One book that has come up in some conversations I've had about nutrtion is called "The Okinawa Program: How The World's Longest-Lived People Achieve Everlasting Health - And How You Can Too."  There are three authors; one is an athropologist and gerontologist, another is a cardiologist and geriatrician, and the third is a medcial doctor (internist).  Though none is a nutritionist, you would think that this trio would at least compile a document that is consistent.  There are numerous and major (and rather obvious) problems in this book, but aside from pointing these out, I'll also argue that this book is an excellent example of what happens when advocates of preconceived notions present their ideas without considering a coherent, overall framework in which those ideas exist.  The authors make some reasonable points, such as: "When your body produces energy from food, it creates unstable molecules (free radicals, also called oxidants) that can damage cells... This does not mean that we all need to become anorexic lest we be overcome by free radicals...  nobody wants to go through life perpetually hungry.  Eating is one of life's true pleasures and we should absolutely enjoy it.  The trick is to eat well and be fully satisfied while still keeping calories low..."  Page 29.

 

Obviously this conclusion does not follow, because only some kinds of foods generate enough free radicals to be a health hazard.  One does not have to "calorie restrict," whatever that means, to avoid dangerous free radical damage from food.  In fact, on my present diet, I eat as much as I want, but I always eat only three times per day, at least three hours between each meal.  People comment about how thin I am, while all of my close, adult "blood" relatives are overweight (and they eat diets rich in unsaturated fatty acids and oxidized cholesterol, despite my attempts to explain the dangers).

 

The authors later claim that a main reason for the Okinawans' longevity resides in their consumption of canola oil, which is a recent product, and so this time the claim is absolutely ludicrous.  One reviewer on the page on amazon.com for this book said the following:  "This book is a very selective presentation of Okinawan cuisine and does not present the whole picture. Its contention that the good health of the Okinawans is due to their diet of fish, vegetables, white rice, and canola oil is simply wrong. Canola oil? A 20 year-old food product contributing to longevity in Okinawans who are now in their 80s and 90s? How exactly is this possible? Okinawans do eat fish, vegetables, and rice, but they also eat lots of pork and routinely cook with lard, not canola oil."  And how do the authors know who eats what on this island?  What methods were used to garner the information presented as "fact" in this book?  The authors simply do not tell us.  Yet they have the temerity to state that:  "One of the most important things about our study is the fact that it is based on a new paradigm shift in Western medicine called evidence-based medicine."  Page 15.

 

These old Okinawans were certainly "poor" by Western standards, yet they had access to just about all the coconut they want - did they not use this tasty and satisfying food that just falls off trees?  Among other, similar Asian peoples who use pigs for food, coconut is fed to the animals, resulting in lard that is much more saturated than a Westerner will find in his or her local supermarket.  The authors state flatly:  "Canola oil is the main cooking oil, and is one of the healthiest oils on the market... That's because it is very low in saturated fat."  Page 72.  Actually, there own claims contradict this one, for example:  "The health effects of recent dietary changes in the Okinawan population can be seen most clearly in Okinawans aged less than 50 years, who eat a much more Western diet - much higher in fat... than the elders."  Page 49.  This I agree with totally, in that one would expect that switching to canola oil, and consuming a lot of it, would result in ill health.

 

And the fact that canola oil is so rich in unsaturated fatty acids is a major problem, because only unsaturated fatty acids can generate free radicals.  The authors talk about how dangerous free radical damage can be in more than one section, for instance:  "Okinawan elders have a lower level of free radicals in their blood than younger Okinawans," but they don't seem to understand basic biochemistry.  And a chart on page 40 is even more revealing, because the reader is told that polyunsaturated fatty acids (PUFAs) from vegetable sources are protective against prostate cancer while PUFAs from animal foods are risk factors for it.  How is this possible when the exact same molecules are involved?  Obviously, they do not have any sense of a coherent, overall framework that unites the existing data.  Later, on page 112, they state that:  "There is no doubt in the scientific community that we should eat more polyunsaturated fat than saturated..." but they correctly point out that:  "When we have too much polyunsaturated fat in our diet, it can promote inflammation, blood clotting, and possibly cancer cell growth..." on the same page.  They also correctly point out (page 112 again) that eating a diet too rich in omega 3 PUFAs can lead to:  "...increased risk for bleeding and its complications such as hemorrhagic stroke."  It seems highly likely that they are not aware that one can simply avoid PUFAs, except in very small amounts, and allow the natural and much less dangerous omega 9 PUFA, the Mead acid, take the place of omega 6s and omega 3s.  And there also appears to be confusion between the actual molecules, such as PUFAs, and "fat" sources people actually eat (such as butter, lard, fish oil, or sunflower oil), which are comples combinations of many different kinds of fatty acids, including different kinds of PUFAs, MUFAs, and SFAs.

 

And here is a statement that is bound to confuse many readers:  "Monounsaturated fat is more resistant to attack from free radicals than most other fats."  Page 113.  Considering that there are only three kinds of fat (in terms of how nutritionists classify these substances), and that saturated fatty acids resist free radical attack, this statement makes little sense.  If resistance of fatty acids (and other lipids) from free radical attack is so important, as they claim (and I agree with them), then a highly saturated fat, like coconut oil, would clearly be best.  Studies of peoples on such diets confirm this point.  In fact, the authors detail exactly why free radical attack on fatty acids should be avoided:  "Fat that has been attacked by free radicals tends to stick to arterial walls, like the walls of your heart arteries - not a particularly desirable outcome if you want to keep your arteries young."  Also page 113.  They appear to be ignorant of studies of peoples who comsume large amounts of saturated fatty acids (and small amounts of unsaturated fatty acids, unlike Westerners, who often consume large amounts of both), and this is something that would not have been tolerated by the Professors in the graduate school I attended.  People like this would have been told that needed to learn the literature or find a different calling.

 

Another error that again demonstrates a lack of basic knowledge is:  "When fat circulates in the blood it's called cholesterol."  Page 113.  Fat is broken down, and then "repackaged" in the body.  Fatty acids bound up as triglycerides are transported in the bloodstream with cholesterol in lipoprotein molecules.  Both fatty acids and cholesterol are considered "lipids," but in no way can it be said that "fat" is cholesterol if it is located in a particular place.  Animal fat sources generally contain more than trace amounts of cholesterol, but as concerned as the authors appear to be about fatty acid oxidation, there is no mention of cholesterol oxidation, which is also very dangerous.  Rather, they talk about HDL and LDL, calling LDL "lethal" cholesterol, even though it is a vital substance and only dangerous if oxidized (except perhaps in very rare disorders).  In fact, the evidence suggests that low LDL increases one's risk for certain cancers, because cells use cholesterol for crucial functions, and if LDL is low, cells may not get the cholesterol that is required.  A mistake that is more common is to fail to discuss the effects of processing, storage, transportation, and cooking of foods rich in lipids.  The authors do claim that Okinawans use low-heat stir frying mainly (rather than deep-frying), and also suggest buying oils that have not been subject to high-heat refining processes, but little more is said.  In fact, molecular-level studies have demonstrated that cooking meat at high temperatures generates large amounts of dangerous molecules.  Eating meat raw may be a much better idea (fatty acid researcher Mary Enig has suggested freezing the meat for over two weeks before consuming it), but one would need to know that the meat was fresh at the time of freezing, of course, and there are better sources of high quality protein in any case.

 

Another idea the authors appear to be particularly fixated on is the "glycemic index," and they advocate eating "complex carbohydrates" rather than "simple" ones.  The idea is that blood sugar levels will rise and lead to insulin resistance.  They tell readers to "...adding just a dash of beneficial fat will slow the absorption of carbohydrate and result in a lower post-meal rise in blood sugar."  Page 101.  Again, I tend to agree with this idea, though I eat more than a "dash" of fat, and since I understand that highly saturated fats are most resistant to free radical attack, I eat coconut rather olive oil, for example.  However, I have found no need to eat "complex carbohydrates" - I don't feel the desire to eat again for at least a few hours, and I don't feel any hypoglycemic or other adverse effects, though I did when I ate other kinds of diets.  In fact, when I ate a diet rich in fiber and "complex carbohydrates," I almost always had gastrointestinal upset after the meal.

 

There are some other strange or contradictory statements in this book, but the key point I am trying to make is that a scholarly investigation requires intellectual flexibility and an ability to see the contradictions in your ideas, if there are any.  If one can do this, one begins to see that there is an overall framework that unifies that data.  Obviously, this framework may be rather "sketchy," especially if there is not much evidence available.  However, with regard to the effects of dietary lipids, the evidence is abundant and the implications as clear as could be.