Good Calories, Bad Calories

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Authors: Gary Taubes
principle, but felt they had an obligation to provide their patients with the latest medical wisdom. Though their patients might appear healthy at the moment, they could be inducing heart disease by the way they ate, which meant they should be treated as though they already had heart disease. So these doctors prescribed the diet that they believed was most likely to prevent it. They believed that withholding their medical wisdom from patients might be causing harm. Though Keys, Stamler, and like-minded physicians respected the philosophy of their skeptical peers, they considered it a luxury to wait for “final scientific proof.” Americans were dying from heart disease, so the physicians had to act, making leaps of faith in the process.
    This optimistic philosophy was evident early in the controversy. In October 1961, The Wall Street Journal reported that the NIH and the AHA were planning a huge National Diet-Heart Study that would answer the “important question: Can changes in the diet help prevent heart attacks?” Fifty thousand Americans would be fed cholesterol-lowering diets for as long as a decade, and their health compared with that of another fifty thousand individuals who continued to eat typical American diets. This article quoted Cleveland Clinic cardiologist Irving Page saying that the time had come to resolve the conflict:
    “We must do something,” he said. Jeremiah Stamler said resolving the conflict would “take five to ten years of hard work.” The article then added that the AHA was, nonetheless, assembling a booklet of cholesterol-lowering recipes. The food industry, noted The Wall Street Journal, had already put half a dozen new cholesterol-lowering polyunsaturated margarines on the market. Page was then quoted saying, “Perhaps al this yakking we’ve been doing is beginning to take some effect.” But the yakking, of course, was premature, because the National Diet-Heart Study had yet to be done. In 1964, when the study stil hadn’t taken place, a director of the AHA described its purpose as the equivalent of merely “dotting the final i” on the confirmation of Keys’s hypothesis.
    This is among the most remarkable aspects of the controversy. Keys and other proponents of his hypothesis would often admit that the benefits of cholesterol-lowering had not been established, but they would imply that it was only a matter of time until they were. “The absence of final, positive proof of a hypothesis is not evidence that the hypothesis is wrong,” Keys would say. This was undeniable—but irrelevant.
    The press also played a critical role in shaping the evolution of the dietary-fat controversy by consistently siding with proponents of those who saw dietary fat as an unneccessary evil. These were the researchers who were offering specific, positive advice for the health-conscious reader—eat less fat, live longer. The more zealously stated, the better the copy. Al the skeptics could say was that more research was necessary, which wasn’t particularly quotable. A positive feedback loop was created. The press’s favoring of articles that implied Keys’s hypothesis was right helped convince the public; their belief in turn would be used to argue that the time had come to advise cholesterol-lowering diets for everyone, thus further reinforcing the belief that this advice must be scientifical y defensible.

    Believing that your hypothesis must be correct before al the evidence is gathered encourages you to interpret the evidence selectively. This is human nature. It is also precisely what the scientific method tries to avoid. It does so by requiring that scientists not just test their hypotheses, but try to prove them false. “The method of science is the method of bold conjectures and ingenious and severe attempts to refute them,” said Karl Popper, the dean of the philosophy of science. Popper also noted that an infinite number of possible wrong conjectures exist for every one that happens to

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