Why you should eat the RFK diet Saturated-fat myths did great harm

“I was eating bran muffins, raisin bran, whole-wheat bread, and brown rice and thinking that was healthy, because that’s what I was taught,” says Dr Tro Kalayjian, a board-certified internal-medicine physician, who weighed 350 pounds at the time he took a deep dive into nutrition science. Kalayjian began to analyse the data on diet for weight loss, obesity, diabetes, pre-diabetes, and high blood pressure, as he would any other condition, and found that “one after the other, head-to-head, low-carb diets were better”. 

As the Trump administration begins to roll out changes to the nation’s nutrition policies, such as Wednesday’s announcement that whole milk will once again be served in schools, understanding Kalayjian’s insights, and the history of the bias against animal fats, becomes more essential than ever. 

Today, Kalayjian is one of the co-founders of Toward Health, a medical program available in all 50 states that offers holistic, diet-focused health care for weight loss and other conditions, with minimal medications and medical interventions. He now weighs 215 pounds, and like everyone on staff, he says, has lost weight and kept it off by following a combination of techniques that included a high-animal-protein, low-carb diet (meaning, yes, whole milk and yogurt, in addition to red meats, dark-meat chicken and other fatty cuts). Trial results for Toward Health’s weight-loss program, after one year, he says, are very similar to the results for patients on Ozempic. 

In other words: the old food pyramid was all wrong, and the new guidelines are much better advice for losing or maintaining weight, including the controversial advice around meat, cheese and whole milk.  

Kalayjian is on one side of the intense medical debate surrounding diet and health that lay behind the recent inversion of the food pyramid by Robert F. Kennedy Jr’s Department of Health and Human Services. The establishment side believes that the traditional low-fat, low-calorie diet, pushed upon Americans since the Sixties, is better for weight loss and overall health. This side is supported by much of the medical establishment, and various anti-meat interests, including vegetarians, environmentalists, religious objectors, and the processed-foods and synthetic-meat industries. It’s why schools were, until Wednesday’s reversal, only allowed to serve skimmed and low-fat dairy products. 

On Kalayjian’s side are the healthy-fat doctors and scientists, whom Kalayjian calls “the metabolic-lifestyle camp”. They claim that the satiating effects of animal fats have a series of positive impacts on weight loss, from making a person feel full sooner to preventing the kind of blood-sugar spikes and crashes that lead to overeating. This camp believes that the other side is “bad science” and that — tragically — “everyone who is overweight is essentially being gaslighted by the medical profession”, as Kalayjian says. 

By all accounts, the new guidelines are a victory for the metabolic-lifestylers — the directives to avoid processed foods and “eat real food”, and the inversion of the food pyramid to promote full fats and animal proteins, represent a renunciation of the previous high-carb, low-fat advice. This is good news, since most health-conscious Americans — and anyone who has eaten a pint of ice cream for dinner, then been hungry 45 minutes later — have already intuitively felt the perils of the blood-sugar spike. It’s also worth noting that in the era prior to easily available high-carb, low-fat processed foods, people were thinner and much healthier, and they ate their meat and two veg, whole fat dairy and so on, with no problems.  

So how did we get here? 

American fear of saturated fat started in the Sixties, according to Nina Teicholz, a journalist with a doctorate in nutrition science who is a leading authority on the topic. It all began with an enterprising physiologist named Ancel Keys, who put forth the “diet-heart hypothesis”, based on bombshell scientific findings with high intuitive appeal. Keys studied people’s diets and rates of heart diseases in seven countries, with the apparent discovery that people who ate little saturated fat and cholesterol were less likely to die from heart disease. The general public was captivated by the research, Keys became TIME magazine’s Man of the Year for 1961, and the American Heart Association adopted his findings, issuing its first exhortation for Americans to avoid saturated fats and dietary cholesterol.

Teicholz tells the story in her 2014 book, The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet. From there, the AHA expanded the mandate in 1970 to suggest that the public cut back not just on saturated fat but all fat, based, Teicholz says, on an idea that was “completely untested”: that this diet could prevent obesity, since fat has nine calories per gram, versus the four calories in protein or carbohydrates. In 1980, when the US Departments of Agriculture and HHS co-issued the first dietary guidelines for the general population, these agencies adopted the entire roster of anti-saturated-fat ideas. The high-carb, low-fat diet jumped from a precaution for the prevention of heart disease to a general guideline for all Americans.

However, Keys’s research, according to Teicholz, was never any good. He cherry-picked his countries, avoiding those like Switzerland and France, where he knew people ate plentiful meat and cheese but still had low rates of heart disease. He also elided complicating factors: for example, he studied the Greek diet on the island of Crete during Lent, when the healthy, heart-disease-free population was eating a meat-free diet — but only temporarily. 

With America’s adoption of this diet has come the obesity epidemic. The government guidelines aren’t the only factors affecting how people eat, but as Teicholz demonstrates in her book, our diet has, in effect, changed nearly in lockstep with government recommendations. The medical establishment and most medical professionals uniformly dispense the government line, which affects people down to the family-practioner level. And everyone who eats through a government program, including schoolchildren, the military, and the poor, are getting offerings in compliance with the guidelines. By Teicholz’s estimate, one in four Americans are affected by them directly.  

At the same time, the American population has grown ever “fatter and sicker”, as Kalayjian puts it. According to a 2018 estimate, 88% of American adults have one or more chronic diseases; they are 50% heavier than comparable countries with similar food supplies; and they die four years sooner, on average. The resulting quality-of-life loss is immeasurable. 

The National Institutes of Health has spent billions of dollars over decades testing Keys’s hypothesis, as Teicholz has documented both in her book and in a separate, peer-reviewed academic paper. But the agency has been unable to confirm Keys’s basic tenets. These studies include the $725 million Women’s Health Initiative, the largest clinical trial in the history of nutrition science, whose results, published in 2006, failed to prove that the low-fat diet had any significant benefit for weight maintenance, and also failed to show any benefit for the prevention of heart disease, type-2 diabetes, or cancer of any kind.

On the flip side, as Teicholz has written, more than 200 clinical trials now show that low-carb diets are superior to low-fat diets for weight loss, and can prevent and treat chronic diseases such as type-2 diabetes, obesity, and heart disease, among others, “often within just weeks”. Moreover, dozens of scientists have reviewed the data, published papers, and come to the conclusion that saturated fats have no effect on heart attacks or death. A review of all these papers was included in the HHS release as part of the guidelines.

And yet, the mythology surrounding saturated fat lives on, fueled by institutional bias among health authorities and aggressive lobbying efforts on the part of processed-food companies.

A cursory internet search calls up cautions against saturated fat on websites like Medline Plus and Harvard Health. And newspaper headlines in both The Wall Street Journal and The New York Times, concurrent with the release of the new dietary guidelines, sounded an alarmist note, with the Times trumpeting in a headline that “Kennedy Flips the Food Pyramid to Emphasize Red Meat and Whole Milk”, and writing in the ensuing story that the decision was “despite the fact that scientific evidence does not support doing so”. As far as protein goes, the Times writes “most American already get enough”. 

The prejudice is so fierce that HHS itself, has, to some extent, caved in. The new guidelines fail, in an essential point, to stick to the metabolic-lifestylers’ best practices, and to the stated convictions of champions such as RFK Jr, and Food and Drug Commissioner Marty Makary. While the government graphics suggest that meat and whole-fat dairy should now be the basis of a healthy diet, in the fine print, the percentage of the daily diet that can come from “saturated fat” (i.e., fatty meat and full-fat dairy) remains unchanged at 10%.

Teicholz claims that “a top adviser to Kennedy” told her that removing the saturated-fat cap would have been too controversial, and would have “overshadowed” the “wins” on sugar and grains. Kalayjian says that the overall direction of the new guidelines is “beyond great”, and cautions that there are some legitimate scientific reasons for concern on saturated fat. “I understand why they punted on it,” he says. There is some evidence that merely adding saturated fats to the traditional American diet, without decreasing carbs, can be worse for health. 

“I think it would have been scientifically appropriate,” he adds, “if they said, ‘We don’t know the answer to this, and that’s why we’re going to remove’” the 10% cap. “That would have been the correct scientific approach. I understand why they didn’t do that, but I think it’s more political than scientific.” 

The new guidelines are an enormous step in the right direction, and should be celebrated. Their only flaw is that they don’t go far enough. Americans must end their irrational fear of saturated fats, especially when it comes to treating obesity and related health conditions. 

“Every day of my life, every part of my body hurt, my back hurt, my joints hurt, I was tired all the time,” Kalayjian says, “I had brain fog. I certainly was not at 100% for myself.” 

Whole foods, including whole milk, saved him; that it will now be available to schoolchildren is a welcome change. 

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