Eat Fat, Get Thin: Why the Fat We Eat Is the Key to Sustained Weight Loss and Vibrant Health
By Mark Hyman
Little, Brown and Company
Dr. Mark Hyman gladly jumps onto the fat-is-good-even-saturated-fat bandwagon with his latest book, Eat Fat, Get Thin. The cover photo—showing nuts, avocados, olives and vegetable oil—tells us what to expect before even cracking the book open. Hyman describes his diet as whole-food, low-carb and paleo-vegan (“pegan”), but what he really is prescribing is a semi-vegan high-fat diet with all the wrong fats. Hyman also recommends a long list of supplements, conveniently for sale on the website set up especially for this book. A fiber supplement three times a day? So much for whole food.
In the book’s acknowledgements, we discover that the recipes come not from Hyman but from a chef-nutritionist who also compiled recipes for Hyman’s 2013 book The Daniel Plan. The recipes feature many current food fads (cauliflower rice, raw kale salads, zucchini noodles, bulletproof coffee with coconut oil, resistant starch, smoothies with raw goitrogenic spinach and vegetable broth).
Dr. Hyman thanks Neal Barnard and Joel Fuhrman (vegans), Deepak Chopra, Jeffrey Bland, Chris Kresser (twice) and others who helped him “get the science and story right.” Despite the focus on accurate science, Hyman is confused (or confusing) when he calls palmitoleic acid (an omega-7 monounsaturated fatty acid) a saturated fat. He also misinterprets studies that he uses to argue that although saturated fats aren’t bad on the whole, a few are (mainly palmitic and stearic acid), and he points out that carbs drive the formation of these saturated fatty acids in the liver. But wait—isn’t stearic acid the one saturated fat that experts have always rated as benign because it doesn’t raise cholesterol levels? Hyman deems meat and eggs as acceptable (after lengthy deliberation), although they are common sources of palmitic and stearic acid.
Hyman’s comments about cholesterol are confusing. He argues that we should leave total cholesterol and LDL cholesterol tests in the twentieth century, yet he devotes a couple of pages to explaining what our numbers should be on lab tests. He states that cholesterol in older people should be higher but recommends total cholesterol under 200 mg/dL. And so on.
Lies, darned lies and statistics! Dr. Hyman gives us a little lesson in research methods, despairing at the use of food frequency questionnaires, which he perceives as worthless, although they are all we have to gauge food intake. He also notes that whereas investigators like to use the statistical measure of relative risk to grab headlines, it is not a very truthful tool to predict whether a given population will develop a particular chronic condition. Calculating absolute risk is the real game-changer in assessing risk. Hyman also discusses statistical problems such as small sample sizes, poor study design and overreliance on meta-analyses and epidemiological (observational) methods that cannot prove causation. He then turns around and relies on meta-analyses and studies that use relative risk and food frequency questionnaires.
A word of caution to individuals with health issues such as kidney stones, small intestinal bacterial overgrowth, digestive challenges or malabsorption. Before considering Hyman’s diet, please research the anti-nutrient content of the foods he recommends. Many contain medium to high levels of phytates, lectins, oxalates and trypsin inhibitors. For example, Hyman enthusiastically recommends eating nuts and seeds of all kinds in many different forms, although raw nuts and seeds are indigestible and harmful unless they have been soaked and dried before eating. Roasted nuts and seeds have high amounts of oxidized fats, trans fats and denatured proteins. Roasted almonds, pine nuts and cashews are high in oxalates, which are often a problem for children with autism. Anti-nutrients from nuts and seeds can pass into breast milk and cause digestive distress in infants.
Almonds contain the most anti-nutrients of any nut and have an omega-6 to omega-3 ratio of almost two thousand to one, yet almonds are Hyman’s go-to food, appearing in numerous recipes. These include homemade almond milk, almond milk smoothies (four recipes), almond sauces and almond pesto. A reviewer commented: “But how much almond milk can a person stand?” Another remarked that she became weary of the “weird almond concoctions.” Hyman recommends getting organic raw almonds to “protect yourself from. . . contaminants,” but “raw” is a misnomer. If the almonds come from California—and most do—they are either pasteurized or sprayed with a toxic chemical.
A chapter on “controversial foods”—which includes eggs, coconut oil and olive oil—provides more “good news on nuts and seeds.” Hyman touts a “37 percent reduced risk of heart disease if you eat nuts,” gleaned from observational studies such as the Seventh Day Adventist Health studies, the Nurses Health Study, and the Physicians Health Study.
Regarding the diet plan itself, a reviewer states: “The original 21-day plan is the minimum, and this plan is however long it takes to lose the weight you…need to lose. So your ‘21-day plan’ might last a year or more. While on the 21-day plan, the restricted food list is very, very, very long.” After completing this phase, the full “pegan” diet incorporates beans, lentils and one-half cup of non-gluten grains per day. Hyman does not include beans and grains in the initial stages because of their lectin content. (Don’t nuts have lectins?)
Hyman characterizes his diet as an “elimination diet” because it initially eliminates gluten, dairy and many other foods. Unfortunately, large quantities of allergenic nuts as well as plentiful soy may defeat the purpose of an elimination diet. At some point, Hyman allows you to add back in small amounts of gluten and dairy, depending on “how you feel,” but only “from time to time.”
Most of the recipes avoid dairy, instead featuring coconut milk, cashew cream, nut butters, avocado and lots of coconut oil mayonnaise. The recipes also eschew grains, substituting coconut flour, seeds and ground nuts. For “healthy” oils, Hyman recommends a good dollop of olive oil along with sesame oil and walnut, almond and macadamia oils (which are expensive and usually rancid), although elsewhere he unjustifiably demonizes macademia nut oil for its high palmitoleic acid content. Hyman’s list of healthy fats does not include any animal fats, although the latter certainly qualify as paleo. Maybe he is worried about saturated fats after all? Butter briefly shows up in a few recipes and in the “controversial foods” chapter. There, he applauds the saturated fats in butter and compares them to saturated-fat-rich breast milk.
For proteins, Hyman recommends eggs, grass-fed meats (except pork), fatty fish and shellfish, poultry, tofu and tempeh, seeds…and nuts—two to three handfuls daily in this “nutty” diet. Hyman appears to be unaware that nuts have variable protein content (from 3 to 50 percent) along with high levels of rancidity-prone polyunsaturated fats and anti-nutrients. Eating liberal quantities of nuts also does not encourage weight loss and may lead to weight gain. Dr. Michael Eades wonders whether nuts are truly paleo. Did our ancestors consume jars of nuts, nut butters and nut oils? Hyman expresses some reservations about protein powders but provides guidelines for using them in smoothies, and he wholeheartedly endorses them in The Daniel Plan, selling the “right” ones on his website.
I will let reviewers on Good Reads sum up my opinion of this book:
• “The groceries alone would be cost-prohibitive, not to mention the supplements and planning. …Would this new life you have be worth living when you literally cannot eat anything out there?”
• “In some local grocery stores, I can buy a pound of bacon and a pound of grass-fed beef for less than a pound of walnuts.”
• “At some point [Hyman] switched from being an authentic-sounding doctor, to being an infomercial salesman. “
• “There is no reason people need multiple bizarre supplements to be healthy nor do you have to cut out gluten and dairy if you don’t have an allergy to [them].”
Would I purchase this book if I weren’t reviewing it? Are you nuts? There are much more interesting books out there such as Sally Fallon Morell’s new book Nourishing Fats and Nina Teicholz’s The Big Fat Surprise. The thumb is DOWN for Eat Fat, Get Thin.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Summer 2017.