Eat Fat, Get Thin: Why the Fat We Eat Is the Key to Sustained Weight Loss and Vibrant Health: 5 (The Dr. Hyman Library)

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Eat Fat, Get Thin appears to be written for a general audience, particularly those who are concerned about their weight. Criterion 3.1. Is the intervention likely to improve the target condition? This reference received a score of 3, indicating that it provides only moderate support for the claim, primarily for the diabetes claim but only weakly for the obesity claim. The cited paper is a report of a series of experiments in both mice and humans. As studies in mice are preclinical and typically used to generate hypotheses for human studies we will focus on the human studies reported, however the mouse studies are fairly supportive of the diabetes claim made by Eat Fat, Get Thin. The authors report two analyses in humans. The first study describes an analysis of self-reported artificial sweetener intake in 381 individuals. The researchers found that individuals who self-reported higher intakes of artificial sweeteners also tended to have higher waist to hip ratios, fasting blood glucose levels, worse HbA1c levels, and performed worse on a glucose tolerance test compared to those with lower intakes. However, all 381 individuals in the analyses were non-diabetic and it is unclear if the observed differences between individuals were clinically meaningful. The analyses were all controlled for BMI in an attempt to isolate the effect of the sweetener intake from the impact of weight on health. However, as sweetener intake was significantly related to participants’ waist to hip ratio it is curious that the researchers did not perform sensitivity analyses with waist to hip ratio as a control variable rather than BMI. Waist to hip ratio is a stronger health indicator and of body fatness compared to BMI so controlling for waist to hip ratio would have allowed the research team to rule out the effects of body fatness rather than just height and weight. As the research team didn’t do this, we can’t rule out that the relationship between sweetener intake and the other health indicators was not just related to the individuals’ body fatness. The second experiment in the paper describes a feeding study conducted in 7 individuals. The researchers had the 7 individuals in the study consume the maximum amount of artificial sweeteners allowed by the FDA over 7 days, but did not forcibly change any other aspect of their diet or lifestyle. Of the 7 individuals, about half of them (4 individuals) had poorer glycemic response at the end of the 7 days while 3 showed no change. The four individuals who appeared to be negatively influenced by the sweeteners actually started the study with a very different gut bacteria profile than those who were unaffected. However, gut bacteria can be influenced by a variety of dietary and lifestyle factors. We cannot rule out that the observed changes in the four individuals were not induced by some other factors. No dietary or physical activity records were collected or reported by the researchers. Therefore, there is no way to rule out the potential influence of these lifestyle factors during the study. Overall, the study was conducted with an extremely small sample size, the effect of sweeteners was only apparent in half of the individuals tested, and there was no control over other factors that may have influenced response. At best, this data shows us that some individuals with a specific set of gut bacteria may be influenced to some extent by artificial sweeteners. Therefore, it is difficult to conclude that artificial sweeteners “alter gut flora or bacteria to promote obesity and type 2 diabetes” as suggested by Eat Fat, Get Thin. Reference 7 Reference The recipes are interesting, but to be honest I don’t know how much use I’ll be able to make of them. Many of them include nuts or milk from nuts, and I am allergic to ALL nuts. Tree nuts, coconuts, peanuts – all that stuff. So the number of recipes I can use is pretty small. As well, the recipes use lots of ingredients. Even if lots of them are spices, it’s quite daunting. The claim received a score of 1, indicating that the claim is greatly overstated. As noted previously, while there is epidemiological evidence to support the claim made by Eat Fat, Get Thin there is also much that disputes it. Stronger forms of evidence such as randomized controlled trials and metabolic ward studies are unsupportive of the claim made by the book. Additionally, dietary patterns low in saturated fat appear to be beneficial for both cholesterol and heart disease outcomes, particularly when compared to dietary patterns higher in saturated fat. Overall, the claim made by the book does not line up with the bulk of the scientific literature available. Overall (average) score for claim 2 Eat Fat, Get Thin also tends to withhold study nuances from the reader. An example of this is a study by Kennedy et al. In this study mice were placed onto 1 of 4 diets: a ketogenic diet (78.9% fat, 9.5% protein, and 0.76% carbohydrate), a typical chow diet (6.5% fat, 23.5% protein, and 56% carbohydrate), a high-fat, high-sugar “obesogenic diet” (24% fat, 24% protein, and 41% carbohydrate), and a calorie restricted diet (66% calorie restricted). The obesogenic diet group gained weight, the low-fat diet group appeared to maintain their weight, and the ketogenic and calorie restricted diet groups both lost about equivalent amounts of weight. Eat Fat, Get Thin decided to compare the keto group to the control group (which has a higher carb content than the keto group) as they specifically state that “weight loss was greater than in rats fed a high-carb diet, even though they ate exactly the same number of calories”. While the results of the study do support the weight loss claim we do note that the mice on the low-carb diet lost their weight from the nonfat component of their weight. So, although there was a difference in weight between the control diet and the keto diet mice there was no difference in body fatness. The significant change in weight is mentioned but the non significant change in fat is withheld from the reader.

Eat Fat Get Thin: Why the Fat We Eat Is the Key to Sustained Eat Fat Get Thin: Why the Fat We Eat Is the Key to Sustained

if you believe all calories are created equal, then might think that staying away from fat is a good idea, but it just doesn’t work out this way The book’s references received a score of 0, indicating that they generally undermine the book’s claim. As noted above many of the references provided by Eat Fat, Get Thin show no differences between low-fat and low-carb diets on weight loss. Criterion 1.3. How well does the strength of the claim line up with the strength of the evidence? seemingly good advice from government, health care industry, and food industry is only “seemingly” – they were wrong about a lot of stuff This reference received a score of 3, indicating that it offers moderate support for the claim. In this study mice were placed onto 1 of 4 diets: a ketogenic diet (78.9% fat, 9.5% protein, and 0.76% carbohydrate), a typical chow diet (6.5% fat, 23.5% protein, and 56% carbohydrate), a high-fat, high-sugar “obesogenic diet” (24% fat, 24% protein, and 41% carbohydrate), and a calorie restricted diet (66% calorie restricted). The obesogenic diet group gained weight, the low-fat diet group appeared to maintain their weight, and the ketogenic and calorie restricted diet groups both lost about equivalent amounts of weight even though the keto group consumed more calories. It is clear that Eat Fat, Get Thin is trying to compare the keto group to the control group (which has a higher carb content than the keto group) as the quote from Eat Fat, Get Thin states “weight loss was greater than in rats fed a high-carb diet, even though they ate exactly the same number of calories”. While the results of the study do support the weight loss claim we do note that the mice on the low-carb diet lost their weight from the nonfat component of their weight, likely water weight. So, although there was a difference in weight between the control diet and the keto diet mice there was no difference in body fatness. Therefore, this study actually raises some questions as to how beneficial the reduction in weight from nonfat tissue is for health. We would also like to clarify that the cited paper reports on an experiment in mice, not rats as claimed by Eat Fat, Get Thin. Overall (average) score for reference accuracy UPDATE: This book made my re-read list because I remembered being fascinated at the author's approach to gaining health. He defines the differences in fat and details the good and the bad. I think I liked this more the second time, but it is still 3 stars for me.This reference received a score of 2, indicating that it offers weak support for the claim. The cited study reports on the extraction of polyphenols and lectins from a variety of beans, however, it does not report any data on the quantity of lectins that are contained within beans, how much remains after cooking, whether this quantity is concerning. Additionally, the paper is more heavily focused on the polyphenol content of the beans and the potential for polyphenols to agglutinate erythrocytes in cell cultures, but not in humans. Reference 8 Reference We feel that it is important to note that Eat Fat, Get Thin was apparently aware of the strong experimental data connecting saturated fat intake to reductions to cholesterol and heart disease. In a later section of the book, the book references a 2014 review that also concluded that there was convincing evidence from both randomized control trials and prospective cohort studies that partial replacement of saturated fat with mono- and polyunsaturated fats is likely to lead to decreases in total and LDL cholesterol. The paper also concluded that there was convincing evidence that replacement of saturated fatty acids with polyunsaturated fat will decrease the risk of cardiovascular disease, particularly in men. I almost wish that Eat Fat, Get Thin had been divided into two books. One book presenting the historical overview, the scientific research, and the essential philosophy behind the concept of eating fat to lose weight. The other book presenting his 21 day weight-loss plan. The first book which I imagine consisting of Part I and Part II (How Did We Get Into This Big, Fat Mess? and Separating Fat From Fiction), I would have given three stars. The second book which I imagine consisting of Part III and Part IV (The Eat Fat, Get Thin Plan and Eat Fat, Get Thin Cooking and Recipes), I would have given one star--or perhaps two--if I'm generous. Maximum of 2 cups per day--tea or coffee--unsweetened. He recommends adding coconut oil to coffee for your breakfast. The book’s references received a score of 2, indicating that they provide moderate support for the book’s claim. Although the cited studies did examine the association between fat and cancer they are often mischaracterized or crucial pieces of information are withheld from the reader. Criterion 1.3. How well does the strength of the claim line up with the strength of the evidence?

Eat Fat Get Thin: Why the Fat We Eat Is the Key to Sustained

What comes through is that Dr. Hyman genuinely wants to improve the public's health and the health of our nation (see the documentary, 'Fed Up' on Netflix). The time is right and he is the man to do it. He joins company with Dr. William Davis (Wheat Belly), Mary Enig (Eat Fat, Lose Fat), Gary Taubes (Why We Get Fat), and Mark Sisson (The Primal Blueprint) but with his vast social media footprint, facebook community, You Tube Channel, celebrity status (documentary films, TV appearances) etc.. he just might be the person to provoke a tipping point where a wider number of the general population adopt the recommendations he makes here which are neither 'Vegan' nor 'Paleo' but a smart mash-up of the best of both. I read a lot of books like this. I enjoy the research and and posture the authors adopt. They all think their book is the definitive answer to what ails people. But putting that aside, I also love the research that is coming out and how this area is constantly evolving to a better understanding on how the body functions and what it needs to stay healthy. I grew up on the four basic food groups and the food pyramid that replaced that. I grew up thinking eating fat was bad, so I find that where modern research is taking us now, is kind of fascinating. is it meat vs veggies, or rather the sugar and refined carbs that are part of the typical meat eater’s diet that we should be concerned with? This is not exclusively a "diet/weight loss" book. Read it for the sound up to date 'nutrition 2.0' information it contains:

When considering review papers, Eat Fat, Get Thin also misrepresents the data. For example, Eat Fat, Get Thin cites a review paper of clinical trials comparing low-carb and low-fat diets. This review reported that 4 out of 8 randomized control trials showed better weight outcomes for low-carb diets when compared to low-fat diets at 6 months. However, the rapid initial weight loss for low-carbohydrate diets is well known and may involve changes in body water compared to low-fat diets. Importantly, this initial benefit in overall weight loss does not typically last over time. When we look at differences in weight loss at one year rather than just the first 6 months, we see that the difference is small and not statistically significant. This data is available in the same paper cited by Eat Fat, Get Thin. The book cites one other review paper worth discussing which is presented as the “final nail in the coffin for proving that high-fat diets did much better than low-fat diets for weight loss”. The main conclusion of the review, however, is that low-fat diets and high-fat diets show similar amounts of weight loss. There was a small but statistically significant difference observed between very rigorously delivered versions of very-low-carb diets when compared to low-fat diets. But even the difference in weight between these two groups was only about 2 pounds, which is clinically insignificant. Additionally, there was no difference in weight loss between low-carb and low-fat diets when comparing the less restrictive low-carb diets, which is the diet pattern prescribed by Eat Fat, Get Thin. Again, this data ultimately undermines the claim made by the book. I have been reading health and nutrition books since I was pregnant in 1970. This is the most up to date and he put the info I had read from many sources in one simple easy to understand book. Since I had read similar things earlier, I didn't learn a lot. If you haven't kept up with research or cared about the importance of organic etc. this would be an excellent choice. He lays out a healthy diet very much like what I put myself on in late 2014 and lost 30 lbs. Got rid of 95% of my allergies, helped with my chronic EBV and fatigue, and feel so much better. So I have no doubt his plan would do the same for everyone. Great reference. Plus fresh food with healthy oils taste so good and keep you satisfied so you never feel you are on a diet. We were falsely sold the low fat info years ago, but our bodies were not made to exist without fat. One other key study presented by Eat Fat, Get Thin, is a review paper by Dias et al. The book uses this study to make the argument that saturated fat intake is not problematic for health if there is an adequate intake of omega-3 fatty acids. However, most of the data reviewed by Dias et al. actually shows that higher levels of saturated fat intake contribute to poor cholesterol levels and heart disease risk. The paper does highlight that many previous studies have not accounted for the intake of omega-3 fatty acids in their analyses. As omega-3 fatty acids may have a protective effect against heart disease, the authors suggest that future studies need to consider this as a variable. However, at no point does the cited paper present evidence that directly supports the hypothesis that intake of omega-3 fatty acids will actually provide protection in the presence of high saturated fat intake. The book received an overall scientific accuracy score of 1.2, indicating that its scientific claims are poorly supported. There was virtually no evidence supporting the claim that eating a high-fat diet is superior for weight loss than lower fat diets. In many cases the data provided by Eat Fat, Get Thin actually undermined this claim showing the two diets to be equivalent for weight loss. We found little compelling evidence to support the claim that saturated fat does not cause heart disease and most well controlled studies report that increased saturated fat intake can lead to increased risk for heart disease or at a minimum issues with circulating cholesterol. We did find some support for the claim that fat intake is not related to the risk for developing certain cancers. However, this seemed to vary based on the specific type of cancer being investigated, with some cancers showing potential relationships and others not. His epiphany came from reading an article in Nexus in 1999 that led him to question Dean Ornish’s low fat advice. He was further influenced by the book Eat Fat, Lose Fat by Mary Enig and Sally Fallon (co-founders of the Weston A. Price Foundation, which has been criticized by medical experts as purveying misleading information) and by the writings of notorious cholesterol denialist Uffe Ravnskov.

Dr. Hyman’s Green Breakfast Smoothie - Dr. Mark Hyman Dr. Hyman’s Green Breakfast Smoothie - Dr. Mark Hyman

Nothing sweet (not just sugar, not just high fructose corn syrup, but all artificial sweeteners (including stevia) and all natural sweeteners (agave, honey, maple syrup). The diet recommended by Eat Fat, Get Thin is likely to cause some degree of weight loss, but we found little evidence that it will improve other major health conditions targeted by the book. There are several other studies cited by Eat Fat, Get Thin that we found to be misrepresented or overstated. For example, Eat Fat, Get Thin references the DIRECT trial and claims that this trial shows that a low-carb, high-fat diet showed greater weight loss than a low-fat diet. However, the group that was given the “low-fat” label by the researchers were not actually following a low-fat diet, as has been previously noted by others. Additionally, the carbohydrate levels were not very different between the two groups with the low-fat group consuming ~50% of their calories from carbohydrate whereas the low-carb group consumed ~40% of calories from carbohydrate. Instead the participants in the “low-fat” diet group were instructed to consume their typical diets and did not make any significant changes to their daily diets. There was, however, another group in the study that was not mentioned by Eat Fat, Get Thin. That group was following a version of the Mediterranean diet which instructed participants to keep their fat intake to under 35% of their daily calories. This level of fat intake was similar to the “low-fat” group, with only a 3% difference in calories from fat between groups. Of note, 35% fat intake is within the suggested fat intake range found in the Dietary Guidelines for Americans. When comparing this lower-fat Mediterranean diet to the prescribed low-carb diet there was no difference in weight outcomes. This study’s findings ultimately undermine the weight loss claims made by Eat Fat, Get Thin.

We’ve been told lots of falsehoods about fat over the past 50 years that have shaped what we eat, what we buy, how we diet—all of which has had huge and disastrous consequences for our health. It all began with two big ideas about fat that have turned out to be wrong…The first was that all calories operate the same way in your body. Since fat has more than twice as many calories as carbs or protein per gram, the natural conclusion was that if you ate less fast, you would lose weight. That, in effect, the fat you ate turned to fat in your body. The second idea was that since fatty cholesterol deposits caused heart disease, and dietary fat, especially saturated fat, raised cholesterol, then the fat we ate caused heart disease. Seems to make sense, except the body is more complex than this simplistic conclusion would suggest…I’ll explain how the government and the food industry jumped on the bandwagon to create a maelstrom of bad advice. It was the perfect storm of overzealous scientists leaping to premature conclusions, anxious government agencies eager to do something to stem the tide of obesity and heart disease, and a profit-hungry food industry that raced in to capitalize on the low-fat mania, leading, in fact, to a rise in obesity, heart disease, and diabetes.” Ch2 He says, “A hundred years ago less than one in one hundred Americans were obese and coronary heart disease was unknown.” It was hardly unknown, although it was admittedly less prevalent and may not have been diagnosed with that name. He is correct that obesity has become a serious problem and is a risk factor for diabetes, heart disease, and a number of other illnesses; but he goes too far when he claims He has commercialized himself and, as with all such television-doctor marketing superstars, I would recommend they all read "The Citadel" by Cronin, about a doctor who became a dedicated physician to help the destitute in England, who veered off course and hawked useless remedies to rich people for personal profit, at the possible loss of his soul and loss of original humanitarian aspiration. I've seen some pretty irresponsible, even dangerous, recommendations on these television shows including PBS, and they all cover their butts by either saying it's either for entertainment value, or that they should always consult their own doctor first. I am one of those “my tummy always hurts!” girls, and this book my just well have changed my entire perspective on food. I feel great for the first time in forever, and I have Dr. Mark to thank. it’s not eating more and exercising less that makes you fat – rather, BEING fat makes you eat more and exercise less