S1E04 - Should We Trust the USDA Food Pyramid?

SUMMARY KEYWORDS 

eat, people, sugar, fruits, pyramid, usda food pyramid, fat, consume, metabolically, animal fat, saturated fat, country, vegetables, years, dietary guidelines, saturated, united states, grains, oils, diet 

SPEAKERS 

Jack Heald, Dr. Philip Ovadia 

Jack Heald  00:00 

Welcome back to the Stay Off My Operating Table podcast. I'm your host, Jack Heald here with the star of the show. Dr. Philip Ovadia. Welcome Dr. O, how are you today? 

Dr. Philip Ovadia  00:10 

Good jack, great to be back again. 

Jack Heald  00:13 

Well, today, I'd like to talk about something that is near and dear to my heart, the USDA food pyramid. As I understand it, you have some insight into the way of eating that the United States Department of Agriculture recommends is best for Americans. We talked about that. 

Dr. Philip Ovadia  00:37 

Sure thing. I think this is something that everyone in the audience will be familiar with. It has been first and foremost in the in this country in the United States, and unfortunately, it has now spread war worldwide. And I think we have had, we have been influenced that now for over 30 years. And the results that have come out of it, I think now speak for themselves. 

Jack Heald  01:05 

Well, let's talk about what those results are. And then let's back up and talk about specifically. What is the contents of the of the food pyramid, the food guide from the USDA? Sure. 

Dr. Philip Ovadia  01:24 

Yeah. So I think you know, it's important, I think most people are going to recognize the, the sort of original version of the USDA food pyramid, which was released in the early 1990s. And persisted throughout the 2000s. And it's that very familiar picture of a pyramid. And at the base of that pyramid, is a whole lot of bread and cereal, and rice and pasta. And we were all told that we need to eat six to 11 servings of that a day. And then on top of that was the vegetable and fruit group. And we were told to eat between five and nine servings of vegetables and fruit a day. And then we got up to the milk and the meat and the poultry and the yogurt and the cheese. And they even threw nuts in there. And eggs. And they told us to eat about two to three servings a day that and then finally was the fats, the oils and the sweet that top of them pyramid and we were cautioned to use 

Jack Heald  02:35 

sparingly. So what's good about the pyramid? And 

Dr. Philip Ovadia  02:42 

not a whole lot to be honest. So I think what's good about the pyramid, I think the only thing it got right was that sweets should be used sparingly. And I think most people when they talk about nutrition, and they think about what is healthy for us. You know, the one thing that I think almost everyone agrees on is the less added sugar that you eat, the less sweets that you eat, the better for your 

Jack Heald  03:15 

health. So everything else is not good. Everything else is wrong. Let's drill down into it. We'll take from the top fats and oils, it also has the use sparingly group. Right, true or false? Yes or no? And what should we What should we believe about this? 

Dr. Philip Ovadia  03:40 

So I think the big error that was made here is lumping all of the fats and oils together because I think there are clearly fats and oils that are healthy, and probably don't need to be restricted. And then there are fats and oils that are very unhealthy and probably should be used sparingly. And I can't are those. Yeah, so I think the fats and oils that are healthy for us are the natural animal fat. So those are things that are you know, either directly from the animal are produced by the animal. So that your butter, that's your lard. That's your tallow, that's your duck bat. Those are probably the most common ones that people encounter. But you know, almost any fat from an animal really is going to be you know, humans have been consuming those bats for literally our entire existence as humans millions of years. And there really is very little evidence to suggest that those facts are dangerous for us. 

Jack Heald  04:46 

Okay, I want to I want to stop you there. There's very little evidence that those are dangerous for us. That's not my understanding. 

Dr. Philip Ovadia  04:54 

I guess I should reframe that and say there's very little good evidence that those things are dangerous for us. There has been a lot of evidence that has either been misinterpreted and or quite frankly falsified when we go through the history of how this pyramid came to be. That that tried to implicate animal based fat, specifically what are called saturated fat, and relate those to poor 

Jack Heald  05:25 

health out. falsified data you said, 

Dr. Philip Ovadia  05:29 

Yes, so one of the early origins of the food pyramid was with a scientist by the name of Ansel Leys, and Ansel. Keys did the famous seven country study it was called this was in the 1950s, where he published a study that showed seven countries and their intake of saturated fat related to their incidence of heart disease of cardiovascular disease. And on that graph, it looked like a pretty straight line that the more saturated fat you country consumed. This was population studies, the more saturated fat that was consumed in a in a country, the higher their incidence of cardiovascular disease. And that was really the seminal study that was used to implicate saturated fat as dangerous to humans. The problem is, is that it turns out that Ansel Keys actually had data from about 22 countries. And he hand picked the seven countries, that would line up nicely, but he ignored countries like France, that at the time had the highest consumption of saturated fat of any country that was studied. And it had the lowest incidence of heart disease of any country that was studied. And in fact, for many, many years, there was what was called the French paradox, because we so believed that saturated fat caused heart disease, that it was just unexplainable to the scientists of the day, why people in France who ate the most saturated fat had some of the lowest incidence of heart disease. 

Jack Heald  07:16 

It's interesting that you're, I'm looking at the USDA, food, pure food guide pyramid. And they actually say, right here on page two, page three, the pyramid focuses on fat because most American diets are too high in fat, especially saturated fat. So saturated fat, that's the animal fat. 

Dr. Philip Ovadia  07:39 

That's mostly the animal fat. Although this is another sort of conundrum when one actually starts to look into these things. Coconut oil, which is almost universally touted as a healthy fat to consume, actually as a higher percentage of saturated fat than most animal fat. Coconut oil is 94% saturated fat. And as you know, almost all these health authorities that you know, all the V you know, many of the people who tell you to avoid eating animal fat will be the same people who tell you coconut fat is a healthy fat consume, and yet it is higher in saturated fat than most animal fat. 

Jack Heald  08:21 

So is it healthy? Is it does it pass the Dr. O beta test for worthwhile oils to 

Dr. Philip Ovadia  08:29 

add your food? Yes, I think Coconut oil is a healthy fat that can be incorporated as part of a healthy diet. 

Jack Heald  08:36 

Alright, so that's the top of the pyramid in the at the bottom of the pyramid. It says we should be bread, cereal, rice and pasta. Apparently, the bulk of our diet should be composed of grain based foods. Right. 

Dr. Philip Ovadia  08:56 

And that I think is a big problem. You know, that I think is one of the major problems with the USDA food pyramid. And I think it's one of the major reasons that 30 plus years after its introduction, we find ourselves with a society that has 80% of us being metabolically unhealthy. 

Jack Heald  09:19 

And we talked about what that means metabolically unhealthy. And another episode I will refer our listeners to check out the list of podcasts for that. I want to focus on that statement you just made you see a direct correlation between the relate release of the food pyramid with the recommendation that we get the bulk of our diet be grain based foods grains, and the decrease in metabolic health and the American population. Is that correct? Yeah, when 

Dr. Philip Ovadia  09:54 

we look if you look at the graph of obesity and diabetes, Type Two Diabetes in the United States, you can see that it has been a pretty steady increase, starting in the right around 1990, the late 1980s up to today. 

Dr. Philip Ovadia  10:15 

And remember that the USDA food pyramid was not the first recommendations that came out of the USDA 1992 was when they made this nice graphic out of it. But the US dietary guidelines were originally you know, introduced in the 1980s. In the early 1980s. 

Jack Heald  10:37 

I remember being a college student, early 80s, and hearing about some sort of guide new dietary guidelines that said, eggs were bad butter was bad. margarine was good. I remember that very specifically. Is that what you're talking about? Yes, yes, exactly. Okay, so, without diving into the dirty, ugly details of the bottom of the pyramid, let's talk about the middle of the pyramid, which talks about for lack of a better word, dairy and bad boy. So we've got dairy and, and meat, poultry, fish, eggs, beans, and nuts. All in one group? Yeah. And then fruits and vegetables in a different group, which, I guess makes sense. What what's your thought? What is your what's your wisdom, and your experience about that part of the pyramid? 

Dr. Philip Ovadia  11:40 

Yeah, so I again, I think combining fruits and vegetables together is not something that's necessarily science based or really based on anything they, I guess they both grow in the ground, or below the ground or, or above the ground on trees. But really fruits and vegetables are very different things. And fruits, especially modern day fruits are very high in sugar. And those are sort of natural sugars. Although again, keep in mind that a lot of the fruits that we consume today had been bred specifically to make them more sugary, and they're larger and, and they were available year round, which they weren't in the past. So those are some of the problems that come up with fruits as opposed to vegetables, which for the most part, tend to be lower in sugar, they still may have some carbohydrates, but they tend to be have higher fiber content. And putting those two together, I think might be a mistake as well. Because when you say that you need to eat five to nine servings of these things. You know, I think the balance between fruits and vegetables can swing wildly within those guidelines, and eating nine servings of fruit a day is probably not going to benefit anyone, metabolic health 

Jack Heald  13:22 

ultimately, well, you're being very circumspect in in how you describe that. If I were sitting in your office, and I said, Hey, Doc, I eat I follow the Dietary Guidelines for fruits. Every day, I'm eating an apple and a couple of cups of grapes and some strawberries and a couple of bananas. And what would you say? 

Dr. Philip Ovadia  13:54 

I would say you're eating too much sugar is what I would say. And you 

Jack Heald  13:58 

know, I have sugar I you know, I avoid soft drinks. I don't put sugar on my cereal. 

Dr. Philip Ovadia  14:04 

Yeah, and you know, that's exactly the problem is that people don't recognize that fruits are sugar. And bananas, for instance, are often put out there as, as a healthy food for diabetics specifically to consume. And the reality is, is that bananas are very high in sugars. And our body doesn't differentiate the form that the sugar is coming in, it just ends up being sugar to our body. So I think eating that much fruit in a day for people is, 

Jack Heald  14:42 

is problematic. So how do we think about what's good for us? And what's not good for us when it comes to vegetables and fruits? Have you got a rule of rule of thumb that you can recommend? 

Dr. Philip Ovadia  14:58 

Yeah, I mean, my general rule of thumb is that the high fiber vegetables, the green leafy vegetables 

Jack Heald  15:06 

are best to consume. And the 

Dr. Philip Ovadia  15:11 

vegetables that are kind of lower in fiber and maybe higher in sugar, things like tomatoes and carrots are not so good to consume. And then I think the fruits for the most part need to be taken in small quantity. And the more metabolically unhealthy are, you are sorry, that, I'll say that better, the less metabolically healthy that you are, the more cautious you need to be around all sugar containing foods. And that includes 

Jack Heald  15:47 

fruit. So if I read between the lines there, what you're saying is that increased sugar in your diet contributes to metabolic ill health. 

Dr. Philip Ovadia  16:02 

Yes, and actually, the way that I frame it to people is once you are metabolically unhealthy, your body can no longer properly process excess sugar in the diet. So you know, if you're one of the fortunate 12% of adults in the United States who are metabolically healthy, and you're active, and you have a good amount of muscle mass, then you don't need to be as concerned about your sugar intake. But so 

Jack Heald  16:31 

I want to what's the what's a good amount of muscle mass? Um, 

Dr. Philip Ovadia  16:37 

you know, I would say if your body your body fat percentage is, is for men under about 18% or so for women, maybe under 24 25%. So that you're mostly muscle and you're active and you're using that muscle a lot, then you have a little bit more leeway and how much sugar is probably okay for you to consume. But again, the vast majority of people in United States, the vast majority of people who come to me for help, as a heart surgeon, or as a, as a metabolic health expert, do not fall into that category. So I think if we're making guidelines that are supposed to help guide the majority of people in this country, which is what the USDA guidelines should be doing, we should not be telling them to eat so much sugar in the form of bread, cereal, rice, pasta, 

Jack Heald  17:39 

and fruit. Okay, us when you say, you said we shouldn't be eating so much sugar in the form of bread, cereal, rice, pasta and fruits. I don't typically think about those first four bread, cereal rice and pasta as being sugar. 

Dr. Philip Ovadia  17:57 

Yes, and that that's another issue with the way that the guidelines were constructed and the food pyramid was constructed, we did not 

Jack Heald  18:06 

make it clear that grains, 

Dr. Philip Ovadia  18:11 

especially highly processed grains, which is the vast majority of the bread, cereal rice and pasta that we consume is converted very rapidly to sugar by our bodies. And our body really does not recognize it as any different than eating sugar. 

Jack Heald  18:27 

So is that what the what a what causes the so called carb crash? You eat a bunch of bread or pasta half an hour after dinner, you can keep your eyes open. 

Dr. Philip Ovadia  18:44 

And yeah, that's certainly part of it. You know, the there's a rapid rise in blood sugar when we eat these foods. And then as our body is trying to get rid of all that sugar, there tends to be a rapid ball in the sugar. And then you know, that's when people tend to crash. And then oftentimes, they'll go through sort of a roller coaster ride over the next few hours over after they eat, where their blood sugar's sort of swinging up and down as the body tries to deal with this big sugar load. And that what leads to the tiredness, the irritability that a lot of people encounter, and then they find themselves then being hungry very quickly again, despite having eaten a pretty good amount of food. 

Jack Heald  19:42 

My hope was that we would talk about, we'd finish on a happy note. So we've touched on the bread, rice, cereal and pasta, which is at the bottom of the pyramid and according to the United States Department of Agriculture, who's clearly looking out for our best interest this make up the bulk of our, of our meals. And I don't think there's anybody's gonna, well, there's very few are gonna argue that this is a bad idea. So let's talk about my favorite part of the pyramid, which is close to the top contains cheese and meat, and eggs. Let's talk about those because those are my favorite things to 

Dr. Philip Ovadia  20:27 

eat. Yeah, and I think the reality is, is that those should be the majority, the base of most people's diet. Those are the foods that we as humans evolved, eating. You know, it's really, although some people do try to argue it, but it's really hard to argue that the vast majority of our existence as humans, prior to about 10,000 years ago, we ate primarily animal products. And that's what allowed us to evolve as humans. 

Jack Heald  21:08 

So if I think of this evolutionarily, 10,000 years ago, is roughly when archaeologists agree that that agriculture started simpler. And we began raising intentionally cultivating plants for the purpose of eating them. Fruits, vegetables, and grains. That right, that's about right. Yep. So according to the USDA, what we should be eating are the foods that we have the least amount of time evolutionarily invested in learning how and knowing how to process with our bodies and the ones we should avoid? Or the ones we've spent? I guess, depending on how old you consider the human species, several 100 to several, several 100,000, several years processing. Yeah, think about it that way. It's, it seems a little silly. 

Dr. Philip Ovadia  22:08 

Exactly. And that that that is the way that I think about it, largely. But even more so again, I look at the kind of evidence that in front of us, that we have now been making these recommendations for 30 to 40 years, and our health has only continued to deteriorate. And the rate of that deterioration continues to accelerate, it seems. So I, 

Jack Heald  22:43 

for those who aren't an old fart, like being remember all this stuff, give us the give us the data. You said, our health is deteriorating? Yeah. What's changed? What was it like 40 years ago? I can I can tell you stories because I was there, but I don't have the data. What, what? What's changed? 

Dr. Philip Ovadia  23:04 

Yeah, I think the best way to look at this is again, I like simple concepts. I like pictures. And you know, some of my favorite kind of exercises and admit this is stolen from various people on the internet is pull up a picture of Woodstock, pull up a picture of people waiting online for the original Star Wars movie. And when you look at those pictures, you do not see obese people. And if you can even go back a little further there are now a bunch of kind of colorized films of people walking around New York City in the early days of photography, the 1920s 1930s. And again, you do not see obese people. And when you look at the rates of obesity in the United States, over the past go back 5060 years, however far you want to go back, it very clear that starting right around 1980 is when those rates start to rise very significantly. 

Jack Heald  24:12 

So is it a relatively flat graph prior to 1980? The percentage of people who are obese? 

Dr. Philip Ovadia  24:21 

Yeah, it's a pretty flat line prior to 1980. 

Jack Heald  24:24 

What was that percentage? Do you know? 

Dr. Philip Ovadia  24:25 

I believe it was somewhere around the four to 5% range four to 5%, more than 5%. 

Jack Heald  24:33 

So four out of 100 people were technically obese. Yep. And today, I think I read it's 38 out of 100 men and 40 out of 100 women. 

Dr. Philip Ovadia  24:45 

Exactly. It's about 40%. So we're talking about 10 times it has gone up 10x in the past 40 years, and you know prior to that for 100 plus years We've had data you know, to track this type of stuff, it was pretty much a flatline. So it's a pretty, it's a pretty stark graph to look at. 

Jack Heald  25:08 

Wow. Okay, so if you're under 40 you don't realize that all the fat people you see that it didn't. It hasn't always been the way things have changed. All right, doctor. Oh, well, thanks for. Thanks for enlightening us there. I think we need to learn a bit more about this, and maybe we'll talk about it in a future episode. For now, this is the Stay Off My Operating Table podcast with Dr. Philip Ovadia. Be sure to press that subscribe button and you'll be notified every time we release a new episode. I'm your host, Jack Heald. We'll talk again next time