 7)

[Guest guest]

THE OILING OF AMERICA (part 7)

by Enig, PhD

NATIONAL CHOLESTEROL CONSENSUS CONFERENCE

Dissenters were again invited to speak briefly at the NHLBI-

sponsored National Cholesterol Consensus Conference held later that

year, but their views were not included in the panel's report,

for the simple reason that the report was generated by NHLBI staff

before the conference convened. Dr. Teter discovered this when she

picked up some papers by mistake just before the conference began,

and found they contained the consensus report, already written, with

just a few numbers left blank. Kritchevsky represented the lipid

hypothesis camp with a humorous five-minute presentation, full of

ditties. Ahrens, a respected researcher, raised strenuous

objections about the " consensus, " only to be told that he had

misinterpreted his own data, and that if he wanted a conference to

come up with different conclusions, he should pay for it himself.

The 1984 Cholesterol Consensus Conference final report was a

whitewash, containing no mention of the large body of evidence that

conflicted with the lipid hypothesis. One of the blanks was filled

with the number 200. The document defined all those with cholesterol

levels above 200 mg/dL as " at risk " and called for mass

cholesterol screening, even though the most ardent supporters of the

lipid hypothesis had surmised in print that 240 should be the magic

cutoff point. Such screening would, in fact, need to be carried out

on a massive scale as the federal medical bureaucracy, by picking

the number 200, had defined the vast majority of the American adult

population as " at risk. " The report resurrected the ghost of

Norman Jolliffe and his Prudent Diet by suggesting the avoidance of

saturated fat and cholesterol for all Americans now defined as

" at risk, " and specifically advised the replacement of butter

with margarine.

The Consensus Conference also provided a launching pad for the

nationwide National Cholesterol Education Program, which had the

stated goal of " changing physicians' attitudes. "

NHLBI-funded studies had determined that while the general

population had bought into the lipid hypotheses, and was dutifully

using margarine and buying low-cholesterol foods, the medical

profession remained skeptical. A large " Physicians Kit " was

sent to all doctors in America, compiled in part by the American

Pharmaceutical Association, whose representatives served on the NCEP

coordinating committee. Doctors were taught the importance of

cholesterol screening, the advantages of cholesterol-lowering drugs

and the unique benefits of the Prudent Diet. NCEP materials told

every doctor in America to recommend the use of margarine rather

than butter.

CHOLESTEROL SCREENING FOR EVERYONE

In November of 1986, the Journal of the American Medical Association

published a series on the Lipid Research Clinics trials,

including " Cholesterol and Coronary Heart Disease: A New Era "

by longtime American Heart Association member Grundy, MD,

PhD.35

The article is a disturbing combination of euphoria and agony—

euphoria at the forward movement of the lipid hypothesis juggernaut,

and agony over the elusive nature of real proof. " The recent

consensus conference on cholesterol. . . implied that levels between

200 and 240. . carry at least a mild increase in risk, which they

obviously do. . . " said Grundy, directly contradicting an earlier

statement that " Evidence relating plasma cholesterol levels to

atherosclerosis and CHD has become so strong as to leave little

doubt of the etiologic connection. " Grundy called for " . . .

the simple step of measuring the plasma cholesterol level in all

adults. . . those found to have elevated cholesterol levels can be

designated as at high risk and thereby can enter the medical care

system. . . an enormous number of patients will be included. "

Who benefits from " the simple step of measuring the plasma

cholesterol level in all adults? " Why, hospitals, laboratories,

pharmaceutical companies, the vegetable oil industry, margarine

manufacturers, food processors and, of course, medical

doctors. " Many physicians will see the advantages of using drugs

for cholesterol lowering. . . " said Grundy, even though " a

positive benefit/risk ratio for cholesterol-lowering drugs will be

difficult to prove. " The cost in the US of cholesterol screening

and cholesterol-lowering drugs alone now stands at sixty billion

dollars per year, even though a positive risk/benefit ratio for such

treatment has never been established. Physicians, however,

have " seen the advantages of using drugs for cholesterol

lowering " is a way of creating patients out of healthy people.

Grundy was equally schizophrenic about the benefits of dietary

modification. " Whether diet has a long term effect on

cholesterol remains to be proved, " he stated, but " Public

health advocates furthermore can play an important role by urging

the food industry to provide palatable choices of foods that are low

in cholesterol, saturated fatty acids and total calories. " Such

foods, almost by definition, contain partially hydrogenated

vegetable oils that imitate the advantages of animal fats. Grundy

knew that the trans fats were a problem, that they raised serum

cholesterol and contributed to the etiology of many diseases—he

knew because a year earlier, at his request, Enig had sent him

a package of data detailing numerous studies that gave reason for

concern, which he acknowledged in a signed letter as " an

important contribution to the ongoing debate. "

Other mouthpieces of the medical establishment fell in line after

the Consensus Conference. In 1987 the National Academy of Science

(NAS) published an overview in the form of a handout booklet

containing a whitewash of the trans problem and a pejorative

description of palm oil—a natural fat high in beneficial

saturates and monounsaturates that, like butter, has nourished

healthy population groups for thousands of years, and, also like

butter, competes with hydrogenated fats because it can be used as a

shortening. The following year the Surgeon General's Report on

Nutrition and Health emphasized the importance of making low-fat

foods more widely available. Project LEAN (Low-Fat Eating for

America Now) sponsored by the J. Kaiser Family Foundation and a host

of establishment groups such as the America Heart Association, the

American Dietetic Association, the American Medical Association, the

USDA, the National Cancer Institute, Centers for Disease Control and

the National Heart, Lung and Blood Institute announced a publicity

campaign to " aggressively promote foods low in saturated fat and

cholesterol in order to reduce the risk of heart disease and

cancer. "

NATIONAL FOOD PROCESSORS ASSOCIATION CONFERENCE

The following year, Enig joined McLaughlin, Director of the

Center for Business and Public Policy at the University of land,

in testimony before the National Food Processors Association. It was

a closed conference, for NFPA members only. Enig and McLaughlin had

been invited to give " a view from academia. " Enig presented a

number of slides and warned against singling out classes of fats and

oils for special pejorative labeling. A representative from Frito-

Lay took umbrage at Enig's slides, which listed amounts of trans

fats in Frito-Lay products. Enig offered to redo the analyses if

Frito-lay would to fund the research. " If you'd talk

different, you'd get money, " he said.

Enig urged the association to endorse accurate labeling of trans

fats in all food items but conference participants—including

representatives from most of the major food processing giants—

preferred a policy of " voluntary labeling " that did not

unnecessarily alert the public to the presence of trans fats in

their foods. To date they have prevailed in preventing the inclusion

of trans fats on nutrition labels.

Enig's cat and mouse game with Hunter and Applewhite of the

Institute of Shortening and Edible Oils continued throughout the

later years of the 1980's. Their modus operandi was to pepper

the literature with articles that downplayed the dangers of trans

fats, to use their influence to prevent opposing points of view from

appearing in print and to follow-up the few alarmist articles that

did squeak through with " definitive rebuttals. " In 1987 Enig

submitted a paper on trans fatty acids in the US diet to the

American Journal of Clinical Nutrition, as a reply to the erroneous

1985 FASEB report as well as to Hunter and Applewhite's

influential 1986 article, which by even the most conservative

analysis underestimated the average American consumption of

partially hydrogenated fats. Editor-in-chief Albert Mendeloff, MD

rejected Enig's rebuttal as " inappropriate for the

journal's readership. " His rejection letter invited her to

resubmit her paper if she could come up with " new evidence. "

In 1991, the article finally came out in a less prestigious

publication, the Journal of the American College of Nutrition,36

although Applewhite did his best to coerce editor Mildred Seelig

into removing it at the last minute. Hunter and Applewhite submitted

letters and then an article of rebuttal to the American Journal of

Clinical Nutrition,37 which were published shortly thereafter. In

the article, entitled " Reassessment of trans fatty acid

availability in the US diet, " Hunter and Applewhite argued that

the amount of trans in the American diet had actually declined since

1984, due to the introduction of soft margarines and tub spreads.

The media fell in line with their pronouncements, with numerous

articles by food writers recommending low-trans tub spreads, made

from polyunsaturated vegetable oils, as the sensible alternative to

saturated fat from animal sources—not surprising

as most newspapers rely on the International Food Information

Council, an arm of the food processing industry, for their nutrition

information.

OTHER RESEARCH ON TRANS FATS

Enig and the University of land group were not alone in their

efforts to bring their concerns about the effect of partially

hydrogenated fats before the public. Fred Kummerow at the University

of Illinois, blessed with independent funding and an abundance of

patience, carried out a number of studies that indicated that the

trans fats increased risk factors associated with heart disease, and

that vegetable-oil-based fabricated foods such as Egg Beaters cannot

support life.38 Mann, formerly with the Framingham project,

possessed neither funding nor patience—he was, in fact, very

angry with what he called the Diet/Heart scam. His independent

studies of the Masai in Africa,39 whose diet is extremely rich in

cholesterol and saturated fat, and who are virtually free of heart

disease, had convinced him that the lipid hypothesis was " the

public health diversion of this century. . . the greatest scam in

the history of medicine. " 40 He resolved to bring the issue

before the public by organizing a conference in Washington DC in

November of 1991. " Hundreds of millions of tax dollars are

wasted by the bureaucracy and the self-interested Heart

Association, " he wrote in his invitation to participants.

" Segments of the food industry play the game for profits.

Research on the true causes and prevention is stifled by denying

funding to the `unbelievers.' This meeting will review the

data and expose the rascals. "

The rascals did their best to prevent the meeting from taking place.

Funding promised by the Greenwall Foundation of New York City was

later withdrawn, so Mann paid most of the bills. A press release

sent as a dirty trick to speakers and participants wrongly announced

that the conference had been cancelled. Several speakers did in fact

renege at the last minute on their commitment to attend, including

the prestigious Dr. Roslyn Alfin-Slater and Dr. Nixon of

London. Dr. Eliot Corday of Los Angeles cancelled after being told

that his attendance would jeopardize future funding.

The final pared-down roster included Dr. Mann, Dr. Enig,

Dr. Victor Herbert, Dr. Petr Skrabenek, B. Parsons, Jr., Dr.

McCormick, a physician from Dublin, Dr. Stehbens from

New Zealand, who described the normal protective process of arterial

thickening at points of greatest stress and pressure, and Dr. Meyer

Texon an expert in the dynamics of blood flow. Mann, in his

presentation, blasted the system that had foisted the lipid

hypothesis on a gullible public. " You will see, " he said,

" that many of our contributors are senior scientists. They are

so for a reason that has become painfully conspicuous as we

organized this meeting. Scientists who must go before review panels

for their research funding know well that to speak out, to disagree

with this false dogma of Diet/Heart, is a fatal error. They must

comply or go unfunded. I could show a list of scientists who said to

me, in effect, when I invited them to participate: `I believe

you are right, that the Diet/Heart hypothesis is wrong, but I cannot

join you because that would jeopardize my perks and funding.'

For me, that kind of hypocritical response separates the scientists

from the operators—the men from the boys. "