Bacon and eggs are healthy and oatmeal is not. That's
just one revelation from cardiologist Dr. Mark Hyman's
new bestseller, "FOOD What The Heck Should I Eat."
It typifies the book's thesis and its attacks on conventional
wisdom surrounding modern day Western society's search for
the best diet. By best I mean healthy and least likely to cause
heart disease, obesity, diabetes, inflammatory bowel disease,
arthritis, autoimmune illnesses, and cancer. And by best I do
not mean the tastiest or easiest to follow.
But first, as a recently retired cardiologist, I, and most
of my colleagues owe the general public a huge apology. The
diet theory of heart disease, i.e. fat and cholesterol in our diet
inevitably contributes to cardiovascular disease, was wrong.
This much Dr. Hyman and I agree upon. Flawed research and
assumptions lead us down a rabbit hole for decades making
patients, and ourselves, afraid to eat anything that to be frank,
tasted good. The low fat, high carbohydrate diet espoused for
decades by the heart associations and government nutritional
boards was wrong. It produced more obesity and diabetes and
probably not greater heart health. It created anxiety, fear, angst,
and guilt in Americans as we de-selected any foods that were
high in fat or cholesterol, in favor of largely unhealthy amounts
I freely admit that I have a carb addiction. For me a slice
of crusty bread or a hot soft pretzel stimulates the part of my
brain that could lead to opiate addiction. So the subject of diet
and heart disease is personal. My now deceased father was an
internist when in the 1960's the diet theory of cholesterol was
first promulgated. I remember him telling me eggs were poison.
He ate fish or chicken every night. Although he did eventually
succumb to coronary artery disease and bypass graft surgery, it
was cancer that killed him.
So if all of the experts were so wrong for so long, is it any
surprise that we still are in search of the best diet for longevity
and good health; or that we distrust mainstream nutritional
authorities? If you want to know how desperate we are to find
the answer, just Google the word "diet" and you will get over
Throughout the course of "FOOD," Dr. Hyman likes to
tell us what the "experts" got right and what they got wrong.
His book is well written with many footnotes. However, some
references are suspect for being less than authoritative, let
alone based upon good science. Here is what I think the author
got right and wrong.
Yes the diet theory of cholesterol was wrong. Refined
carbohydrates (think white—like white bread, white rice, etc) are
converted into sugar by the body. The body then stores excess
sugars as fat. So unless you are burning off 4,000 calories a
day with intense exercise, you will gain weight with a diet rich
in carbs even if you watch how much sugar you eat. Dr. Hyman
is also correct in assigning blame to big food companies who
disguise and include sugar in everything we buy, from ketchup
to salad dressings.
He cites the PURE study that found there was, "...no link
between total fat and saturated fat and heart disease." However,
to quote the Harvard School of Public Health, "PURE study
makes headlines, but the conclusions are misleading." The jury
is still out on this. I also question his enthusiasm for coconut
fats and oil. They are extremely high in saturated fats. Dr. Hyman
and the PURE study notwithstanding, I think the science behind
coconuts and heart disease is far from settled. If you look at
countries that consume lots of coconuts, like Guyana and
Malaysia, heart disease incidences are quite high. Dr. Hyman
states, "...cultures with more than 60 percent of their diet as
coconut oil have no heart disease..." is wrong. For me coconut
oil is not a health food. He defends saturated fats by noting,
"Breast milk is 24 percent saturated fat—higher than the six
percent the AHA recommends." Infants need lots of fat. Adults,
not as much. To infer otherwise is bad science.
Dr. Hyman applauds, or at least approves of, governmental regulations and taxes on sugar-laden sodas. However when it comes to consuming raw unpasteurized milk, which has killed
and made people ill, his response is, "In the end, this fight is as
much about the freedom to choose the foods we want..."
He criticizes BPA containing tin cans, but doesn't explain
how to buy ones that are not. It's not that easy. Trust me, I have
tried. He takes issue with lobster since it has moderate amounts
of mercury, yet it has less than 10 percent of the heavy metal in
swordfish and is in the middle zone of fish and shellfish when
examined for mercury content.
He urges caution about eating "nightshades" (potatoes,
peppers, tomatoes, and eggplant), as "some people react badly
to them." Yet, these are important and integral parts of a proven
healthy Mediterranean diet. He goes further and says they have
"negative effects..." that "...include pain, inflammation, and
arthritis." Yet again in the southern Mediterranean nations,
where lots of these are consumed, there is no greater incidence
of arthritis or inflammatory bowel disease than the rest of the
Not even beans and legumes are safe from his bad food
list and he states that most of us should have no more than 1/2
cup per week. He gives hints about how to make food healthier
that may in fact be true—like chopping up garlic and letting
it sit for forty minutes before using it. Or letting rice cool and
then reheat it to alter the resistant starch content. But one has
to question how practical this is in a nation where we cook at
home less, and eat out more, than we ever did before.
Some of his suggestions are easy, like steaming vegetables
for only four minutes rather than letting them soak away in
boiling water. His advice about buying organic is well meaning
but with umpteen families struggling to pay food bills, how
many realistically can afford a 10-20 percent surcharge on their
food budget for this? In fact, there is little data to show that
"covered" fruits, such as bananas or avocados, are healthier
when buying the organic version.
One of his more extreme contentions is, "Thanks to soda,
now even kids have fatty livers and need liver transplants." I can't
disagree with the first part, but as to needing liver transplants,
I am not sold on this. I question how many and where is the
reference for this. He cites none.
He contends that the American Heart Association gets
funding from cereal makers and therefore is not objective when
assessing heart-healthy food sources. This may be true. However
in citing Kevin Michael Geary's article on Medium.com, "Is the
American Heart Association a Terrorist Organization?" his only
apology is, "The title is a bit inflammatory, but the content is
accurate." This web site is an open blogging platform.
He of course does not believe that we should be eating
gluten. He implies that whether we have Celiac disease or not,
gluten is bad and our bodies react poorly to it. This is not new
information and his inference that "Celiac is a root cause of...
everything from cancer to dementia and autism" is without good
documentation. But this isn't even the most absurd statement
he offers about gluten or wheat. He states, "...because (of) our
environment, habits, and medications—(there has been) a rise
in Cesarean sections..." The only "habit" that has created a rise
in C-sections is our habit of suing doctors. The rise in C-section
rates correlated exactly with the rise in malpractice suits against
OB doctors delivering less than perfect babies via the vaginal
route. It has zero to do with our diet.
For just a moment let's forget the science here. His "Pegan"
diet, (part Paleo and part Vegan) is just not easy to maintain.
And even if you can succeed with it at home, just try following
his advice when you eat out, travel, or go to a friend's home for
He begins the book with a story of visiting a poor South
Carolina family and spending time with them demonstrating
how to shop and cook healthy. One wonders how well that
family has been able to adhere to his advice long after he has
gone. There is much to admire in this work, and his attacks on
many of our long-held dietary beliefs and nutritional dogma are
well deserved. But in the end this may be just another in a long
line of tomes dealing with our bipolar love and fear relationship
to eating and food. I wonder if it will survive the test of time.