The other day I got an email from David Brown, proprietor over at Nutrition Education Project alerting me to an exchange he and Jimmy Moore had with a professor of epidemiology in New Zealand. Now, the first thing you need to know is that David, unlike me, is a meticulously nice guy and he employs that graciousness in what he does to try and inform and educate policy makers, researchers, nutritionists, the media and so forth.
I’m just a slash & burn, hit & run kinda guy who stumbled into this whole nutrition and fitness thing, and now here I am. So, David and Jimmy Moore have engaged professor Jackson in a polite & cordial manner. After nearly three weeks of considering what I might do, if anything, I’ve decided to do likewise; and moreover, to make it a multi-part effort over the next week or so.
In this post, I’m going to introduce you to the professor and quote some key assertions of his from that exchange with David and Jimmy. Those assertions will be the basis of the next posts. The second post is going to lay the foundation of principles. That is, our evolution strongly suggests (when not already dictated) certain things about our diet, and when those principles come in conflict with current observational study and hypotheses, we ought to be extra demanding of quality evidence.
The weight of evidence for an extraordinary claim must be proportioned to its strangeness. –Pierre-Simon Laplace
I then wish to spend some time looking at what Prof. Jackson and other researchers like him may regard as the best evidence for their position that saturated fat is atherogenic. This is where I could use some help from readers who may know what, say, the top five studies might be. Please drop your thoughts in comments as we proceed — such comments will in part guide how I put together subsequent parts of this series.
Finally, we’ll take a look at the best contradictory evidence and try to draw some conclusions.
So, just who is professor Rod Jackson? Here’s his page at the School of Population Health, Faculty of Medical and Health Sciences, University of Auckland.
Rod Jackson is Professor of Epidemiology and Head of Epidemiology & Biostatistics at the School of Population Health, Faculty of Medical and Health Sciences, University of Auckland. He is also the director of EPIQ (www.epiq.co.nz), an in-house group undertaking teaching, research and consultancies in Evidence-based Practice (EP), health Informatics (I) and Quality improvement (Q), for healthcare services. He is medically trained, has a PhD in Epidemiology and is a member of the Australasian Faculty of Public Health Medicine. He has published approximately 200 peer-reviewed papers. His main research interest for the last 25 years has been the epidemiology of chronic diseases, particularly cardiovascular diseases. He is one of the architects of New Zealand risk-based clinical guidelines for managing CVD risk. He is currently involved in developing and implementing a web-based decision support system – PREDICT – to help primary care practitioners across the country systematically manage CVD and diabetes risk at the ‘moment of care’ for their practice populations.
Well, that’s quite a resume. From that I think we can trust that professor Jackson will have a very good familiarity with everything we ultimately touch on in this series.
And now, let’s take a look at some of the statements and claims made in the aforementioned exchange with Jimmy and David.
Saturated fat is the underlying cause of coronary heart disease – the single biggest killer in the western world. Fortunately most Americans are aware of this and over the last 40 years consumption of saturated fats, including butter, which is almost pure saturated fat, have fallen dramatically. Over the same period coronary heart disease deaths have fallen by almost 75%. No other common disease has fallen by so much so quickly. […]
The totality of the evidence on millions of people from basic biochemistry through metabolic ward studies, large scale cohort studies, randomised controls and finally the plummeting coronary heart disease death rates across the western world in line with major falls in saturated fat consumption and blood cholesterol levels, provides better evidence for the saturated fat – CHD relationship than anything else in medicine. I have spent over 25 years reviewing this evidence and it is important not to cherry pick the individual studies that suggest it is not true. There will always be some conflicting evidence – it is the nature of science – and the modern way to address this is to undertake systematic reviews of all the high quality evidence. […]
The advice people like me have been giving governments and the public about reducing their risk of heart disease over the last 25 years seems to have been extremely successful.
Then, there’s this this item: Professor calls for tax on ‘poison’ butter.
A top public health expert is calling for a health tax on butter, saying it’s "pure, natural poison" and as bad as cigarettes.
New Zealanders eat more butter per head than any other nationality and Auckland University epidemiologist Professor Rod Jackson says that’s why our cholesterol levels are also among the world’s highest.
"We have a health tax on alcohol and cigarettes and there should be a health tax on butter. It’s the most poisonous commonly consumed food in New Zealand. It’s about the purest form of saturated fat you can eat and it has no protein and no calcium. Butter has had all the good things taken out and just left the poison."
New Zealanders get about 20 per cent of their saturated fat intake (and therefore bad cholesterol) from butter. We average around 8kg a year – three times as much as Australians and 16 times more than the Japanese.
Jackson says while the dairy industry had done some "fabulous" things to produce low-fat alternatives, "its one major weakness is butter". "If only they could find a nice effective process for turning butter into biofuel."
So there you have it. Looks like I have my work cut out for me.
On one final note, I am going to insist this time around that all comments directed toward professor Jackson be respectful. Yes, that’s ironic, coming from me, but I wish for this series to not be tainted with irrelevancies, no matter their propensity to inspire and entertain.