Fat: It’s Not What You Think
by Connie Leas
Prometheus Books, 2008
Reviewed by Katherine Czapp
This useful and educational book by Connie Leas provides a great service to both the general reader and the confused patient who seek straightforward answers to their questions about diet and health. Connie Leas is not a biochemist or an expert in lipids, but enjoyed a successful career as an accomplished technical writer. Now retired, Leas continues to write as a hobby and chooses subjects she herself feels need particular exposure. She writes without deadlines and only pitches her books to publishers when they are complete. In her most recent effort, she brings her well-honed skills of transforming complicated information into easily accessible language to the controversial topic of fat.
Not being a recognized “authority” has its advantages. First, with no reputation to defend, Leas did not write with a hidden agenda guiding her hand. Leas approached the topic of fat and diet with the eyes of the uninitiated, and reasonably assumed that if she found the material complex and daunting, the average reader would, too. She resolved to buckle down and learn what she had to in order to explain it clearly to her readers. In matters where complex and contradictory research threatened to obscure the path to clarity, Leas leaned “toward the most persuasive and commonsensical points of view.” As she encountered more controversy, especially regarding the subjects of saturated fat, cholesterol and heart disease, “…the more I researched,” says Leas, “the more convinced I became that we’ve been misled.”
The admirable result of her dedicated effort is a book that not only clearly explains the biology related to fat and its metabolism, but exposes the shaky “science” that has led to Americans’ unreasonable fear and loathing of fat—both in our diet and in our bodies.
Dr. George Mann, retired professor of medicine at Vanderbilt University and former Director of the monumental Framingham Heart Study, provided the foreword to Fat. In it, Dr. Mann denounces the half-century of misinformation dispensed by the American Heart Association and the National Heart Institute, which blames saturated fat and cholesterol for the nation’s epidemic of heart disease. “It is the greatest biomedical error of the twentieth century,” writes Mann. “The advice lingers, for selfish personal reasons and commercial avarice. . . Readers will be appalled at the ways they have been misled in these matters.”
Before parsing even a single fatty acid molecule, Leas introduces her readers to a couple of sociological phenomena that ought to inform and arm us in any encounter with received knowledge. An “informational cascade” is a condition in which “. . . people—even scientists—tend to follow along with and propagate the ideas of someone who acts like an authority.” This phenomenon is classically demonstrated in the perpetuation of the diet-heart hypothesis, which Leas notes was started in 1968 by Surgeon General C. Everett Koop, who “took his cue from Ancel Keys, whose erroneous but popular anti-fat message started the whole anti-fat campaign.”
Although scientists were never able to confirm this faulty hypothesis, it stubbornly persisted, in part because of a “reputational cascade,” in which “scientists fear that questioning the popular wisdom may pose a risk to their careers.” One can easily see how doctors routinely overdiagnose and overprescribe when controlled by the dangerous forces of these two phenomena. Too often today medical research in general often devolves to what Leas calls “science by consensus.”
Fat is not only about saturated fat and cholesterol. Topics range from fat digestion and fat’s many vital functions in the body, to the anatomy of body fat cells and their role in numerous health conditions, to the dangers of lowfat diets and how man-made trans fats have infiltrated the processed food chain and become health-destroyers.
Leas helpfully provides straightforward explanations of often-confusing biochemical terminology, such as triglycerides, omega-3, 6 and 9 fats, trans and cis fats, and polyunsaturated oils. We frequently see and hear these terms bandied about in the media, but even though they seem familiar from so much repetition, very few of us understand them very well. And sometimes innocent nomenclature confuses matters even more. In the case of saturated fat, for example, Leas pauses to point out to the reader that these fat molecules are saturated with hydrogen atoms, “not glop as we might imagine.” We are conditioned to think “glop,” of course, because we have always heard the fear-inspiring “arteryclogging” or “heart-stopping” precede “saturated fat” so many hundreds of times from purported media “authorities.”
Leas discusses recent research that reveals body fat to be now considered the largest endocrine organ of the body, and elucidates the multifarious effects of some of the many hormones that body fat produces, such as leptin and adiponectin. These hormones regulate appetite and fatty acid metabolism in the body, and play important roles in relation to homeostasis, as well as in obesity, diabetes and other disorders.
The sections devoted to obesity and body fat contain many of the theories currently popular on the roots of the obesity epidemic (processed industrial foods, ubiquity of corn syrup, demise of traditional family mealtimes, and so on). But is it really so disastrous to be overweight or even obese? Paradoxically, there is mounting evidence that people whose weight hovers between corpulent and statistically obese live longer, and are less likely to die from Alzheimer’s, Parkinson’s, infections and lung disease than their thin counterparts. To the further chagrin of dieters, the lowered risk of these diseases does not come at the expense of an increased risk of cancer, heart disease or diabetes. And fatter people may be happier than thinner people, too.
Fat: It’s Not What You Think makes a valuable contribution to the growing literature that exposes the ways in which the modern, industrialized diet has led to widespread disease. Just as important, Leas helps to resurrect fat’s wrongfully besmirched reputation. In just over 160 pages of text with more than 50 pages of references this clear, concise synopsis of information and research is a resource one will reach for again and again. It would make a fine introduction to the subject for the high school student interested in biology and health. If you have friends or family who are still terrified of fat and don’t know that butter is better than canola oil, this could be the book to convince them. If your doctor is threatening you with statin drugs to “cure” your “dangerous” cholesterol levels, Fat just might make him think twice. After all, more than half the dry weight of our cerebral cortex is cholesterol, and you can be proof of the fact that high serum cholesterol is associated with faster mental processing.
Thanks to Connie Leas for tackling a controversial subject with common sense and good humor, and creating a useful handbook on the topic for a wide audience.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Winter 2008.