#people hear about vegans who only eat vegetables and are like Yeah i understand that
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gender-euphowrya · 4 months ago
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it's really baffling to me that when i tell people i don't eat veggies they're like "THEN WHAT DO YOU EAT" like. do you not know about the other food groups. have you exclusively been eating carrots and leaves like a bugs bunny
#you don't need to be fucking sherlock holmes to figure out that it's. well. everything else#meat. dairy. pasta/rice/potatoes that kinda thing.#like people treat me like a fucking alien for my food tastes like can you really not picture in your head a meal without vegetables#are you that fucking turnip-pilled#it's not that deep#like the doc i saw today looked at me like i was sprouting tentacles when i said i don't eat tomatoes#like... yeah i'll eat tomato-based stuff like tomato sauce & all but not just plain tomato#i still don't get How people eat tomato like it's so slimy yeurch#like it's not me having the fuss levels of a 5 year old who doesn't waaaanna eat his peaaaaas#it's. my brain cannot even conceptualize vegetables as food. i KNOW that's what they are but i don't have the ''oh ! edible thing'' reactio#like you hand me a bowl of salad and a bowl of rocks and i'll find them equally unappetizing. gun to my head i wouldn't eat either#i don't know ! i don't know why ! is it autism ! is it arfid ! is it something else ! is it just arbitrary tastes !#WHO CARES ?#that's the way i work and the way i've always worked and fuuuuck i Don't care about changing it#i don't think i can in any case. not to the extent people expect me to. i'm doing my best#so what if i get fat and die at 50 i'm here for a good time not a long one#i'd rather die young and have lived life according to my rules than die old and have restricted myself & forced myself to do stuff i hate#who gives a fuck i'm not having kids anyway i won't have a bunch of people relying on me living old for shit so whatev#people hear about vegans who only eat vegetables and are like Yeah i understand that#but say you eat anything Except vegetables and suddenly it's an extremely weird diet and i must be some kind of crayfish from mars
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gamer-logic · 3 years ago
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Since my state, Georgia, is having the annual Peaches to Beaches event which is two days of statewide yard sales, I thought it would be interesting to show how America, the states, and any other countries wanting to participate both 1p and 2p would be during this event. So here you go!
Georgia is happily selling fresh produce like boiled peanuts and Vidalia onions and peach-based deserts. Her homemade peach cobbler and ice cream are to die for!
Antonio (Spain) also sells many fresh tomatoes, olives, and other vegetables. He doesn't understand why no one wants his Olive Juice though.
Hawaii and Alaska make a killing selling lemonade at their stand with a free complimentary handmade flower crown with every purchase. While using their sheer cuteness to attract everyone including one of those sweet biker gangs. It's really surreal to see a huge gang of buff, tattooed, tough-looking guys in leather wearing flower crowns and drinking lemonade. Allen's also there to supervise and ward of creep. Also, to provide people more 'incentive' to buy their lemonade.
Texas breaks out the Texas BBQ and is in a Barbecuing turf war with Jett (Australia). They draw huge crowds for the five-alarm chili as well and hold a competition who can eat the most without burning out their tongues and/or passing out.
Florida sells some of the weirdest stuff you'll ever see. "Want a full-scale model of a gator made entirely out of bottle caps? Only ten bucks! Want a portrait of Florida Man painted with orange juice? 15 bucks!"
Nevada also tries to sell weird and sketchy stuff to scam everyone. "This piece is the genuine article folks! One napkin gently used by Elvis Presley himself! Just 500 bucks! Also, gets into a haggling war with Lars (Netherlands). Somewhere Alfred's dad instincts go off and he reminds himself to ground Nevada.
California, Oregon, and Washington collaborate and California sells anything vegan or made with avocadoes and the autographs of Hollywood stars, Oregon sells his old tye-dyed shirts and records, they also made him sell his old groovy hippy bus from the sixties he'd never got rid of no one knew they had. Oregon can be a bit of a hoarder, so they had to tie him to a chair and gag him because he wouldn't surrender the bus without a fight. Washington also tries to sell and drink cups of coffee, but in the hot Southern heat, this doesn't end well.
Louisiana sells anything Cajun-style from frog legs to fresh gumbo, to beignets. Also has a full collection of Mardi Gras masks and shrunken voodoo heads on sale for two bucks a pop.
Gilbert (Prussia) gets tricked by Nevada and gets a ton of stupid things he doesn't need. Ludwig (Germany) tries unsuccessfully to keep him on a metaphorical leash.
Ludwig always checks the quality of things he sees and buys dog toys and supplies for Blackie, Berlitz, and Astor. Later, he actually buys a kiddie leash for Gilbert.
All the while Lutz (2p! Germany) is asleep in a lawn chair with his hat on his face after drinking like six cold beers from this really good booth. All the while, Klaus (2p! Prussia) finds an antique Teutonic Knights flag from a vendor whose family was from Germany.
Vash (Switzerland) buys antique guns from Alabama and Roderich (Austria) also checks out some of Tennessee's guitars. He's horrified upon seeing Alabama's banjo and washboard.
Mathew (Canada) and Emma (Belgium) combine their powers and tag team to sell the best pancakes and waffles on earth with genuine Canadian maple syrup.
New York sells tons of baseball memorabilia and collectibles. Allen, trying to save his bad-boy image, tries to be discreet when buying some while taking Hawaii and Alaska around to get something with their lemonade money. James also gets some hockey memorabilia with Michigan and Minnesota who also got snow cones.
Alaska and Hawaii see a giant deluxe dollhouse but are almost in tears when they don't have enough money. But they end up getting it for free because no one can resist their weaponized puppy dog eyes. Also, no one can resist a growling Allen. Using the leftover money, they buy cute little rainbow umbrella hats for everyone and have Allen wear one who begrudgingly accepts it.
James, walking by with an armful hockey gear and flannel shirts, bursts out laughing when he sees this. In revenge, Allen forces him to wear one too and help him carry the dollhouse, much to Hawaii and Alaska's delight! "I said go my way puck head!" "No, it's my way, you vegan loving hoser!" A passing Francis (France)' is in stylish horror when they also make him and a nonchalant Luis (2p! France), holding a case of vintage wines, wear them too. Hawaii and Alaska go around giving umbrella hats to everyone including a sleeping Lutz they pass by.
Loving (Romano) practically has to supervise Feliciano (Italy) and keep him from buying anything too stupid on impulse or get scammed. They still end up with stacks upon stacks of cookbooks, kitchen wear, and a Mona Lisa made entirely out of Macaroni. They also get umbrella hats.
Flavio (2p! Romano) browses through clothing racks to get ideas for his vintage line. Also checks out the handmade fabrics like quilts. "Such craftsmanship! This pattern is so unique and chic! I simply must have it! What's your price Bella?" The nice old woman selling the quilt just smiles, "Oh just about five dollars young man." "Perfect!" Flavio hands the quilts off to Andreas (2p! Spain) who's practically buried underneath the fabric. Luciano (2p! Italy) facepalms while holding a new knife set in its case. "Oooh! Look at those adorable hats I just have to have one." Cue three more umbrella hats and a humiliated Luciano. "Just kill me now..."
Katyusha (Ukraine), Elizaveta (Hungary), Lillie (Liechtenstein), Natalya, (Belarus), Katya( 2p! Ukraine) and Anastasia (2p! Belarus), and Michelle (Seychelles) explore with armfuls of clothes, new ribbons, and a gun case for Switzerland (Lillie), cast iron frying pans (Elizaveta, watch out Prussia!), farm tools (Katyusha), Jewelry and unmentionables (Katya), dresses (Anastasia), an assortment of switchblades (Natalya), and one of those singing fish on a plague (Michelle). It's definitely an interesting group.
Kiku (Japan) and Kuro (2p! Japan) find a nerd booth selling comics, manga, and Japanese weapons like katanas. Kuro test swings a blade and tries to slice the table so hard it breaks the blade, "Hmmm, not sharp enough for me, got anything else?" He throws it on the pile of broken blades he's already tested. Kiku stockpiles on limited-edition manga and he and the vendor end up getting into a huge, heated by Kiku standards, debate on who's waifu is best. Further down, Alfred reads every Marvel/DC comic while keeping an ear out on every state's location. He checks on Texas via his glasses and notices he's beating Australia in the chili contest. "That's my boy!"
Wisconsin wearing a cheese head sells anything cheese-based. He's got cheddar, goat cheese, string cheese, cheese spray, gorgonzola, grilled cheese, cheese curds, Mac n' Cheese, cheese sculptures of all world monuments, you name it he's got it! He also starts a war with Iowa's corn dishes and Idaho's potato dishes. They eventually end up flinging cheese, potatoes, and corn after they start dissing each other's foods. "Take this cheese brain!" "Nice aim, I-da-ho!" "I told you not to call me that!" "I'm gonna go children of the corn on y'all's behinds!" Poor Nebraska is stuck in the middle.
Alfred (America) hears the commotion and using his parent radar, immediately knows who it is and reminds himself to ground Iowa, Wisconsin, and Idaho later along with Nevada who, though still grounded for sure, makes him feel a little proud of since he managed to out haggle Netherlands.
New Mexico and Arizona also sell Native American handicrafts along with things like dreamcatchers and giant inflatable aliens. While Delaware, being the boring stick in the mud that he is, walks by with a framed and complete U.S. quarter collection from a vendor.
Kansas sells out of every sunflower she had courtesy of Ivan (Russia). Ivan and her the team up to buy out every sunflower seed from here to kingdom come. Viktor (2p! Russia) buys all the vodka he can find and a new shovel while Xiao (2p! China) tries giving people tattoos for 10 bucks a pop.
He tries to convince Yao (China) to get a hello kitty one to match the giant plushie he's holding, with the encouragement of Leon (Hong Kong) and Yong Soo (South Korea) who all collectively agree he needs to quit being such a grandpa. They also like calling him an antique-like the items on sale. " Aiyah! I'm not that old, aru!" "Yeah, you are Sensei." "Don't deny it! Da Ze!" Respect your elders!" "Tattoos originated in Korea da ze!" He totally is that old.
Oliver (2p! England) holds a bake sale and has people lined up for blocks to get some. Arthur (England), after having his scones shut down after it poisoned some unlucky squirrels, fries selling authentic magical items like unicorn hair or pixie dust. Everyone thinks he's a little crazy but he did sell a good bit of old magic books he needed to get out of his house, after making sure no one could actually use them of course.
The Nordics also went perusing for antique and handmade furniture when Mathias (Denmark) spots two full sets of Viking costumes and tries to get Lukas (Norway) to try them on with him. Lukas wasn't amused.
Berwald (Sweden) and Tino (Finland) also find a great handmade table to get after inspecting the workmanship and a full Lego set for Peter (Sealand), now if only Mathias would stop squealing like a little kid at the full piece lego death star. Emil (Iceland) keeps thinking he's the mature one until he spots a mini top hat and cane for Mr. Puffin.
In the end, everyone ends up wearing umbrella hats courtesy of Hawaii and Alaska, loving all the strange things they bought or counting the profits they made. Alfred (America) is proud of his kids and visits everyone one of their stands. He ends up looking pretty funny with an umbrella hat (HW, AK), a washboard, (AL),a picture of Florida Man, (FL), a balloon alien (NM, AZ), a tye dye shirt (CA, WA, OR), hockey stick shaped glasses (MN, MI), a giant stack of comics with a replica Thor hammer and Captain America shield on his back, all in a shopping cart (NV), and a giant turkey leg in his hand (Tx). Unsurprisingly, it was a tie between Oliver, Texas, and Australia for who earned the most with their food. Georgia just smiled as this was another great year for her state and people!
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hteragram-x · 4 years ago
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Firefighter AU (again)
It’s been a while since I posted anything about this AU, but I got some inspiration and finished new short story. This time about Virgil and Remus briefly discussing their jobs and characters. I think you can read it separately and still get what’s going on, but if anyone’s interested I’ll link previous related posts.
[HERE] is the introduction, [HERE] are some general HCs, and over [THERE] you can find previous story where Remus and Virgil met for the first time :>
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Word count: 1348
Relationships: technically Dukexiety, but they’re not there yet
TW: mentions of fire (what a surprise), mentions of dead animals, mentions of a car crash, swearing
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The phone rang for about half a second before Virgil picked it up and gave his practiced introduction. It was calm and quick. Then he fell silent and let the woman on the other side of the line speak, listening carefully and responding with a few instructions. In an even voice he explained that the team has already been sent, that the fire engine was on its way. That there was no need to panic and that someone else has already called and now the only thing she should do is patiently wait, sit at a safe distance from the flaming car, and keep him updated if anything bad happened before the brigade arrived.
He made sure the woman was safe, said goodbye, and let the conversation end.
 Then he leaned deeper into his chair with a heavy sigh.
“I have a question!”, the loud yell right behind Virgil nearly sent him flying to the floor. He glared at Remus, clutching his headset and trying to readjust it before it slid off his ears. Why was he still surprised by these random outbursts? He should have gotten used to them weeks ago.
“What kind of question”, he asked in a tired voice very much aware that getting mad at Remus would only make his behaviour more annoying. Or worse… it’d make Remus upset... “The one I answered forty nine times already or something new?”
“A new one!”, Remus beamed sitting on a spinning office chair and moving closer to Virgil. “And if you’re exaggerating anyway you could’ve said sixty nine. That would’ve cost you nothing.”
“It would also cost you nothing to not say that right now, and yet you did”, was a slightly drained response.
"I always do!”, Remus giggled in a surprisingly cute way and leaned even closer, still remembering to not push Virgil too far from the desk. They were both currently at work, so distracting his co-worker too much and slowing down his response for even a few seconds could have potentially tragic consequences. Remus was definitely a careless person, but not when it came to other people’s lives. That fact was often shocking even to those who knew Remus for a very long time.
Virgil lifted an eyebrow making a “go on” kind of gesture with his right hand.
“Okay”, Remus started excitedly sounding as if he was trying to hype himself up to do something difficult. “How do you do it?”
Virgil lifted his second eyebrow in a silent question.
“I mean: how do you stay calm during the calls. Why do you even work here? I can scare you by saying “boo” in quiet monotone. And then you talk with panicking people who just crashed their car into the lamppost like it’s nothing!”
To Virgil’s credit he put a lot of effort to making his brain not fixate on the “Why do you even work here?” part of Remus’ words and not see it as a kind suggestion to fuck off. He mostly failed, but the intensions were there.
“I- I’m not sure”, he responded carefully after a moment filled with sounds of a chair squeaking under Remus who was usually unable to stay still for more than four seconds. “I have a separate… headspace for work, I suppose. I dunno how to explain it. Just like… switching to a different mindset when it’s something professional. Don’t you have the same thing with putting down the fire? I assume you don’t stare creepily at other people when you enter the building that’s in flames”, he added with a small smile, reminiscing their first encounter.
“Usually I don’t”, Remus answered with slightly disturbing, cheerful honesty that Vigil learnt to expect from his chaotic co-worker. “But, yeah… you’re right. I can be calm when I’m professional. And I’m way less tempted to taste fire when I’m fighting it. You know? Like… you don’t think so much about eating a bear when it’s chasing you down the extremely narrow path where trees are getting closer and closer until the forest gets very dark and there is no way to escape anymore.” Remus finished a rushed sentence with wide, light-hearted smile that lit up his face not unlike a lighter with which he almost singed his moustache on regular basis.
Virgil blinked at him and slowly shook his head.
“O- One thing at a time, okay?”, he answered finally. “Let’s leave the bear out of this for now. I know I shouldn’t ask, but did you just say that you’re ‘tempted to taste fire’?”
“Yeah!”, Remus answered with enthusiasm sending Virgil another bright smile that somehow still looked nice despite some unhinged glint always present in his green eyes. “You can make so many tasty things with fire. Like grilled vegetables! Or…”
For some reason, the fact that Remus was vegan never failed to astound the confused operator. Maybe his dietary choices would be less unexpected if he also didn’t rate every dead animal he ever saw on the street on a scale from ‘probably inedible, not enough fur’ to ‘no one touch that! It’s my lunch’.
“…or potato chips!”, Remus finished a long list of foods. ”Those are kinda made with fire?”
“…yes?” Virgil said carefully, not really sure where this line of logic was even going.
“See?! Fire makes tasty things. Ergo, hypothesis, fire is tasty too!”
“That’s… that’s the stupidest thing I’ve heard today…”
“Well, jokes on you, because I’ve said something much more stupid only twenty minutes ago. You just weren’t there!”
“I’m not sure this defence is as strong as you think…”, Virgil sighed, annoyed at himself for a tiny bit of fondness that seeped into his voice. “Anyway! Please don’t eat fire.”
“Fine”, Remus said tipping his head back with a huff. “You’re so boring.”
“And you’re a dumbass. I can’t believe I was scared of you at first…”
“You were?!”, Remus asked delighted despite knowing this information before. It was always nice to hear that he actually frightened someone, even if it was a guy scared of drinking with a straw for the fear of chocking on it one day. Or maybe especially if it was that guy.
“Shut up…”
Surprisingly, Remus did fell quiet. They sat in silence for a few minutes glad that the phone stayed silent as well. It was nice to have a few minutes of peace and calm before someone else needed help. It meant that people were safe and it let them just appreciate each other’s company in the half-empty office.
“By the way… I do get the whole ‘work mindset’ thing”, Remus continued suddenly as if they never stopped or changed the topic. “It’s like I have a separate brain and personality that kick in when it comes to these things. I see everything differently.”
Virgil nodded in understanding.
“I’m less scared when I know I have to help someone.”
“Exactly!”, Remus exclaimed, once again almost making Virgil fall out of his chair. “I have that too, but I become more serious instead! So you’re a coward, but a protective one. Got it.”
“Get out of my office.”
Remus laughed and didn’t make a single move to exit the room. He sat more comfortably in his chair, reaching into a pocket for his favourite lighter with luminescent tentacles painted over sparkly black background. It was one of the most “Remus” things Virgil has ever seen.
The next stretch of silence didn’t last as long as Virgil would have wanted. After about a minute his phone rang again, distracting his from very vivid visions of the firehouse burning to the ground because of Remus’ negligence. He gave his colleague a brief smile and promptly answered the call, his head immediately clear – the thoughts about anything irrelevant temporarily forgotten. Few seconds later the alarm went off and the dishevelled firefighter jumped off the chair with a serious expression. He gave Vigil last look seeing his focused eyes and calm, patient face. Then he switched his own brain into appropriate mode and run out of the room towards Roman and the rest of his brigade.
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Next part is [HERE].
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My one-person general taglist: @imma-potatoo
My one-person taglist for this AU: @isabelle-stars
I used the term “taglist” very loosely here :D
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paleorecipecookbook · 6 years ago
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RHR: The Truth about Saturated Fat, with Zoё Harcombe
In this episode, we discuss:
Why you need to eat fat
Why the Paleo diet template makes sense
Where these misguided ideas about fat came from
The Seven Countries Study
Zoё Harcombe’s research on fat
Why you should be skeptical of some news headlines
Why dietary guidelines don’t work
The epidemiological evidence
Conclusions about saturated fat
Show notes:
The Obesity Epidemic: What Caused It? How Can We Stop It?, by Zoё Harcombe
“Evidence from Randomised Controlled Trials Did Not Support the Introduction of Dietary Fat Guidelines in 1977 and 1983: A Systematic Review and Meta-Analysis,” by Zoё Harcombe
“The Nitrate and Nitrite Myth: Another Reason Not to Fear Bacon,” by Chris Kresser
USDA Food Composition Databases
“Re-evaluation of the Traditional Diet-Heart Hypothesis: Analysis of Recovered Data from Minnesota Coronary Experiment (1968–73),” by Christopher Ramsden
“The Challenge of Reforming Nutritional Epidemiologic Research,” by John Ioannidis
youtube
[smart_track_player url="https://ift.tt/2pzvMar" title="RHR: The Truth about Saturated Fat, with Zoё Harcombe" artist="Chris Kresser" ]
Hey, everybody, Chris Kresser here. For the past 50 years we’ve been told that eating meat, saturated fat, and cholesterol is unhealthy. Recently, a growing number of people are turning to a vegetarian or vegan diet with the goal of improving their health.
But is it really true that meat and fat are bad for us? And are vegetarian and vegan diets a good choice for optimizing health and extending lifespan? If not, what is the optimal human diet? Join me on the Joe Rogan Experience on Thursday, September 27th, as I debate these questions with vegan doctor Joel Kahn. You can tune in live at 12 noon Pacific Time at JoeRogan.live. That’s J-o-e-r-o-g-a-n.live, or you can catch the recording at podcasts.joerogan.net, on YouTube, or in iTunes or Stitcher.
If you’d like to receive updates about the debate, including links to the recording and new articles and information I’ve prepared on this topic, go to Kresser.co/Rogan. That’s Kresser.co/Rogan and put your email in the box.
Okay, now onto the show.
Welcome to another episode of Revolution Health Radio. This week I'm very excited to welcome Dr. Zoë Harcombe as the guest on the podcast.
Dr. Harcombe is a Cambridge University graduate with a BA and MA in economics and math. Zoë enjoyed a successful career in blue-chip organizations before leaving corporate life in 2008 to pursue her passion. Her early career involved international roles and management consultancy, manufacturing, and marketing in global organizations from FMCG to telecoms before specializing in personnel and organization. At the peak of her career, Zoë was vice president for human resources for Europe, Middle East, and Africa. Having written three books between 2004 and 2007 while being head of people, Zoë left employment to research obesity full time. This culminated in the publication in 2010 of The Obesity Epidemic: What Caused It? How Can We Stop It?
Zoë returned to full-time education in 2012 to complete a PhD in public health nutrition, which was awarded in March 2016. Her PhD thesis was entitled “An Examination of the Randomised Controlled Trial and Epidemiological Evidence for the Introduction of Dietary Fat Recommendations in 1977 and 1983: A Systematic Review and Meta-Analysis.” A number of peer-reviewed articles have emanated from this work, and the first was the 64th most impactful paper in any discipline in the year 2015. Zoë lives with her husband and rescue animals in the Welsh countryside surrounded by food, a.k.a. sheep, hens, and cows.
Now I'm really excited to talk with Zoë because she recently published a paper critiquing the U.S. dietary guidelines and the U.K. dietary guidelines for the lack of evidence behind their recommendation against eating saturated fat or limiting it to less than 10 percent of calories in the diet. And she, as I just suggested with her bio, has probably spent more time looking at this than anybody else. She wrote her PhD thesis, as the title suggests, on the evidence, or lack of evidence, rather, behind the dietary guidelines around total fat and saturated fat. And she went all the way back to the late 70s and early 80s to look at the studies that were used to create the original dietary guidelines. And then the second half of her paper looked at all of the research that has been published since then through 2016.
And as we’ll discuss in the show, the conclusion is that the dietary guidelines never really had any meaningful evidence behind them to justify restricting saturated fat back in the late 70s and the early 80s. And the same is true today in 2018. So I hope you enjoy this interview as much as I did, and let's dive in.
Chris Kresser:  Zoë, it is such a pleasure to have you on the show. We were just chatting before the show, and I can't believe we haven't connected by now. We walk in many of the same circles, and I’ve followed your work for some time. So I'm really, really grateful that you’re able to join us.
Zoë Harcombe:  Oh, I thank you so much for having me. I’ve just followed you for so long and your “nitrates in bacon” is my just absolute go-to blog. Stop, people, worrying about bacon.
Chris Kresser:  All right. Well, we’re going to talk a lot more about that and there’s so many things we could talk about today. But the main reason that I wanted to have you on the show is to talk about your recent paper critiquing the dietary guidelines both in the U.S. and in the U.K. related to total fat and particularly saturated fat. And everyone who’s listening to this knows that for many, many years, really, I guess about 40 years now, right? It goes back to about 40, 41 years now, we've been told that fat in general, although that's maybe slightly changing in the public perception recently and even in some of the dietary guidelines that fat in general is bad, and particularly saturated fat is terrible.
But as we’re going to discuss in the show, your research has shown that that's maybe not what the evidence actually says. So before we dive into that, why don’t you tell everyone a little bit about your background and how you came to this work.
Zoë Harcombe:  Okay, I’ll do a really quick one because I know you’re not sort of a three-hour podcast man. So I’ll give you a composite history. First fascination came when I was studying at Cambridge University in the late 80s, early 90s and started seeing obesity growing around me. And it was just a fascination to me because it's the last thing that people want to be. People do not want to be overweight, let alone obese, and it was just starting to explode and had already exploded in the U.S. And I was just fascinated.
So I wanted to understand, why do we have an obesity epidemic? When you start looking at why, you go back to looking at when, and you can't help but see, particularly on the U.S. graph, that it just takes off like an airplane at about 1976 to 1980, that pivot point in the NHANES data. And of course, therefore, you go back to look at that period of time. Did anything particularly happen? Did we suddenly start eating 10,000 calories a day and sitting around on our backsides? Well, actually, no we didn't.
Did you grow up hearing that saturated fat would give you a heart attack? You’re not alone. Check out this episode of RHR for an in-depth look at the science surrounding saturated fat with researcher and author Zoё Harcombe. 
And the UK data was particularly interesting. We seem to be eating fewer calories nowadays than we did back in the 1970s, when we were much slimmer. Barely any obesity in the UK by about 1972. And you then start looking at an event called the dietary guidelines, which came in with the Senator McGovern committee in 1977, and of course these were then embedded in the US Dietary Guidelines for Americans in 1980 and then every five years since. And there is debate.
There are people who will say the introduction of the dietary guidelines has nothing to do with the rise in obesity and type 2 diabetes and more beta conditions related to diet and lifestyle. But it at least needs to be looked at. I mean, I say it coincided with the epidemics in obesity and diabetes, and we need to therefore explore was that a coincidence or was it a factor that was material in the changes in our health. And I am one of the people who thinks it is material and that our shift to basing our meals on starchy foods, grains, fruits, vegetables, largely carbohydrates, being encouraged to consume as high as 60 percent of our diet in the form of carbohydrate, the one macronutrient we don’t actually need, I do think it has made a difference. And I’m not alone in that view.
And then of course you look at guidelines and say, well, what were they about? And of course, they were about restricting total fat to no more than 30 percent of calories and saturated fat to no more than 10 percent. And because they were only three things that we ate and because protein is in everything other than sucrose and oil, so it tends to be fairly constant in any natural diet, and the peer study showed this beautifully, nice evidence for this, protein tends to stay constant around 15 percent. So as soon as you set the fat guideline, you’ve automatically set a carbohydrate intake minimum of 55 percent. And that’s what we did.
So I wanted to understand why did we set that total fat guideline. If that was the thing that started everything, why did we do that? And did we get it right or did we get it wrong?
Chris Kresser:  So you have a BA and an MA from Cambridge in economics and math, and then in 2016 you got a PhD in public health nutrition. And what I find really fascinating is what you … tell us a little bit about your PhD thesis.
Zoë Harcombe:  Yeah, so the PhD thesis was using the relatively modern techniques, and they have been around since the 1970s, but we’re really using them a lot now. And that’s the systematic review and meta-analysis. And when we pulled together evidence from randomized controlled trials, ideally, if not from cohort studies, it’s considered to be the pinnacle of the evidence that we could examine. So I approached looking at the dietary fat guidelines in four ways. And one was to say, what was the RCT evidence at the time available to the committee? Had they looked at it back in …
Chris Kresser:  That’s “randomized controlled trials,” for those who are not familiar.
Zoë Harcombe:  Yes. Yeah, so the randomized controlled trial evidence available to the US committee in 1977, and then the UK committee deliberated in 1983, and that allowed one more study available to the UK committee that wasn't available to the US committee, and that was the Woodhill Sydney Diet Heart Study. And also to look at the epidemiological evidence available, had the committee chosen to look it at the time the guidelines were set? So that was the first two papers, the first half of the PhD. And then the second half was to bring it up to date and to say if the committees were deliberating again today and they had all the RCT, randomized controlled trial, evidence available and all the epidemiological evidence available we have today, what would the conclusions be, looking at it in an up-to-date scenario. And that was the four parts.
Chris Kresser:  Yeah, so you’ve spent, how many years did it take for you to get your PhD?
Zoë Harcombe:  Yeah, three and a half. I did it full time. I just decided to stop everything else I was doing and do it full time. And as anyone who’s ever done one meta-analysis knows, to try and do four …
Chris Kresser:  Yeah, that’s a lot of work. But the upshot here is that you have a PhD in public health nutrition. You spent the better part of four years examining the evidence base for the last 40 years connecting fat and saturated fat to health and disease. And this is exactly why I wanted to have you on the show to talk about this topic because it's one thing if you have a kind of armchair critic who's cherry picking one or two studies to make their point, which often happens on the internet, right?
Zoë Harcombe:  Yes.
Chris Kresser:  It's another thing to have someone who's trained at the level that you've been trained at who spent four years objectively looking at this evidence and then publishing on it and showing where it doesn’t add up. So let's dive into that now.
I want to start by talking about some basics because I think they’re really important. I love how you did this in your recent dietary guidelines paper. Just a few facts about fat that maybe not everyone is aware of or has thought about much.
Zoë Harcombe:  Okay, so I shared these in conference presentations and I was really pleased that when I did this, there’s peer-reviewed study. They didn’t get edited out because I thought they might be a bit chatty, if you know what I mean, for a peer-reviewed paper.
Chris Kresser:  Yeah, yeah.
Zoë Harcombe:  But I actually had a couple of nice comments in the margin of people saying, “Oh, good point, I hadn’t thought about that.”
Chris Kresser:  Yeah, yeah. I had the same reaction.
Why You Need to Eat Fat
Zoë Harcombe:  Oh, thank you. So the most important one is that we must consume fat. Human beings must consume fat. We die without consuming dietary fat. We must consume essential fatty acids, that’s why they’re called essential.
“Essential” in nutrition means something that we must consume, not just something that the body needs. And of course we have the fat-soluble vitamins A, D, E, and K, and they come in foods with fat. And they need fat to be absorbed. So that’s pretty vital. When people demonize fat to the extent that they do, they always give the impression that we could get away without eating this stuff. And we couldn’t. I don’t know how quickly we’d die, but we would. So we need it.
Number two, again, that people seem to realize particularly when they demonize saturated fat is that every single food that contains fat, and it’s actually quite difficult to find a food that doesn't contain fat, sucrose doesn’t. But not much else doesn’t. So every food that contains fat contains all three fats. That’s:
Saturated fat
Monounsaturated fat
Polyunsaturated fat
And only the proportions vary. So again, people talk as if we can avoid saturated fat and only eat unsaturated fat, and that is completely impossible unless you're in a lab and you’re trying to create single fats. It is impossible if you’re going to eat food, which I recommend that all people do.
And then the other interesting factoid, I love playing around on the USDA all foods database and just looking at things that add up and things that don’t add up. And it was a real surprise to me when I first started looking at foods that when it comes to food groups, there is only one food group that has more saturated than unsaturated fat, and that is dairy products. So your struggle to find a meat, and I have not yet found one, that has more saturated than unsaturated fat, typically the main fat in meat is monounsaturated fat. And that goes for lamb or steak or chicken.
Chris Kresser:  Even pork.
Zoë Harcombe:  Absolutely. And therefore lard, which I just love, because people just think lard is pure disgusting.
Chris Kresser:  Saturated fat, yeah.
Zoë Harcombe:  Saturated fat.
Chris Kresser:  If you were to put lard or coconut oil together, people would say lard would be the unhealthy choice from a saturated fat perspective. But of course, coconut oil is 97 percent saturated, I think.
Zoë Harcombe:  Yes.
Chris Kresser:  Something like that.
Zoë Harcombe:  And lard is 39 percent.
Chris Kresser:  Right.
Zoë Harcombe:  So nowhere near as bad. And that’s not saying that saturated fat is worse than unsaturated fat. It’s just stating a nutritional fact. The only food group that has more is dairy products. And then of course you’re getting to, “Well, are dairy products bad for us?” And it’s really difficult to think that they are when you look at the nutritional profile of dairy products and the bone nutrients calcium, phosphorus, vitamin D. Look at any profile of any dairy product and you can’t help but think …
Chris Kresser:  And the evidence.
Zoë Harcombe:  Yes.
Chris Kresser:  I mean there’s a ton of evidence suggesting that full-fat, but not nonfat or low-fat dairy are beneficial for both cardiovascular and metabolic health. And there was actually a new study recently published, I’m not sure if you saw it. I am less persuaded by it. Or you mentioned it, the PURE Study.
Zoë Harcombe:  Oh, yes.
Chris Kresser:  Because it has within-country or between-country comparisons, which I think we’ll be talking about later, is problematic. That was an issue with the Seven Countries Study. But it does align with many of the other studies that have been done on this topic previously, showing that when people eat more full-fat dairy, that's associated with lower body weight, with lower blood sugar and better glycemic control, and with lower risk of heart disease based on cardiovascular markers. And that's actually the reason that the full-fat dairy works better than the low-fat or the nonfat dairy in that regard because some of the nutrients that are thought to be beneficial for cardiovascular and metabolic health are in the fat.
Zoë Harcombe:  Yes, amazing.
Chris Kresser:  So if you take out the fat, you take out the benefit.
Zoë Harcombe:  Yeah, yeah.
Chris Kresser:  Yeah.
Zoë Harcombe:  Absolutely, I’m a huge fan of dairy, personally.
Chris Kresser:  Me too. I mean, of course if someone is lactose intolerant or they’re intolerant of the proteins, it needs to be avoided. But for people who are not, what I always say is at least the evidence that we have suggests that it's healthy when it's well tolerated by the individual.
Zoë Harcombe:  Yes.
Why the Paleo Diet Template Makes Sense
Chris Kresser:  So given this, given that fat is essential, that all foods contain all fats and that saturated fat is not even the highest percentage of fat in any food except for dairy, this leads us to some pretty interesting conclusions. You mentioned in your paper, which I loved, and I loved that they kept it in here too, it’s illogical that the same natural food would be both helpful and harmful. Like you can't eat a steak and eat it so that you're only eating the unsaturated fats and not the saturated fats.
Zoë Harcombe:  Yeah, yeah. There’s no other way of putting that. It just, it doesn’t make sense. Whether your belief system is in God or nature, food is provided around us on this planet, and it makes no sense that in that same food that we need to thrive and survive, something has been put that is trying to kill us at the same time as all the things being there that are trying to save us and enable us to live. And we’ve evolved of course over—I’m reading Sapiens at the moment, so there’s an argument over our heritage—but, I mean, we’ve certainly been around potentially since Australopithecus, Lucy, two-and-a-half, maybe three-and-a-half million years ago. And we’ve done pretty well eating anything we can forage or hunt around us.
Chris Kresser:  That’s right.
Zoë Harcombe:  The idea that they came up with in the last 40 years that this stuff is trying to kill us, it’s just so stupid.
Chris Kresser:  It doesn’t add up at all.
Zoë Harcombe:  Yeah.
Chris Kresser:  It doesn’t add up. So another example you used which I love because it really turns nutrition-dominant paradigm ideas on their head is the olive oil versus pork chop example. Tell us about that.
Zoë Harcombe:  Yeah. So I have a little postcard that I leave on the chairs at conferences, as well, so there’ll be many around the world. And I put up a picture of a sirloin steak, mackerel, olive oil, and mention the pork chop. And a couple of interesting, fun factoids. One is that the mackerel has twice the total fat and one-and-a-half times the saturated fat as the sirloin steak, which isn’t a problem because both of them are great foods. But of course we’re told not to have red meat and we’re told not to have oily fish. So that’s illogical.
And then olive oil has 14 percent saturated fat versus a typical pork chop might be only sort of one to two grams, but then people say, “Oh, you wouldn't consume 100 grams of olive oil.” No, but a tablespoon of olive oil has more saturated fat than a 100-gram pork chop. And again, we can make a mockery of nutritional advice when you know something about food.
Chris Kresser:  Yeah, I mean, and it’s easy to see how you could have a salad, if you have a big salad with a couple tablespoons of olive oil and dressing versus a 200-gram pork chop, you’re still eating more saturated fat there.
Where These Misguided Ideas about Saturated Fat Came From
So, I mean, this is so obvious when you look at it this way, and it makes you wonder, how did we get the idea that saturated fat is bad in the first place? I know there are some political and social roots of this, and feel free to talk a little bit about that if you want. But in particular, how did this arise from the evidence? What was your sense of that as you did your PhD and looked deeply at all of this?
Zoë Harcombe:  Yeah, so one of the most important chapters in the PhD is the review of the literature. And you go back in the review of the literature, and of course in this topic area, you’ve got to go back to the Russian pathologists in the early part of the 19th century, when they noticed the cholesterol deposits in the arteries of the autopsies that they were doing. So they started to hypothesize, had these cholesterol deposits actually caused the death of this relatively young person that they were performing an autopsy on, and could they come to any conclusions about those sort of cholesterol stores of fatty deposits?
And many people know this, it’s been said in conference presentations, that at the time they then started experiments on rabbits, feeding them foods containing cholesterol, feeding them purified cholesterol, to try to see if they could mimic the impact that they thought food might be having on the human body. And of course, as some people have worked out, rabbits are herbivores and the only foods that contained artery cholesterol are foods of animal origins. No exception. So you find dietary cholesterol only in meat, fish, eggs, and dairy, which are things that rabbits can't tolerate.
Chris Kresser:  Yeah, it’s strange. In a certain way, this almost supports what we were just saying. Eat a species-appropriate diet. The message there is not “don’t eat cholesterol.” It’s “don’t feed cholesterol to an animal that’s not supposed to eat it and don’t feed humans foods that we’re not supposed to eat.”
Zoë Harcombe:  Absolutely. And very interesting. When they fed purified cholesterol not in animal foods to the rabbits, they didn’t have any problems. And when they fed cholesterol foods to dogs, they didn’t have any problems because dogs are omnivores.
The Seven Countries Study
So we then wind forward to the 1950s, and Ancel Keys gets a bit of a bad rap in our world. I like to look on him in quite a more balanced way because he did some brilliant work, like the research starvation experiment. But he did kind of fall by the wayside a little bit on the fat thing.
So his first exploration was with the Russian experiments in mind to try to see if dietary cholesterol impacted blood cholesterol. And he concluded it did not, and he never deviated from that view. And the best quotation I found on that was from the 1954 symposium on atherosclerosis, and he said, “Cholesterol in food has no impact on either cholesterol in the blood or the development of atherosclerosis in man.” Which was brilliant because he had actually exonerated animal foods. But he didn't make that connection at the time. Maybe his nutritional knowledge just wasn't good enough and he just hadn't quite worked out, “If I’m finding nothing when I’m feeding human subjects,” because you could do that then with ethics, “human subjects massive amounts of dietary cholesterol via loads of animal products, they don’t develop any blood cholesterol problems and they don’t develop any signs of atherosclerosis,” he should’ve concluded, “I therefore just exonerated what I’ve been feeding them.” Which would be:
Eggs
Cheese
Meat
Possibly fish
But most likely meat, cheese, and eggs. But he didn’t. For some reason he was convinced that fat was the bad guy. If it wasn’t cholesterol in food, then it had to be fat in food. And yet again, having given his human subjects animal foods, he should’ve said, “What are the macronutrients in those animal foods? Okay, so it’s fat and protein. Dairy products have got a little, little bit of carbohydrate, but essentially what I've just fed them is fat and protein. So I should turn my attention to the one thing I haven't fed them, which is carbohydrate.” But he didn't do that.
So he was convinced that total fat was the problem, and of course we then had the Mount Sinai presentation in 1953, which gave us that famous Six Countries Graph, which has nothing to do with the Seven Countries Study. And then of course there were a number of countries that he'd left out. And Yerushalmy and Hilleboe found this out and unfortunately published a little bit too late, in 1957, saying, “Hey, hang on, you left out all of these other countries. And if you put them all on there it looks a bit like a spider scatter, that the pattern has gone. But the Seven Countries Study had already started in 1956. And Keys seemed pretty determined that he was going to come to the end of the Seven Countries Study and find fat guilty.
Now interestingly, and this is not terribly widely known, he could not find anything against total fat. So when, as part of my PhD, I pulled the epidemiological studies that were available at the time the guidelines were introduced, and of course the Seven Countries Study was one of those, and you’ve got Framingham and Honolulu, Puerto Rico, the London bank and bus study, and the Western Electric study being the others, none of those six found any relationship between coronary heart disease and total fat. So Keys acted. He went in with the total fat hypothesis. He accepted that it was not total fat. Now he had spent so much time and money on this study, he needed to find something. And he could find an association between saturated fat in the different cohorts, and coronary heart disease in the different cohorts. But at the same time he claimed, and this is in the summary paper, “I found no issue with weight, obesity, I found no issue with sedentary behavior activity, I found no issue with smoking.”
So things that we now know he was wrong about, we give him the benefit of the doubt on the one thing that he did find, which was saturated fat. And the other five peer studies, the ones I’ve just mentioned, did not find anything against saturated fat. And of course, they were all in country studies. So they were right, they were in community studies.
So you take Framingham. It’s a small town, it’s looking at people who eat a certain level of total fat or saturated fat versus people who don’t. So you’ve got all the other factors, or many of them, constant. You’ve got the same GDP, the same politics, the same community, the same access to healthcare. Go to Japan in the 1950s versus the US in the 1950s, you’re comparing efficiently.
Chris Kresser:  Completely different.
Zoë Harcombe:  Exactly.
Chris Kresser:  Not even apples and oranges. We’re not even in fruit category there. I just want to pause here and just highlight this for people who are less familiar with research and methodologies. What Zoë’s saying is that if you … the problem with comparing groups of people between countries is that there's so many factors that vary from country to country and lifestyle, physical activity, the type of foods they eat. Saturated fat comes in lots of different types of food. So what kinds of foods are people eating in the US versus in Japan, where saturated fat would be found in totally different type of food? So comparing between countries just makes the possibility of confounding factors and all of the other issues of epidemiological research, it just amplifies them and makes them even more likely. So typically, especially today, those between-country studies are often discounted or taken with a large grain of salt because it's so hard to control for factors even within the population, much less between different populations.
Zoë Harcombe:  Absolutely. Absolutely yes.
Chris Kresser:  Okay, so, I mean, this is … the crazy thing to me about this, Zoë, and I'm sure this struck you at many intervals throughout your PhD, is just how much of a house of cards the whole evidence base is behind the idea that saturated fat is bad for us. There’s this illusory truth fallacy that we were chatting about before we hit the record button, as well, which is the idea that if you hear something repeated enough times, you just start to believe that it's true, whether it has any basis in fact or not. And we think maybe that researchers and scientists are immune to this illusion. But the fact is, they’re not.
John Ioannides, one of the most famous epidemiologists in the world, one of my favorite quotes of his is, “Claimed research findings may often be simply accurate measures of the prevailing bias.” So, I mean, that sums it. He has all these pithy quotes that just sum it up in, like, 10 words. Which basically means that once you have a certain idea and it's out there because of groupthink and confirmation bias, that idea will often just be perpetuated, even if it was never based in fact in the first place. Because someone will link to that original study that turned out to be erroneous as proof, then someone does a later study and you link to that second study. And then it just becomes a chain of references that all point back to that original study that then it was later shown to be invalid. So it's crazy to me that 40 years of dietary policy has been based on such flimsy evidence.
Zoë Harcombe:  I should declare my own bias, actually, going in, because up until 2010 I’d been a vegetarian for about 20 years. Then my own bias going in was that fat was bad, saturated fat was bad, saturated fat equaled animal fat, which of course I now know absolutely that it doesn’t. All fats are in all foods, especially coconut oil, which is purely vegan. And I believed what I’d been taught at school, that we should be eating low-fat foods and healthy whole grains and plenty of fruit and vegetables. And I believed it too. And I was at a dinner party just a couple of weeks ago, and there were a couple of young people who were engaged and full of life and full of news and full of opinions.
And as we sat down to dinner, they were reliably informing me and my husband that they didn’t eat much meat because it was full of saturated fat, which of course it isn’t, and saturated fat is bad for you, which of course it isn’t. And I said, “You guys work in the finance industry. How did you pick up, how did you become authorities on dietary fat at your tender young years?” We had done a superb marketing job on fat and cholesterol worldwide and people have fallen for it.
Chris Kresser:  Absolutely. Yeah, yeah, and it’s deep. It’s really a form of conditioning. At least, I’m not sure what’s happening with with kids now, but I grew up certainly at a time where butter and eggs and all those foods were really demonized. And it becomes kind of part of your cultural conditioning, and it's so deeply hardwired in the brain, it can be really hard to let go of it. I, as my listeners know, I was a macrobiotic vegan at one point. So I took it about as far as you could go.
Zoë Harcombe:  Wow.
Chris Kresser:  And I remember in high school, I was an athlete and the whole carb loading paradigm. I was eating, like, bagels with nothing on them, like dry bagels and breakfast cereal with nonfat milk for breakfast, and eating pasta and pancakes before my basketball games because the thinking was that would be good for athletic performance and also good for my health.
So I can be pretty extreme when I go for something. I took it to the extreme and when I started to figure out, I mean, it took a very serious chronic illness for me to snap out of that. And even with that, I remember when I was first starting to eat more fat, I had this distinct feeling, like I was doing something wrong or I should do it behind closed doors, or that something bad was going to happen to me. And it took quite a while for that to unwind. So I think there’s that kind of deeper psychological influence happening here too.
Zoë Harcombe:  I’ve read your stuff on that. You write so, like it just happened yesterday. I mean you just describe it, and you just did it then. I could see you running around the track with your bagel. It sort of stays in your mind, doesn’t it, how we felt and what we thought we were doing when we did all of that stuff.
Zoё Harcombe’s Research on Fat
Chris Kresser:  Absolutely. So let's talk a little bit more. Let’s kind of dive in with a little more of a fine-toothed comb on your thesis and your review of the RCTs from 1977, the randomized controlled trials. Which again, if we’re looking at a hierarchy of evidence, it's not that RCTs are perfect or they don't have potential issues, but certainly when compared to epidemiological issues and all of the problems there, which we’ll discuss a little later, they are more reliable. So what did you find in your review of RCTs related to saturated fat and either death from all causes and death from heart disease?
Zoë Harcombe:  So this paper came out in February 2015, and it went nuts. And if you Google it, it was front page in New Zealand and in the UK papers. And I spent the whole day when it came out. The phone was ringing the second I put it on in the morning and it was the BBC, could I come in? And I ended up doing about 20 or 30 interviews that day, just back to back. And it just went nuts. So I think it went nuts because it was the unique part of the PhD that was looking at the evidence at the time. And so people were picking up on the idea that we’ve been eating low fat for 40 years and the evidence wasn’t there at the time to back up the call to do that.
So the major findings from that paper were first of all that there were only six studies, six randomized controlled trials that were available to the UK committee. Only five were available to the US committee, and they’ll be pretty well-known to people. It’s like the Rose corn oil, olive oil trial, the low-fat diet; the Leren Oslo Diet-Heart Study; the MRC soybean study; the Sydney Diet Heart Study; and the LA Vet study. And you pull all of those together, there is no difference whatsoever. Not even to just leak the significance, it was actually the exact same number of deaths in the controlled side as in the intervention side. There was no significant difference in coronary heart disease mortality, it wasn’t quite an identical number, but it was something like 221 versus 219, or something. It was so close. It was virtually identical, again.
A really interesting finding, and this just massively undermined the diet–heart hypothesis and was not a finding that we expected to come across. It just came out. We were able to measure the … Across the polled studies, there was a significant difference in cholesterol being lowered in the intervention studies. But of course that made no difference whatsoever between mortality or coronary heart disease mortality. And I then went on to try to understand why it may have been the case that cholesterol had been lowered by the intervention and not made any difference to health benefits apart from the fact that cholesterol is not bad for us. But why didn’t intervention diets lower cholesterol?
And I think it’s because the main intervention was to swap out saturated fat and to swap in polyunsaturated fat. And a lot of the polyunsaturated fats that they were putting in, corn oil, soybean oil, vegetable oils, contain plant sterols. And plant sterol is effectively plant cholesterol, and it competes in the human gut with the human cholesterol and it replaces it, to an extent. So if you take plant sterols in margarines or spreads or in vegetable oils or indeed in some grain plant products, or some people take them from tablets from the health food shop, which is a really crazy … they will replace your own cholesterol to an extent and lower your blood cholesterol. But I’ve looked at the evidence for the end outcomes on heart disease. I’ve got another paper on that that was published in an editorial, and that shows that actually the overall benefit is not there. It’s actually overall harm of administering plant sterols in the end outcomes of heart disease.
But I think that’s why they lowered cholesterol and perhaps the studies weren’t long enough for the harm from that replacement to actually manifest itself in a difference in outcomes. And I would then expect the interventions to have more deaths from heart disease and more deaths therefore from all-cause mortality.
One of the other really big aspects I think that grabbed the media is the point that we made at the end of the paper, saying that these six studies, when he pulled them together, amounted for fewer than two-and-a-half thousand men, not one single woman had been studied, and not one of those men was healthy. They had all had a heart attack already.
Why You Should Be Skeptical of Some News Headlines
Chris Kresser:  So this is just really key here. You cannot generalize, even if the results were consistent across all these studies, which they weren’t, implicating … Or it sounds like they were consistent in the opposite direction that people thought they were. But even if they had implicated saturated fat as increasing total and CHD mortality, coronary heart disease, that would only be applicable to men.
Zoë Harcombe:  Sick.
Chris Kresser:  With pre-existing, yeah, sick men.
Zoë Harcombe:  Yeah.
Chris Kresser:  Not women and not men that are not sick.
Zoë Harcombe:  Yeah, absolutely, yeah. And interestingly not one study called for change, and studies at the time were far more ethical, I think, than they are today. Far less media orientated, far less trying to get a press release. They would just say things how they were. And a couple of them were a bit nervous about potential toxicity of the fish oil that we’d administered, and they’re the ones that were a bit worried about … the corn oil study had more deaths in the intervention group, and said, “We’re worried about the potential harm from the fish oil intervention.” And the low-fat diet study, the last sentence of that study just cracks me up. It just says, “A low-fat diet has no place in the treatment of myocardial infarction,” which is heart attack.
Chris Kresser:  It's interesting to me what you just said that how much the, both the reporting on studies has changed in the media and also even the way that researchers talk about their findings themselves to the media. I think I was reading an article in Science that was published in 1993, and they were talking about relative risks, which we can get into more detail when we talk about epidemiological evidence. But this is the percentage increase in risk from a given intervention, and they were outside of nutrition, still today in any other field, epidemiologists would consider anything below a 200 to 400 percent increase in risk to be indistinguishable from noise, meaning they would consider anything less than a 200 percent increase in risk to be not significant statistically. And in this article, Marcia Angell, who is a former editor of the New England Journal of Medicine, was quoted as saying that, “They typically didn't really accept a paper unless it had a relative risk ratio of over three for nutrition.” And that just blew me away because today, like IARC's panel about red meat and processed meat causing increased risk of cancer, the percentage increase is 18 percent.
Zoë Harcombe:  Yeah.
Chris Kresser:  That’s not even remotely close to the 200 percent which is the lower end of the threshold. And yet the media headlines are not saying indistinguishable increase in risk observed in people eating more red meat. They come out and just claim causality. They say, “Red meat and eating red meat and processed meat is going to kill you.”
Zoë Harcombe:  And as Bradford Hill would say, “There’s nine criteria and that double is just one of them.”
Chris Kresser:  Yeah.
Zoë Harcombe:  “So hit the double and then you can look at the other eight.” But none of them hit the double, none today get anywhere close.
Chris Kresser:  Nowhere near and yet, and I think this is partly an artifact of the world we live in, just with, like, proliferation of the internet and so many headlines. Everyone's vying to get attention and so you have to … a headline that said, almost insignificant increase in risk observed in people who eat more red meat than other people. But of course there are other diet and lifestyle factors that we’re not considering. That's not to make a good headline, right? Nobody’s going to click on that. And so people want the flashy, clickbait headline saying low-carb diet will shorten your lifespan or eating red meat will give you a heart attack. Even though I would hope that the researchers themselves somewhere deep down know that that’s a gross exaggeration of their findings.
Zoë Harcombe:  Yeah.
Chris Kresser:  And as for the media, I guess it’s just that we don’t have science journalists anymore.
Zoë Harcombe:  We don’t. I do a note every Monday where I look at a paper from the previous week and dissect it. And you can tell, mostly the ones that get into the media have had a press release. And if you look at the press release and you look at the media article, the media have just taken the press release almost verbatim. The press release provides a couple of quotes, they end up in every single article. Completely lazy journalism. Occasionally they might call in the UK me or Dr. Aseem Malhotra or Dr. Malcolm Kendrick and just say, “Do you want to give an opposing quote?” and occasionally they’ll stick it in.
Mostly they’ll just run off the press release, and the researchers should be challenging the press release. I mean, our paper in February 2015 was press released, and I remember having a few toings and froings because I wanted it to be scientific. It’s a big enough claim in itself to say we only studied two-and-a-half thousand sick men, and then we introduced these guidelines for 250 million Americans and 50 million Brits. That’s okay, enough. We don’t need to sensationalize it anymore than that.
Chris Kresser:  Absolutely.
Zoë Harcombe:  So I tried to get it down to the facts that we found and not to put any spin on them.
Chris Kresser:  Yeah. Yeah, to your credit, I mean, that's so hard to do in this crazy media environment that we live in now. And to be fair, there are definitely researchers that make an effort to do that. And you still will see that in reports where, I was reading one on, I can't remember what it was, but it actually stood out to me because I don't see it as often as I do. I was impressed by both at what the researchers were saying and that the author of the article. Because they went out of their way to say this is just an association or correlation. It doesn't prove causality, and here are the reasons why it might not be a causal relationship, and why we need more research. But my sense of that is it's almost like when you watch, if you see a commercial for a drug and then you have like the 20 seconds of side effects after the 10 seconds of the commercial. People have heard that so many times they just kind of tune that out and they’re only really still paying attention to the headline.
Zoë Harcombe:  Yeah.
Chris Kresser:  So let’s talk. So you went back, you reviewed the RCTs from the late 70s that were responsible for creating dietary guidelines that, as you said, applied to hundreds of millions of people around the world and probably affected many more even just by osmosis. Those ideas becoming firmly entrenched in industrialized society, even if they weren’t part of formal dietary guidelines. And then you went back and analyzed all of the research that had been done from, was it from the late 70s to 2016?
Zoë Harcombe:  Yes, so we then took it up to date. And I actually said in the recent paper that’s just been published by the BJSM, the one on is saturated fat a nutrient of concern, and that’s because the USDA is now looking at it again for the next dietary guidelines. And I actually put in that paper that the day that the paper is saying there was no evidence at the time came out, I was astonished that Public Health England came out almost immediately on the day. I said, “Okay, so maybe there wasn’t evidence at the time, but we’ve got plenty of evidence today.”
Chris Kresser:  Right.
Zoë Harcombe:  I was surprised that they were prepared to concede. I thought they said, “No, no, no, this is ridiculous. The Seven Countries Study was marvelous and that’s all we need. And we can ignore everything else.” But they didn’t. They said, “Okay, there was no evidence, but there is plenty nowadays.” And of course it takes so long to get papers published that with my supervisory team, we’d already moved on to the next step, which was looking at the evidence available today. So we had that paper pretty much ready to go. And of course you keep in the original six studies, then you just add in any other randomized controlled trials that have looked at coronary heart disease, mortality, and total mortality. Those were our two outcome criteria so we wouldn’t lose some RCTs that only looked at events, for example. But then that then brought in the Women’s Health Initiative, the DART study, the STARS study, and the very well-known Minnesota Coronary Survey study.
Chris Kresser:  Zoë, before we go on I want to pause there. Let’s talk about why you chose total and coronary mortality as an endpoint and why that's important—to focus on the mortality endpoints versus just the events.
Zoë Harcombe:  Yeah, I’ve got to credit Dr. Malcolm Kendrick with this, and I am such a Dr. Malcolm Kendrick fan, it’s just not true.
Chris Kresser:  Yeah, me too.
Zoë Harcombe:  And I just remember, I mean, I’m fortunate enough to know him and consider him a friend and to meet him on occasions. And just every time I meet with him he says stuff and I'm just, why is this not just the only thing that’s being taught in medical school because it’s so sensible? So he’ll say, “I can guarantee that you won’t die from heart disease by pushing you off a cliff.” And it just, it then sticks in your head. Okay, so the important thing is total mortality because there is no point to reducing heart disease if you increase deaths of something else. So all this stuff going on with statins. Oh, we think we can reduce some events. We could have a whole different program on statins. But would there be any point in making any benefit anyway, even if they could, if they, for example, as they might do, increase your risk of cancer or dementia or mind health, etc., etc.? So it has to be total mortality. The only thing that matters is are you going to help people to live longer, to die later?
Chris Kresser:  Absolutely.
Zoë Harcombe:  That’s what we’re trying to do with health interventions. And so we’ve got to have all-cause mortality in there and then we’ve got to have heart disease mortality and not just events. Because that’s where the dietary fat guidelines came about. They were issued in the name of trying to stop deaths, particularly in men at the time, younger men at the time, from coronary heart disease. So if they’re not going to achieve that, then they’re not even going to achieve what they were introduced for. So why on earth were they introduced?
Chris Kresser:  Yeah, thanks for clarifying, and sorry to interrupt. But I'm banging on this drum all the time. I just want to make sure that people understand it because it's a crucial distinction. You frequently see headlines like “XYZ intervention reduces the risk of heart attack by 20 percent,” which again, as we just said, in an epidemiological study, that's meaningless. We can’t distinguish that from chance anyways.
But even if it's an RCT, then the first thing I’d do is go look at the table to see if they even measured total mortality. Which previously, that was less common. It’s more common now, I'm finding. But then when you look at total mortality, there is often no difference. So that’s where the disease substitution is happening that you were just talking about. The risk of death.
Zoë Harcombe:  A bit of gossip. Malcolm Kendrick wants to die from a heart attack.
Chris Kresser:  Rather than cancer?
Zoë Harcombe:  Exactly. Rather than cancer.
Chris Kresser:  Yeah, that’s what I tell people too.
Zoë Harcombe:  Yeah, he doesn’t want to go early, don’t get me wrong. He probably wants to go at sort of 98 drinking a glass of red wine, playing with his grandchildren when he gets them.
Chris Kresser:  Yeah. You just have a heart attack in your sleep overnight. You don’t wake up one morning. That sounds a lot better to me than dementia or Alzheimer’s or cancer.
Zoë Harcombe:  Yeah.
Chris Kresser:  So you don’t need to belabor this, but it’s really important to point out because I think it's something that people who are less familiar with research may not have thought of. So okay, so you chose total and CHT mortality, and I believe you ended up with 10 RCTs?
Zoë Harcombe:  Yeah. So the original six and then the Women’s Health Initiative, DART, STARS, and the Minnesota Coronary Survey, pull them all together, there’s no difference in all-cause mortality. There’s no difference in coronary heart disease mortality. Again, there was a significant reduction in cholesterol in the interventions that did not meet any difference in coronary heart disease mortality or all-cause mortality.
So essentially, all we did by adding in the former recent studies was that we increased the number of people studied quite dramatically. It came up into the tens of thousands, not least because the women’s health initiative alone brings along tens of thousands of people to the party. And of course it then became more female than male because of all the women in the Women’s Health Initiative. But we still in those 10 only ended up with one study including both men and women that would be a primary prevention study, so people who had not already had a heart attack, and that was of course the Minnesota Coronary Survey. And this in itself found no significant results at the time of publication and of course we then had that brilliant paper where … it should be on the tip of my tongue, the person who went back to look at this, Christopher, I’m thinking. You know the person I mean, who went back to look at the Minnesota Coronary Survey and also went back to look at the Sydney.
Chris Kresser:  Was it Hibbeln?
Zoë Harcombe:  No.
Chris Kresser:  No that’s Joseph Hibbeln and Christopher, they’re both the guys who have done a lot of the critique of the polyunsaturated fat research, or am I thinking of someone different?
Zoë Harcombe:  Oh, I’ll be kicking myself and don’t worry. Stick it in your show notes. But it’s a very well-known team that went back to look at both of those studies and even thought there was no evidence found against the dietary intervention at the time, they found that there was some unpublished data. And it just made it even more robust that we had been demonizing fat at the time. So all the RCTs as of 2016, and there haven’t been any since, and there’s still no more evidence than we had at the time the guidelines were introduced.
Chris Kresser:  Wow, it’s just, it’s really kind of remarkable, actually. And it’s again just going back to this idea that a lot of this evidence is really based on a house of cards. And as an example of the fallibility of these guidelines, the US in 2015 for the first time removed their advisory that we should not be eating dietary cholesterol. Because they finally acknowledged the cholesterol in the diet does not have any relationship with heart disease. And that was kind of like a pretty major thing that just, like, slipped through.
There weren’t really big announcements or any fanfare around that. Like, “Hey, everybody, we’ve been really wrong about this for the last 30 or 40 years and we just want to bring that to your attention.” And I even remember reading editorials written by scientists who were kind of still anti-saturated fat and cholesterol, and were saying things like, “We can’t really make too much of this because the public is going to lose faith in our ability to guide them with diet.” And I have a sense that the same thing is going to happen with saturated fat in the next few years. And maybe already people know this, but they're just not willing to do it yet because if they do, people will absolutely lose faith in the diet guidelines.
Zoë Harcombe:  Yeah, and they need to.
Chris Kresser:  Yeah.
Zoë Harcombe:  I mean, let’s face it, they need to lose faith. The best thing that they could do, the dietary guideline committees, would be to come out and say, “Guys, we were wrong. I’m sorry, we were wrong. And we’re going to get it right from now on.” And that would be the only way that we would start having trust in them again. But all this surreptitious slipping things out, then slipping things in, anyone who’s working in this field is just finding this completely unprofessional and noncredible.
 Why Dietary Guidelines Don’t Work
Chris Kresser:  I mean, this is a whole other discussion, but it’s worth pointing out that the idea of top-down, one-size-fits-all dietary guidelines that will apply to everyone is really not consistent with our understanding, our modern understanding of human biology, biochemistry, and physiology. And I think that this, the whole idea of dietary guidelines that would apply to everyone needs to just die. Because that has led to this reductionist approach, which one researcher calls nutritionism, I like that idea, which is that a nutrient is a nutrient is a nutrient no matter what it's found in.
Saturated fat in candy or pizza or junk food will have the same impact as saturated fat found in a steak or another whole food. And it’s led to this extreme focus on macronutrients and isolated food components rather than looking at the whole context of the diet. And that's starting to change slowly. There have been some pretty good studies in the last couple years. There was one, I’m sure you know which one I mean. It was looking mostly at weight loss and they compared, they designed a study that was comparing the effects of a healthier low-carb versus a healthier low-fat diet. And they found that both were actually pretty effective compared to the standard junk food diet that most people eat.
And we need more studies like that, and if we let go of this kind of one-size-fits-all approach, we might actually be able to start looking at the context of foods we’re eating, and then where maybe one person does need to eat more fat and fewer carbs and another person might do better eating a little bit less fat and more carbs from whole foods relative to that other person. So to me that’s one of the biggest assumptions behind the dietary guidelines that’s not mentioned.
Zoë Harcombe:  Yeah, that was the Gardner study, wasn’t it?
Chris Kresser:  Yeah.
Zoë Harcombe:  I corresponded that enough.
Chris Kresser:  Yes, the Gardner study.
Zoë Harcombe:  Yeah, very good study, yeah.
 The Epidemiological Evidence
Chris Kresser:  So let's just briefly touch on epidemiological evidence. I mean, there’s so many issues with observational nutrition studies. I don't know if you saw John Ioannidis’s recent review. It was published in JAMA and I’m going to pull up a couple choice … It was called “The Challenge of Reforming Nutritional Epidemiological Research.” And I’m going to read the first two sentences because they’re classic Ioannidis in how pithy and direct they are. It says, “Some nutrition scientists and much of the public often consider epidemiologic associations of nutritional factors to represent causal effects that can inform public health policy and guidelines. However, the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.”
Zoë Harcombe:  Oh, I couldn’t agree more. I just couldn’t agree, I mean, I had the privilege of seeing John present at the Food for Thought conference in Zurich, which was arranged by the British Medical Journal and Swiss Re, a reinsurance company, and he gave the, I guess you’d call it the keynote, after-dinner speech by videoconference into the conference hall where we were in Zurich. And it was uncomfortable, shall we say, for some of the audience.
Chris Kresser:  I could imagine. In an audience full of nutritional epidemiologists, probably didn’t like what he had to say.
Zoë Harcombe:  Yeah, largely. I mean, I sat near Nina Teicholz, and we were absolutely loving it. But I won’t mention any names, but a couple of nutritional epidemiologists did walk out.
Chris Kresser:  Yeah, yeah, I’m not surprised. It’s hard to consider, and there are ways that nutritional epidemiology can be done better. We can have more advanced data collection methods and an application of Bradford Hill criteria, which you mentioned, to increase the chance that the relationship between variables is causal. But the way it is now … there’s another critique that I love by Archer and he says, “For results to be scientific, data must be, number one, independently observable. Number two, measurable. Number three, falsifiable, Number four, valid, and number five, reliable. And these criteria distinguish scientific research from mere data collection and pseudoscience.”
And when you look at nutritional epidemiology, they do not satisfy those basic criteria for science because they're relying on data collection methods like food frequency questionnaires, which are just a joke. I mean, they’ve been so thoroughly debunked as a reliable way of assessing what someone is eating. We know that human memory is not an accurate reproduction of past events. It’s just basically a highly edited anecdote regarding what we ate. And we know that these approaches that are used to assess what people are eating in these studies are really not accurate and not reliable and don't fulfill the basic criteria of science.
So, I mean, we could talk a lot more about the problems with epidemiology, but I think let's, given the time constraint, let's just go on and talk with those caveats, those huge caveats. What did the epidemiological evidence suggest if it had been included in the original analysis that you looked at and then also since then?
Zoë Harcombe:  So we covered in some depth at the time that essentially it was just the Seven Countries Study that found anything. None of the six studies found anything against total fat, and then just the Seven Countries Study alone found something against saturated fat. When you bring the epidemiology up to date, and I actually did it, I had to do it in a different way in the fourth part of the PhD because they didn’t have data on current epidemiology and total mortality or coronary heart disease mortality. So there was going to be nothing that I could actually update the original studies with.
So I had to look at different measures of looking at any relationship that I could find with deaths and total fat or deaths and saturated fat separately. Of course they’re not interventions anymore. So you are into just this epidemiological base of looking at the fat intake in different regions or in different studies. So it was slightly different to the other three that were looked at, and they were completely different studies, and probably studies therefore that are less well known to people. They were certainly less well known to me. So things like the Ireland-Boston study, Kushi, the US Health Professionals, Lipid Research study that’s very well known. The Pietinen Finnish counts study, a UK health survey by a couple of people called Boniface and Tefft. She’s not very well known, this new heart study, and then the Gardner Japanese study, which is probably not too badly known within the field. And when you separate it out, look in it, coronary heart disease deaths, so we couldn’t get the total mortality anymore.
But we could at least get the heart deaths and align those to either the total fat, where it was examined, or the saturated fat. There was, again, no significant difference for coronary heart disease deaths and total fat or saturated fat consumption. We were back to a limitation of the pooled studies from those seven that I’ve mentioned being almost entirely male. So 94 percent of the people involved in those studies were male. They were at least mostly healthy. Almost all of them had not already had a heart attack, but there was still no relationship for coronary heart disease deaths and total or saturated fat. So there was then a fifth paper that I published with the BJSM that wrapped up the four studies.
So it went through essentially what we’ve gone through now, which is, what did I do, looking at RCTs then, RCTs now, epidemiology then, epidemiology now? What was found? What wasn't found, which was far, far more. And then an era that I suggest we’ll probably be heading into quite soon was to put what I’d looked at in context of other meta-analyses that had been done. Because I’m a PhD researcher, I was not straight out of finishing my degree. But I’m still just a PhD researcher looking at this evidence fresh in a systematic way.
A number of other people have also looked at the data in this field either for mortality or for events or for interventions or for epidemiology. And I therefore wanted to look at what everybody else had done to say have I found something different. Has everybody found this? Because you have to do that. You can’t come to the end of your PhD and say, “I find if I might drop the toast buttered 100 times out of 100 it falls on the butter on the floor,” if everybody else has found more (audio cuts out 59:06) it doesn’t fall with the butter on the floor. You’ve got to put your own research in context.
Chris Kresser:  That’s another core principle of science. Shapiro, an epidemiologist, said, “We should never forget that good science is skeptical science, and science works by experiments that can be repeated. When they’re repeated they must give the same answer.” So this is another core principle. So what did you find when you looked at these other meta-analyses?
Zoë Harcombe:  So the main ones that were pulled together, and there’s a great table in the paper five, which is one from 2016. I think it's called “Dietary fat guidelines have no evidence base: Where next for public health nutritional advice?”
Chris Kresser:  That’s a pretty straightforward title.
Zoë Harcombe:  Yeah, it is pretty straightforward, actually yeah.
Chris Kresser:  Not beating around the bush.
Zoë Harcombe:  They’re pretty good, actually. They help you with titles. So they come up with catchy ones.
Chris Kresser:  Yeah.
Zoë Harcombe:  And I then went through, for example, I got the tape in front of me, so you’ve got Skeaff and Miller from 2009 who looked at RCTs and epidemiological studies. And they looked at mortality and events for total fat. You’ve got a fairly well-known study with Siri Tarino and colleagues from 2010 looking at epidemiology of fatal and nonfatal coronary heart disease and cardiovascular disease. Mozaffarian, who I had the pleasure of meeting in Zurich over the summer, and his paper looking at just events, not mortality. We might come back to that one. And then of course you’ve got the two well-known Hooper studies, that’s the Cochrane research, which should be the gold standard, but we can take a bit of a better look at that one. And then you’ve got Schwing, Jacqueline, Hoffman from 2014, RCTs, and my own study. And then of course you’ve got the Chowdhury study that looked very interestingly at the four different types of fats, saturated fat, monounsaturated fat, polyunsaturated fat, and they included trans fats in their research looking at coronary disease for both randomized controlled trials and epidemiological studies.
Chris Kresser:  Right, and I’d like to read the conclusion of that one: “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”
Zoë Harcombe:  Here, here.
Chris Kresser:  So that was the Chowdhury, and then, so there were, I think, 39 total reports.
Zoë Harcombe:  Yeah, 35 non-significant. And we don’t shout that often enough.
Chris Kresser:  Yeah.
Zoë Harcombe:  If you stop—and I’ve done this for a Welsh TV program that I was working on—we went to Cardiff, which is the capital city of Wales, and we walked down the main street in Wales and we said to people, “What do you think about fat? What do you think about fruit?” And people would tell you, “We need to eat five a day and fat is bad for us.” So people have got the messages. But what we’re not telling them is when you actually look at all the evidence, 35 out of 39 results were non-significant. No findings. And that has to be the most significant thing that has been found, that we didn't find much. Why don’t we look at that more often? That’s so more powerful to me than the four findings. And if we just whiz through those. In the Chowdhury study that you mentioned, the one finding that they did make was against trans fats, and I don’t think you or I would give them any argument over that one.
Chris Kresser:  No.
Zoë Harcombe:  Mozaffarian, I really liked him in Zurich. But I was involved in a paper that critiqued his 2010 study which said, “You should replace saturated fats and polyunsaturated fats because there’s an impact on CHD events.” And our paper criticized that paper for excluding two studies that were not favorable to polyunsaturated fats, which was the Rose corn oil study and also the Sydney Diet Heart Study. And including, and it’s all bad studies, the Finnish Mental Hospital Study, which was not randomized, not controlled, crossover trial. I mean, just the worst possible trial to try and slip in to pretend it’s an RCT. So we critiqued that paper. I like to think he wouldn't publish that paper if he had the opportunity tomorrow. I can't speak for him, that wasn't right.
And that’s, of course, exactly what the Sax paper did last year, the American Heart Association paper. Again left out two unfavorable studies, the same two. Included the Finnish Mental Hospital Study, they shouldn't have done. And so basically, there were only two findings, and they boil down to one because it was the same research team, Hooper and the Cochrane team, working out of the east of England in the UK. One paper was from 2011 and the other was from 2015. And among 11 known findings for CVD, mortality, total mortality by modified fat, reduced fat, any kind of variation of fat, the only finding they could come up with was for CVD events when they looked at all RCTs for saturated fat reduction intervention. And we can get into that.
Chris Kresser:  Yeah, I mean, I think we can stop here at least in terms of the actual studies because it's, just to review what we've discussed, the randomized controlled trials that have been done since the late 1970s to today have not supported the idea that saturated fat increases the risk of death from heart disease, or any cause. The epidemiological evidence that has been done throughout that period does not support that hypothesis either. And even if it did, we'd still have all of the issues that epidemiological research, that make it problematic, like the healthy user bias and inaccurate methods of data collection, small risk ratios.
We talked about that earlier, how the increase in relative risk is so low that it doesn't really meet the threshold for assuming a causal relationship in any kind of epidemiology outside of nutrition, and even in nutrition 20 or 30 years ago. Other people who've meta-analyzed these data have come to a similar, if not the same, conclusion as you did in your research and your PhD thesis. And I just want to highlight something that you said about how the Finnish study, which is really not a good study at all, has been included in a number of analyses. And you might wonder why that would happen if the researcher is aware of its limitations and that it's not a valid study to draw any inferences from on this topic, why would it be included?
And again I’d like to turn to a John Ioannidis quote, and he says, “Consequently, meta-analyses become weighted averages of expert opinions. In an inverse sequence, instead of carefully conducting primary studies informing guidelines, expert-driven guidelines shaped by advocates dictate what primary studies should report.”
Zoë Harcombe:  Yeah.
Chris Kresser:  Doesn’t that sum it up?
Zoë Harcombe:  He’s so brilliant, isn’t he?
Chris Kresser:  So in other words, we start out with, the way that science should proceed is by doing experiments, and then if any guidelines are made, to make them based on these objective experiments. But the way it actually happens, a lot is we start out with a certain agenda and then we design studies that will return results that support that agenda. And anyone who's worked with data in any capacity knows how easy that is to do.
Zoë Harcombe:  Yeah.
Chris Kresser:  And it's not even conscious all the time. This is where confirmation bias comes in. It’s very difficult to guard against. I have to, and I’m not 100 percent, I’m not saying I’m 100 percent successful. But I can watch even myself. If I go and look for research on a particular topic and I have a certain idea, it's very easy to just skip the studies that don't support that idea. And that happens among scientists. It's a real cognitive bias that is very difficult to guard against. And I think it has a huge effect on research.
Here's another quote, this is from Casazza: “Confirmation bias may prevent us from seeking data that might refute propositions we have already intuitively accepted as true, because they seem obvious. For example, the value of realistic weight loss goals. Moreover, we may be swayed by persuasive yet fallacious arguments.” So again I come back to psychology. It's a real … we’re human beings doing this work, right? All researchers and scientists are not infallible. They’re human beings as well. Many of them have their own ideas and preferences about diet and nutrition. They’ve been influenced by many of the same things that we as laypeople or myself have been influenced by. And it really, really does affect the outcomes of this research.
Zoë Harcombe:  Yeah, yeah. I would agree with you. I mean I went in with a vegetarian, fat is bad, carbs are good bias. I am aware that I was so shocked by the things that I found when I started researching in this field, even before the PhD, you do then get quite skeptical and quite angry. And I now almost trust nothing. So every week I’m taking a paper from any kind of field, though mostly typically nutrition, and the low-carb study was one that I did recently, and then there was a weight loss drug that came out. And then I looked at red meat, the evidence because that was topical for something. And when I’m going in, I just assume that there’s going to be errors, and I’ve yet to find a published paper that doesn’t have something that you can point out as being really quite seriously wrong or disingenuous or open to interpretation.
Chris Kresser:  Yeah.
Zoë Harcombe:  I mean it’s really shocking. I saw on Twitter just a couple of days ago a guy, an academic, got so fed up with all the emails that you do get saying, “Oh, I really enjoyed this paper. Please can you write some papers for us.” Because papers are big spinners for the journals. He got so fed up with all these spam emails that he made up a complete nonsense study using Latin words that made something look really impressive, but it was basically saying something like, “If you do this with excrement, this happens.” I mean it was just, it really was, he was really taking the mickey and it got through peer review and he put it on Twitter. And he said, “I’m delighted to say that my complete nonsense article has just been published by this complete nonsense journal.”
Chris Kresser:  Yeah, and I’ve heard other experiments like that that have been done where a lot of stuff like that has made it through peer review. And there have been a lot of critiques of peer review and why it’s broken and the links to the money in the research industry. Marcia Angell, who I mentioned earlier, in the context of the relative risk who was the former editor of New England Journal of Medicine, has famously said that some, I’m going to paraphrase, but “I now no longer think we can believe any published research,” is basically what she said.
So yeah, I mean, I think it doesn't mean that research is not valuable. It doesn't mean that we have to just become, I think you can go too far with this where we just say, “Oh, forget it. There’s no point in even trying. Let’s just discount all research equally.” Because there are differences in the quality of research and there are still studies that are done well even if they're not done perfectly. And it's the best tool that we have, that we’ve discovered today to try to answer some of these questions, at least on a population-wide scale.
 Conclusions about Saturated Fat
So I want to close by just kind of going through some conclusions here. One, we’ve talked throughout that the evidence against total saturated fat is incredibly weak, if not nonexistent. But something we touched on briefly but I want to highlight here is that even if saturated fat were harmful, you have to consider the source of it in the diet. Get away from this reductionist approach where we think that saturated fat coming in different forms is going to have the identical effect. Because we don’t eat nutrients. We eat foods that have nutrients in them.
 And I love how in your paper you pointed out that pizza, desserts, candy, potato chips, pasta, tortillas, burritos, and tacos accounted for 33 percent of saturated fat consumed in the diets of US citizens. A further 24.5 percent was unaccounted for and collated as “all other food categories,” which is almost certainly processed food. And so as a result, only 43 percent of saturated fat came from natural foods like dairy products, nuts and seeds, and burgers and sausages. Although I'm guessing that the burgers and sausages had highly processed buns and sugary ketchup and other stuff on them too. So how can we even look at those things as being anywhere remotely similar, much less the same?
Zoë Harcombe:  Yeah. I mean I actually took out the processed meat in that section. So I got the natural foods listed down to cheese, nut butter, nuts, and seeds. And collectively together they accounted for 20.8 percent of saturated fat intake. But then I actually made the point it would’ve been ideal for the unprocessed chicken, beef, and eggs to have been separated from the processed meals because they always just lump them together. And they will always put, whenever there’s a study damning red meat, particularly in the US, it will always include hamburgers, which they are very firmly processed food in the UK, but for some reason seems to be considered as some sort of Paleo food in America.
Chris Kresser:  Right, right.
Zoë Harcombe:  And meat-type dishes, or something, which might be a curry.
Chris Kresser:  KFC.
Zoë Harcombe:  Yeah, exactly, Kentucky Fried Chicken.
Chris Kresser:  That’s the way most people eat chicken, KFC or chicken nuggets at McDonald’s. There’s your chicken.
Zoë Harcombe:  Absolutely, yeah. Or maybe a curry takeaway ready meal that you pop in the microwave and if it's got a couple of percent of meat in it, you’ve done well. You bought a more expensive one than the average, which doesn’t even bother putting the meat in.
Chris Kresser:  I mean, I’m … yeah, go ahead.
Zoë Harcombe:  No, and that’s the crazy thing because I want us to be able to have heated agreement. I don’t want to be fighting anyone out there. The whole world is much better if we get on and we’re in harmony than when we’re fighting over anything, whether that’s territory or politics or nutrition or anything else. So I would love for us to find a way forward. And I think there could be a way forward by saying, “Guys, can we have a heated agreement that we can demonize processed food?”
And I know there’s industry conflicts all over the place and we have to expose the industry conflicts with the guidelines set in committee in the UK, they are completely dominated by the processed food industry and grocery retail. I mean, it’s just horrific. If somehow we could get the conflicts out of setting health guidelines, which please, for goodness’ sake, must be objective. We must tell people honestly what is healthy. Not tell them what the food industry wants them to believe is healthy. That’s got to be step one.
Chris Kresser:  Absolutely.
Zoë Harcombe:  If we can get all of that nonsense out, surely then we could agree that real food has got to be better than processed food. And there might be some debate what’s real food. But if it’s found in a field, it’s found growing on a tree, it’s found in the natural environment … I said to my niece when she was five years old, fish swim in sea, fish fingers don’t. Breaded fish.
Chris Kresser:  If it comes in a bag or box, you probably shouldn’t be eating it.
Zoë Harcombe:  Yeah.
Chris Kresser:  I mean, of course, there are exceptions. Butter usually comes in a box, but yeah, that’s a general guideline, right?
Zoë Harcombe:  Yeah, we know what real food is. It’s the best-quality meat, eggs, dairy products, fish you can get a hold of, it’s vegetables, seeds, nuts, fruits in season. There will be some debate over legumes and whole grains and how recently they’ve been part of our consideration set, and I agree with your point, there’s not one diet fits all because some people just cannot tolerate grains and legumes and fibrous products, suffering from irritable bowel syndrome or celiac or other digestive conditions. But somewhere within that real food, total consideration set, surely we ought to be able to set some principles that people can follow that are not based on advice from the processed food industry.
Chris Kresser:  Absolutely, and I mean, I've said this so many times that Sean Croxton, who used to write in the health space, he came up with a diet advice that was JERF, he called it. J-E-R-F, just eat real food, which is, like, look, okay, we can debate about is it better, like you said, whole grains or legumes, in or out, saturated fat higher or lower, carbs higher or lower within this context of a whole-foods diet. But is there any doubt that if everyone ate real foods, we would decrease the burden of chronic disease and early mortality by something like 60 to 80 percent? I mean, I have no doubt of that.
And that’s again where this reductionist focus on nutrients completely isolated from the context of the foods that they come in has been such a disservice. Because imagine if we spent the last 30 or 40 years just hammering home the message that eating real, whole, nutrient-dense foods is really, like, if you want to simplify it for public health, like, that's the message. Don't even worry about those other finer points. And we would not, well there's a whole other discussion about whether people will actually follow that advice if you give it to them and given the influence of our brains with highly rewarding and palatable foods in the food industry and all of that. But there's no doubt that if people really did follow that advice, we probably wouldn't even be having this discussion right now.
The other thing about that is it is possible at least in theory to, like, if we really wanted to answer the question of is saturated fat harmful, the way we would need to do that is we would need to take two groups and they would both have to have the same baseline healthy diet that we’re talking about. Just eating real, whole foods, right? And then in one group, they would eat more saturated fat. And then we would, this is to be a randomized controlled trial, we’d lock them up in a metabolic ward so that we could control all of the variables that we know can influence health, or at least most of them, and then we’d follow them for about 15 or 20 years and see what happens. And the problem is that's never going to be done. I mean, that study would be hundreds of millions of dollars, if not billions, and no, Coca-Cola's not going to pay for it, right? I mean none of the, no drug company is going to pay for that study. So unfortunately, that study is unlikely to ever happen.
Zoë Harcombe:  Yeah, but “just eat real food” would work as a message until.
Chris Kresser:  Exactly.
Zoë Harcombe:  Yeah.
Chris Kresser:  Just eat real food, and then we can use other mechanistic studies and other lines of evidence and maybe even shorter trials to try to answer some of the finer points. And those trials should also include individual, should also pay attention to individual factors or genetic or non-genetic factors that might bear on the answer to that question, so that we don't then extrapolate the findings to everybody instead of just one group of people, for example. We know there are genetic polymorphisms that make some people hyper-responders to saturated fat and that can lead to an increase in LDL particle number. And the clinical significance of that is still controversial and debatable. But we know pretty certainly that that does happen.
So, but then if you were to extrapolate those results to someone that didn't have those genetic polymorphisms, that would not be a valid inference. So yeah, it’s just disappointing that, I mean, we know this and yet we still go on doing the same things over and over again. And I have to throw in one last Ioannidis quote which—from that more recent, or I think from one of his previous papers, and I'm going to paraphrase this one because I don't, let me see if I can find it—yeah, “Definitive solutions won’t come from another million observational papers or small randomized trials.” In other words, that was from a paper he wrote called “Implausible Results in Human Nutrition Research.” So in other words, doing the same thing over and over and expecting a different result is the definition of insanity, right?
Zoë Harcombe:  Absolutely.
Chris Kresser:  So, Zoë, thank you so much for joining me, and I know we went a little long, everybody, but I hope you enjoyed it and got a lot out of it. And I just, I wanted to have one podcast that we could direct people to to really answer this question and look at all the evidence on saturated fat in particular and its relationship with mortality and heart disease mortality. And I think we didn't cover everything, but I think we did a pretty good job of getting the most of it out there. So thank you so much.
Zoë Harcombe:  Oh, thank you. Can I just add one thing, because I think we just about completely nailed everything.
Chris Kresser:  Please, of course. Yeah.
Zoë Harcombe:  When we ran through the 39 results and found that only four were significant, and we dismissed Mozaffarian and we agreed with Chowdhury, and then the two Hooper results, which were just on the CBD events, we can actually put those to bed as well because aside from the fact that they’re events and they’re not mortality and we both agree that mortality is best, the thing that you have to then look at is why did Hooper find something different to all the other people? And when I went in detail, Hooper had actually managed to include four studies which involved only 646 people that were not about cardiovascular disease. And she’d asked the study authors if they happened to have data on cardiovascular disease events. So this was non-peer-reviewed data. That was the first thing.
When, and I owe Dr. Trudi Deakin in the UK, I always credit her for this finding, she spotted in the Hooper paper that when Hooper actually did as she should do, the sensitivity test on that one single finding, it was no longer significant. So the test that had to be done was not just which studies intended to reduce saturated fat or which studies actually did reduce saturated fat.
Chris Kresser:  A key distinction there.
Zoë Harcombe:  That’s really, really important, yeah. So Trudi looked at this and found that it is declared in the paper, but it’s tucked away on sort of page 158, or something.
Chris Kresser:  Right.
Zoë Harcombe:  That when the ones that were tested did actually reduce saturated fat only were included, there was no statistical significance and it was not generalizable because again in the whole of the evidence that was looked at by Hooper in either of those two papers, there was no single study of healthy men and women. But I think sensitivity tests apart from non-peer-reviewed data and apart from events, I think we can actually put that one to bed as well. So when you do that, because that’s the one that the other sites still try to hang onto. That’s the one that came up in the Professor Noakes trial when that’s down there for him as an expert witness. They tried to wave that in front of us and said, “Oh, see saturated fat is bad.”
Chris Kresser:  Right.
Zoë Harcombe:  So we hit them back with an, “Oh, no it isn’t.”
Chris Kresser:  What’s the data?
Zoë Harcombe:  Yeah, we kind of went in on the data. So there just is no evidence, and knowing the facts about fat, it would make no sense if there were.
Chris Kresser:  Exactly. And that reminds me of the recent low-carb study which you and I both critiqued on our blogs. It wasn’t a low-carb study. The people were eating something like 40 percent of calories is carbohydrate, not to mention the fact that they reported a calorie intake that was basically at starvation level, which would invalidate the entire data set. So you don't even need to go any further. I mean we did, but, like, that would've been enough, right? And all it takes is one major error like that, and it casts doubt on the entire data set and makes any kind of inferences that you would draw from it invalid. And I don't think people understand that enough.
Zoë Harcombe:  Yeah, I think critiques, I think the word you used there was quite polite. Actually, I think we both annihilated that study.
Chris Kresser:  Yeah, well it was.
Zoë Harcombe:  And a few other people as well, Nina Teicholz and Georgia Ede.
Chris Kresser:  Several, yeah. I mean, it was frankly like shooting fish in a barrel.
Zoë Harcombe:  Yeah, it wasn’t hard, that one, was it?
Chris Kresser:  Yeah, it was not hard. I’m just actually kind of shocked that that kind of study makes it through peer review and gets published, given all of those issues. So anyways, yes, thank you so much for doing all of the work that you do, Zoë. It’s such a pleasure to meet you, virtually, at least, and to be able to really just concisely and comprehensively go through all of these deficiencies in the evidence and to just make it clear for people that this, despite the fact that they've heard this probably for 30 or 40 years, depending on how old they are, and despite the fact that it still forms the basis of our dietary guidelines, there really is no evidence to support it.
Zoë Harcombe:  Yep.
Chris Kresser:  Fantastic. Well, where can people find more about your work, Zoë?
Zoë Harcombe:  Just ZoeHarcombe.com. So my surname is H-a-r-c-o-m-b-e. So that’s ZoeHarcombe.com. And as I say, I blog every week. That’s my sort of business model. So if anyone wants to sign up and get the newsletter, there is lots of stuff on open view. But if you do that, then you support what I do and you help me to stay independent because I don’t take any money from anyone for anything in any circumstance.
Chris Kresser:  Key. Absolutely.
Zoë Harcombe:  I just work away and come up with what I want to find. And I know some people are on the email list who are quite fans of whole grains, for example. And I know every time I write a newsletter saying I looked at this whole grains study and it really didn’t stack up, I know that I’m upsetting some people who are subscribing, but I have to go with where the evidence takes me and I have to report as I find. So that’s what I do.
Chris Kresser:  Yeah, yeah. I’m disappointing my readers all the time with my opinions and it’s important, I think, to stay true to what the data is showing and be as objective as possible about it. You’re one of the few people that I do follow regularly. I love reading your stuff, so everyone who’s listening to this, go check out the blog. It’s one of the most thorough and insightful sources on all of these topics that we discussed today.
And Zoë, we didn’t get a chance to go into much detail on red meat above and beyond its saturated fat content, which as we know is less than its polyunsaturated fat content. But Zoë has recently tackled that, the evidence behind red meat being associated with high risk of heart disease and death. And i'd really recommend checking that out too, because that's another persistent myth that continues to this day.
Zoë Harcombe:  Indeed.
Chris Kresser:  Okay, everybody, thanks for listening. Continue to send in your questions at chriskresser.com/podcastquestion, and we’ll talk to you next time.
The post RHR: The Truth about Saturated Fat, with Zoё Harcombe appeared first on Chris Kresser.
Source: http://chriskresser.com September 25, 2018 at 07:12PM
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I answered a lot of shit cause i was bored. enjoy or don’t i don’t fucking care
1: Name: Cheynne.
2: Age: 21
3: 3 Fears: Dying alone, never finding actual love, everyone dying but me because of something I could have stopped.
4: 3 things I love: Music, Good movies, Good acting and good accents in movies.
5: 4 turns on: Good smile, Nice eyes, If you look like you could kill me, nice hair
6: 4 turns off: Being a dick, Entitlement, if you act as if I owe you something, not telling me I upset you or did something wrong and then being an actual dick when telling me whats wrong.
7: My best friend: IRL? Myself. Online I have many.
8: Sexual orientation: Asexual panromantic
9: My best first date: Didn’t have one
10: How tall am i: 5’2. 5’3 if I stand up all the way.
11: What do I miss: When I felt true emotions.
12: What time were you born: 3:02pm
13: Favorite color: Black. Because it is the absence of all colors and I just like it,
14: Do I have a crush: On people I know? No. On actors yes. Many.
15: Favorite quote: “never more quoth the raven” and or “all we see or seem is but a dream with in a dream”
16: Favorite place: My bed.
17: Favorite food: Pizza or Chicken
18: Do I use sarcasm: no…none….
19: What am I listening to right now: Barns Courtney “hellfire”
20: First thing I notice in new person: Eyes or How they speak, like volume and tone.
21: Shoe size: 8.5 or a 9 depending
22: Eye color: Greenish hazel
23: Hair color: Natural is like a dark brown
24: Favorite style of clothing: Comfortable, leggings and my hoodie
25: Ever done a prank call?: Not that I can recall
27: Meaning behind my URL: I liked how it sounded in my head
28: Favorite movie: Currently…jeez…uh either CA:CW or CA:WS
29: Favorite song: Gasoline by Halsey
30: Favorite band: Don’t have one currently
31: How I feel right now: Dead inside…like normal
32: Someone I love: Love is very hard for me cause of things
33: My current relationship status: Single
34: My relationship with my parents: ummmmmmmmm Emotionally destroying. My father(s) can fuck off. And my mom is just a whole can of worms
35: Favorite holiday: Halloween
36: Tattoos and piercing I have: I have 2 tattoos one on my back and one on my wrist. I had my labret and my nose at one point.
37: Tattoos and piercing I want: *shrugs* idk man
38: The reason I joined Tumblr: Cause I hated myself. Idk actually it was in like 2012 so
39: Do I and my last ex hate each other?: We don’t speak so
40: Do I ever get “good morning” or “good night ” texts?: Hahahaha you act like I have IRL friends and family who actually care. no
41: Have I ever kissed the last person you texted?: My mother..yes
42: When did I last hold hands?: 2-3 years ago
43: How long does it take me to get ready in the morning?: less then 5 minutes
44: Have I shaved your legs in the past three days?: yep
45: Where am I right now?: My house. On my bed
46: If I were drunk & can’t stand, who’s taking care of me?: Myself.
47: Do I like my music loud or at a reasonable level?: depends on what I am doing or where I am.
48: Do I live with my Mom and Dad?: Fuck no. thank god
49: Am I excited for anything?: Um Avengers: IW, Season 3 of Animal Kingdom, and Joe coles newest movie.
50: Do I have someone of the opposite sex I can tell everything to?: No
51: How often do I wear a fake smile?: every time I leave the house.
52: When was the last time I hugged someone?: Last Friday, One of my bosses left the store I work at.
53: What if the last person I kissed was kissing someone else right in front of me?: Ew. I don’t like having to see my mom kiss her boyfriend.
54: Is there anyone I trust even though I should not?: Yes and No
55: What is something I disliked about today?: Waking up to some shitty shit.
56: If I could meet anyone on this earth, who would it be?: Finn and Joe Cole o I could tell them they are actually so amazing at every role they do. Sebastian Stan. And Bill Skarsgard
57: What do I think about most?: Fanfic ideas
58: What’s my strangest talent?: I can do a weird thing with my middle fingers.
59: Do I have any strange phobias?: Holes in things. But only sometimes
60: Do I prefer to be behind the camera or in front of it?: Behind
61: What was the last lie I told?: Idk honestly
62: Do I prefer talking on the phone or video chatting online?: Online
63: Do I believe in ghosts? How about aliens?: Yes, and Yes
64: Do I believe in magic?: I mean if I didn’t my witch sisters would be a little peeved at me.
65: Do I believe in luck?: Yes
66: What’s the weather like right now?: grey and rainy
67: What was the last book I’ve read?: smoke gets in your eyes: tales from the crematory.
68: Do I like the smell of gasoline?: yes
69: Do I have any nicknames?: yes
70: What was the worst injury I’ve ever had?: I worked in a deli and my hand slipped one night and I needed 6 stitches. My finger is forever warped from it
71: Do I spend money or save it?: both
72: Can I touch my nose with a tongue?: nope
73: Is there anything pink in 10 feet from me?: yep sissors
74: Favorite animal?: Sloth,
75: What was I doing last night at 12 AM?: watching “redlight” Cillian Murphy in that movie. Hes amazing
76: What do I think is Satan’s last name is?: Well he is just a fallen angel right, god cast him down and all archangels have no last name so.
77: What’s a song that always makes me happy when I hear it?: You are my sunshine.
78: How can you win my heart?: Understand my past is very fucked up and in such has caused me to become a very unemotional and uncaring person at times.
79: What would I want to be written on my tombstone?: Finally
80: What is my favorite word?: Cunt
81: My top 5 blogs on tumblr: @roman-ova @imaginesoverreality @animalkingdom-anonymous @bookofreid and so many more so
82: If the whole world were listening to me right now, what would I say?: Fuck off
83: Do I have any relatives in jail?: Yes
84: I accidentally eat some radioactive vegetables. They were good, and what’s even cooler is that they endow me with the super-power of my choice! What is that power?: Teleportation.
85: What would be a question I’d be afraid to tell the truth on?: How people really feel about me.
86: What is my current desktop picture?: A gif of Pietro from AOU
87: Had sex?: Nope
88: Bought condoms?: nope
89: Gotten pregnant?: nope
90: Failed a class?: many
91: Kissed a boy?: yes
92: Kissed a girl?: a few
93: Have I ever kissed somebody in the rain?: nope
94: Had job?: yep a few
95: Left the house without my wallet?: yes
96: Bullied someone on the internet?: when I was young and very dumb
97: Had sex in public?: Nope
98: Played on a sports team?: Only in PE and I wanted to die
99: Smoked weed?: Nope
100: Did drugs?: Nope
101: Smoked cigarettes?: yes
102: Drank alcohol?: yes
103: Am I a vegetarian/vegan?: Nope
104: Been overweight?: Still am bitch, hypothyroidism is a whore
105: Been underweight?: nope
106: Been to a wedding?: Yes.
107: Been on the computer for 5 hours straight?: every day
108: Watched TV for 5 hours straight?: yeah
109: Been outside my home country?: yep
110: Gotten my heart broken?: yep
111: Been to a professional sports game?: yes, hockey, basketball, and baseball
112: Broken a bone?: nope,
113: Cut myself?: I self harmed for 9 years so
114: Been to prom?: yep
115: Been in airplane?: yes
116: Fly by helicopter?: Nope.
117: What concerts have I been to?: Warped tour 2011, blood on the dance floor like twice.
118: Had a crush on someone of the same sex?: Bitch….every day
119: Learned another language?: Yes German 1 and 2 in high school
120: Wore make up?: yep
121: Lost my virginity before I was 18?: nope still am bitch
122: Had oral sex?: nope
123: Dyed my hair?: yes. All the time
124: Voted in a presidential election?: yep in the…2016..
125: Rode in an ambulance?: over 12 times
126: Had a surgery?: yes 2.
127: Met someone famous?: Yeah one of the guys from La ink and a few authors
128: Stalked someone on a social network?: yeah…who hasnt
129: Peed outside?: yes
130: Been fishing?: yes
131: Helped with charity?: yeah
132: Been rejected by a crush?: every time
133: Broken a mirror?: yes
134: What do I want for birthday?: My family to actually give a shit about me.
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wanderinguterus1 · 4 years ago
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Economy Class
“Deserve is a bullshit term. None of us deserves anything. We get what we get.” -Brit Bennett
I once read an article in which a researcher detailed a human behavioral study conducted on airplanes - particularly, among economy class passengers. On some planes, economy class passengers have to pass through the first class area before getting to their (inferior) seats. The study found that on these planes, negative behaviors increased. For example, arguing with flight attendants and fighting with other passengers - all significantly higher in economy class if first class seats were present. The researcher landed on this theory: seeing first class patrons - with their roomy seats, individual arm rests, and ample leg room - made economy class passengers like they were being treated unfairly. In other words, when people are forced to witness drastic inequality, their mindset shifts in a negative direction.
Teaching in a private school, I am often reminded of that article. A few days ago, after third period, I made my way around the classroom, sanitizing the students’ desks. In the beginning of the year, I delegated this job to students, but over time, I realized doing it myself was easier than overseeing reckless 14-year-olds with sanitizer bottles, fearing they would spray a friend in the face or drop the sanitizer on someone’s computer. The label on the bottle warned: “Attention: Can Cause Blindness.” I decided not to take my chances with teenage boys.
I had an hour until my next class arrived, so I sat down at my computer and began flipping through quizzes and recording grades. The soft tapping of the keyboard drastically contrasted with the sounds of hyper ninth graders who had filled the room a few minutes ago. I was enjoying the silence when a former student came by to visit.
“Hi Ariel!”
“Hi Ms. Long.”
Since I had taught her as an 8th grader, I remembered her as a tiny, overly nervous 13- year-old. Now a senior, Ariel moved with confidence, sitting in the desk to my right and straightening the quizzes I had graded and discarded haphazardly.
“Are these To Kill a Mockingbird quizzes?” she asked, looking over the students’ answers.
“Yes.”
“I hated that book.”
I shook my head and sighed. Pulling my mask down to take a quick sip of coffee, I resisted the urge to rebuke her for her bad taste.
“My sister got into Yale,” she announced.
“That’s awesome,” I responded tentatively. Ariel, an average student, had a genius sister. I wondered how Ariel felt about her sister’s acceptance into the Ivy league, although it couldn’t have been too unexpected. Caitlin had been winning academic awards since she was in middle school and had spent the previous summer shadowing a world-renowned journalist.
“Yeah, and I got a full ride to FSU.”
“Wow! I’m so proud of you! I bet your parents are so happy!”
“Yeah, but since it’s not really fair that they don’t have to pay for my college, and Caitlin’s tuition is like 40 thousand a year, they are going to give me the equivalent of that in cash every year to make it even.”
I stared at her, wondering if I had actually heard her correctly. And wishing someone had taught her to “read the room.” Did she just imply the injustice of a full ride? And admit that her parents would be giving her, an 18-year old, forty thousand dollars in cash? To make things FAIR?
Obliviously, she continued, “I’ll probably be able to buy a house as soon as I graduate college.”
Suddenly, I had a realization: being a teacher in a private school was like sitting in the first row of economy class with the first class section in clear view. Every day. For eternity.
I’m not jealous because I want a bigger house or a nicer car or a boat; I just want a baby. One baby. Forty-something thousand dollars stands in the way of my husband and I adopting or trying IVF, but here sits an 18 year-old who will be gifted that amount of money each year for the next four years of her life. She would be able to buy four babies by the time she's 21.
I think of money in terms of babies now. For example, I heard that a Pokemon card sold on eBay yesterday for 500,000 dollars. Instead of dollars, I imagined that Japanese cartoon character being traded for twelve and a half babies.
Don't get me wrong; I understand that compared to so many, I lead a privileged life. I come from a two-parent, middle class home, and I’ve never known what it’s like to suffer from racial discrimination. If I lived in a less developed country, I would be comparing myself to very different types of people: women who sit outside for hours every day, rain or shine, selling vegetables for next to nothing; taxi drivers who work seven days a week, twelve hours a day, just to be able to feed their families. These people don't spend time writing autobiographical essays about how flawed the system is. Even though I understand these truths, I can't help but feel, at times, that I've been shafted.
                                                       *
Two years ago, I lay naked save for the papery hospital gown, in a cold pre-operation room. Hooked up to an IV, I waited on my doctor to arrive and remove the twelve fibroid tumors he had found during my ultrasound. Luis stood by the bed, holding my hand and telling me about the infamous Star Wars holiday special of 1978 in an effort to distract me.
“It actually had Wookie porn in it. Wookie porn. What were they thinking? Chewbacca’s father just groans for like ten minutes straight. It's known as one of the worst films to ever air on television.”
The surgery, an abdominal myomectomy, consisted of cutting open the abdomen in order to remove the tumors. After a year of trying to have a baby and failing, this was our first expensive problem-solving attempt.
On the other side of the curtain, a nurse greeted her patient. “Good morning! What are we having today?”
The voice of a man replied, “It’s a girl.”
“How exciting, is it your first?”
“No,” his female counterpart answered with a chuckle.
I tried to focus on Luis’s Star Wars story, but I kept thinking about the happy couple, leaving later that day with their brand new baby girl all wrapped up in her soft, pink blanket, smelling like cookies after they’ve been dipped in milk. I would leave with nothing but a cleaner uterus and a fat hospital bill.
Moments later, a surgeon arrived, nodded his head to us and continued to the other side of the curtain. I heard him ask, “Ok, so C-section and tubal ligation today, right?”
I almost laughed out loud. So my body was about to be cut open to make it a welcoming home for a fetus while my roommate’s doctor would be rearranging her organs to do the opposite.
I hear the sounds of a table wheeling around and the clanking of instruments. “Do you have a name picked out?”
“Yes, her name is going to be Seven.”
“That’s unique.”
“Well, she’s number seven. I have had six kids in ten years. So yeah, I'm ready to get the tubes tied.”
I looked at Luis indignantly. Seven children in ten years!? I'd been diligently tracking my temperature in order to perfectly time our “lovemaking,” doing headstands after sex, and eating vegan cheese, and this girl is popping out babies every other year. How can two women’s bodies be so utterly different? Luis widened his eyes as if to say, “Well? Do you really want seven children?”
My husband had a way of reframing any depressing situation. When we visited friends who lived in houses much nicer and more expensive than ours, he said things like, “I didn't really like their shower head,” or “I wouldn’t want to live that far away from the city.” Whereas I was seriously considering asking my hospital roommate if she wanted someone to take Seven off her hands, he was probably just thanking the universe that he wasn’t going home this afternoon to a house full of seven kids. On a plane, he would probably find a way to prefer his tiny, middle seat in the back row near the bathrooms to the luxurious first class experience. “Economy people are more friendly than rich people,” he might say.
                                                   *
Before the surgery, I had asked the doctor multiple times how long I would be in recovery, but he would only respond with, “Everyone is different.”
Well, in my mind that translated to two or three days of bedrest, because I rarely use more than three sick days in a school year. Unfortunately, my superior immune system had nothing to do with post-surgery pain, and for seven days afterwards, I was confined to the couch, unable to stand up straight or move more than a few feet without stopping, and in serious pain when my abs contracted. Any time I sneezed, coughed, or tried to flip myself over, it felt like someone was using a straight razor to open my stomach as if it were an Amazon box.
After an entire week of lying on the couch and taking opioids every five hours, I went back to work, still a bit hunched over and rather pale. And on the eighth day, I had to go back to the doctor for a post-op appointment so the bandage could be removed and the healing process be judged.
The bandage - about six inches wide five inches thick, had been placed right on my underwear line. I had already tried to remove it a little myself, just out of curiosity, but I didn’t get very far because it felt like it had been super-glued to the most sensitive area of my body. No one had warned me to shave completely before surgery.
In the car on the way to the appointment, I worried about the removal process and, not wanting to experience more pain, asked Luis, “The doctor probably has something to put on this to make it come off easily, don’t you think?”
“I don’t know,” he said, sounding doubtful. This should have been a signal to me. Luis, being a man, knows how men think. He knew, but didn’t want to break it to me, that there was no way a doctor has ever concerned himself with how painful a bandage removal process would be.
Choosing to be naively optimistic, I decided to trust in the kindness of medical professionals; surely they wouldn’t put me through more pain after so recently having had my abdomen cut open. However, once I was lying on the examination table, naked from the waist down, feet up in the stirrups, doubts started to creep in. As the now familiar ultrasound wand moved around inside my body, Dr. Edwards crowed on about how clear and devoid of fibroids my uterus looked.
Ok, surgery was successful, fibroids are gone, good job, thank you, now please get this thing out of me. When the ultrasound finally ended, he asked, “Do you want to remove the bandage or do you want me to?”
I hesitated, because that question implied that there was no procedure involved... that any random Joe off the street could just stroll in with normal people hands and just rip off this thing with no training whatsoever. My wheels were turning... So... you aren’t going to like, put some kind of magic lotion on me first?
Unfortunately, magic lotion only existed in my fantasies. In reality, surgery proved just a portion of the pain I would endure before it was actually over.
I began to remove the bandage, deciding I would rather be my own executioner. I picked the top part until my fingernails could get underneath, and started to tug. The skin rose as I pulled- it had been eight days since its placement and the glue didn't seem to have weakened at all. How was that possible? If humans are smart enough to design SuperBandage, aren’t we also advanced enough to create anti-adhesive?
When I got to the lower half of the bandage, which was on top of hair, things went downhill quickly. Removing it felt like getting a bikini wax - which I’ve only tried once and chickened out halfway through.
Eventually, I conceded. I couldn’t willingly put myself through the torture. “Can I just do it later, at home? In the bathtub?” I pleaded.
The doctor gave me a puzzled look, as if he didn’t understand the question. “I need to see if your scar is healing.”
“I’ll send you a picture. I swear.”
He chuckled, but I wasn’t kidding. I have never hated anyone more than I hated him in that moment. I bet he had never endured a bikini wax. He probably winced when his wife plucked his eyebrows. I made a mental note to give him a horrible Yelp review.
I refused to continue, so Dr. Edwards took over: he pulled and the nurse pushed the skin down as he went across - yes, pushing right below my stitches. I have never felt such excruciating pain in my entire life; it was like being stabbed with a hundred tiny needles on a part of my body that was only meant to be touched with loving hands. At one point, I instinctively grabbed the doctor’s arm, forcing him to stop. Staring at the bandage, which was only halfway removed, I cursed all men, including Luis. Why didn’t anyone tell me to shave? Why didn’t they give me anesthesia for this?
When the torture finally ended, Dr. Edwards looked at me with amusement in his eyes, and asked, “You ok?” as if I had been overly dramatic. I decided that I would never, ever, forgive him. Public Service Announcement for Women: Shave before any abdominal surgeries. And never settle for a male doctor if a female one is available.
I often wondered why I was putting myself though so much pain to bring a new life into the world. Was the desire to have children an evolutionary curse? Growing up, I never questioned whether or not it would happen because that’s what women are meant to do, right? What is a woman if not a mother? At least that’s what all the women I knew growing up led me to believe. Receiving the hospital bill in the mail a few weeks later prompted me to further question this desire. If I hadn’t cared about being a mother, Luis and I could have used the surgery money to take a trip to our dream destination - South Africa - flying first class.
Sometimes, when I’m lying naked from the waist down with my feet in stirrups, I think about my early 30s, when eggs and fertile windows were blissfully far from my mind. Unfettered by thoughts of motherhood, I concerned myself with traveling as much as possible.
Reading Walden had convinced me that staring at a computer screen all day was no way to live. Thoreau had inspired me to work with my hands, to get outside, to “suck the marrow” out of life. So after six years of teaching, I quit my job and departed alone on a plane to New Zealand. Although I had never even set foot on a farm before, I planned to volunteer on various organic farms as a way to connect with the natural world. The research I had conducted for this adventure amounted to about one hour’s worth of googling.
Since I had lived in a country where I didn’t speak nor read the language for three years, I craved traveling without a language barrier. My inferior sense of direction often weakened my resolve for adventure, so I needed a place where, at the very least, I could read the street signs. My first stop was a dairy farm in Opotiki. I pronounced this as if the last two syllables were “tea- key” as in tiki bar. The bus driver couldn’t understand me; he said he had never heard of such a place.
After some discussion and help from the internet, he dropped me off at the bus stop in “Ah-PO-Tah-key,” where a 20-something-year-old French guy named Clement stood smoking a cigarette. He had been sent by the dairy farmer to pick me up and seemed bored by the task.
Getting off of the bus, I must have looked a bit like Elle Woods showing up for her first day at Harvard. I wore skinny jeans, pink Uggs, and a tie-dyed sweatshirt. Clement had on overalls smeared with a brown substance, work boots, and a look that said, “You have no idea what you are getting yourself into.”
“Hi!” I exclaimed, eager to make a companion after a long solo flight and bus ride.
Clement lifted his chin in greeting and pointed to an old, faded black Honda Civic.
I stuffed my backpack into the trunk, and headed for the passenger seat, after an awkward moment with Clement in which I realized that the right side of the car was actually the driver’s side.
Undeterred by Clement’s apathy towards me, I asked, “How has it been, working on the farm?”
“Lot of cow sheet,” he responded, in a thick French accent.
He then reached for the radio and turned the music up to a decibel that prevented me from responding. Maybe my expectations for companionship had been a bit high.
The drive to the farm consisted of Clement driving about 20 miles over the speed limit on tiny, winding dirt roads, and me closing my eyes and holding tightly to the sides of my seat with both hands. At some point, I felt the urge to vomit, but I just laid my head back and practiced yoga breathing. Clement did not seem to notice.
By some miracle, we arrived at the farm without incident, where I met John, an older man who owned a little red house on seven acres. He explained that Clement and I would be sharing the spare room, meant for volunteers, and he showed me where my overalls and work boots rested.
“Be ready to go at four a.m. I’ll have yogurt and granola ready for breakfast,” he said, handing me an empty water canteen. “Tonight, before you go to sleep, you need to fill this with boiling water and put it under your blankets. It's going to get cold in your room.”
Cold didn’t adequately describe the sleeping quarters. Until it was time for bed, Clement, John and I had been lounging in the cozy, carpeted living room near the fireplace. However, around nine pm, when we moved to the back bedrooms, the wood floors felt like ice on my bare feet. I retrieved a sweatshirt, a scarf, a pair of gloves, and two pairs of socks from my suitcase and put them all on. The temperature must have been around forty degrees, because I could actually see my breath in the darkness. Sleeping proved difficult; every hour, I put on another piece of clothing from my suitcase, eventually looking like the pigeon lady in Home Alone. The canteen was only big enough to heat up one body part and remained warm for just half the night. Throughout all of my tossing, turning, and the unzipping and zipping of my backpack, Clement slept peacefully in normal pajamas. At four a.m., when the rooster started crowing, I wanted to weep. I yearned for my warm Tel Aviv apartment, central heating, and my teaching job, which suddenly felt like a white collar position.
I snuggled deeper into my bed, hoping to enjoy the blankets for a few more minutes, until I saw Clement pop out of bed and don his overalls. Refusing to be the weakling that he probably expected me to be, I followed his lead.
“Did you bring a hat?” John asked, when I entered the kitchen.
“No. Why?” I asked, thinking if I had a hat, I probably would have worn it to bed last night.
“Some of the cows have lice and you could catch it.”
I eagerly accepted the hat John proffered.
Clement and I ate our yogurt in silence - not surprising for him, but I was just too cold and tired to care.
John led us to the barn after breakfast, where we would be milking the cows. When I walked through the doors, my hand instinctively covered my nose: the smell - similar to a Port- O-Potty at the end of a crowded, weekend-long music festival - attacked me. John and Clement, unaffected by the stench, chuckled at my reaction.
“Better than the smell of cars in the city,” John said, smiling.
I wasn’t convinced.
Now it was time to learn how to milk a cow. In my imaginings of this moment, I would sit on a cute step stool, a sweet little cow would trot up to me, and I would gently tug on her teats, squirting milk into a tin bucket below. I would repeat this a few times, and a day’s work would be done.
In reality, John owned about 200 cows. The barn housed 50 stalls into which the first herd of cows were guided; each stood so that her butt faced into the shed. John handed me one of many thick, black hoses that hung from the ceiling. At the end of the hose was a steel device with four suction cups; I needed to attach the suction cups to the cow’s teats. The three of us would walk up and down the stalls, eventually connecting the suction cups to all fifty cows, and then John would turn on the machine.
For the first set of cows, this went pretty smoothly; according to John, these were the “old gals” who were used to the process. But when the younger cows were led into the stalls, they seemed less than thrilled. I watched in horror as one of them furiously kicked her hind legs, trying to escape the suction cups. John ran over to her, adeptly tying each of her legs to the stall. What happened next was both horrifying and impressive. I remember learning about how vultures can vomit on demand; it's one of their defenses when threatened. Well, apparently cows have a similar skillset. The moment John finished tying up the second leg, that cow shot projectile diarrhea right onto his chest.
I managed to get through the morning milking - which took two hours total - without trauma. I felt victorious but exhausted; I longed to go inside and take a nap.
“Meet me back out here at noon,” John said, after the barn had been cleaned.
I wondered why we would need to come back to the barn so soon. Clement delighted in informing me that the cows were milked twice a day.
Eventually, Clement, John and I fell into a routine, and for two whole weeks, I milked cows (twice a day) without contracting lice or getting kicked in the face. I even learned some tricks for sleeping in 40 degree temperatures, like taking a scalding hot shower right before bedtime, throwing on clothes as quickly as possible, then running straight to the bed, where I had previously placed the hot water canteen.
When I look back on my New Zealand adventure, I marvel at my resilience. How I just trudged out to the barn in those big rubber work boots at four a.m. and kept talking to Clement even though he only responded in grunts. And even though I’m older now, and slightly less malleable, I’m still managing. Every day I go to school and greet those first class passengers without displaying any “negative behaviors.” (I still welcome Ariel when she comes to visit me.) And I’m going to keep tracking my ovulation and putting away money for adoption, at least for another two or three years. And if we are relegated to fly in economy class on a plane full of first class passengers for the rest of our lives, at least Luis will be there to remind me that first class isn’t all that great anyway.
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nearlyhuman · 7 years ago
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I didn’t even make this a read more you’re just gonna have to scroll or press j
2: Age? 24 3: 3 Fears? alienating people I want to like me, going to school when i should have not, not going to school when i should have 4: 3 things I love? Vegetables, girls who i don’t know but then they invade my personal space, taking long walks almost every night of the summer 5: 4 turns on? they’re personal 6: 4 turns off? baby talk, the word “daddy,” self-consciousness, physical pain 7: My best friend? my fam, J + K, my boyfriend 8:Sexual orientation? they say its a spectrum but so far i haven’t ever wanted to do a girl  9: My best first date? i don’t remember what my first official date with R was but definitely not the other guy so I guess the other other guy who is married now. or there was one that wasn’t a REAL date but it was KIND of a date but it really wasn’t but that one might win  10: How tall am I? huge 11: What do I miss? Knowing my place 12: What time was I born? @ night 13: Favourite color? going to be honest the truth is i never understand this question and it doesn’t really make sense to me and that’s why the answer always changes... green... gold... pink... black... idk 14: Do I have a crush? idk if i’m supposed to say yes but i’ve been w/ my bf for years now i think it’s something other than a crush by now 15: Favourite quote? I don’t have one over all but one I recently read that I love is this: “Malcolm X never lived to see the government fall but the state he opposed made him a stamp. And that's the best you can hope for if you never give up - your enemies will teach your corpse to dance.” Pat the Bunny. 16: Favourite place? lately it’s been the inner harbor at night 17: Favourite food? lately it’s been a tray of peaches we got at TJ’s 18: Do I use sarcasm? Only when I shouldn’t, like when i’m pissed off and being a baby about it 19: What am I listening to right now? R taking medicine lol 20: First thing I notice in a new person? it probably depends on the person, but i usually look at their face and try to figure out if they’re nice, mean, or bland, etc 24: Favourite style of clothing? to this day the only person i think i ever knew that i had strong feelings about how they dressed was when two brothers at the pizza place where i worked just wore the same 3 shirts over and over and over and the same pants and shoes every day. I also like other famous people who also wear the same thing every day. 25: Kiss someone that starts with the letter “R”? i have ONLY kissed people with the first initial R 27: Meaning behind my URL? I used to feel like I didn’t have the right feelings like a normal person, but then i went to therapy for a while and now i’m pretty fine with my feelings, but i still like my url and don’t feel like putting in the effort to find something i like better 29: Favourite song? i don’t have one atm but i guess one foot on the gas one foot in the grave has been #1 for a couple years, before that it was hypocrite cte 30: Favourite band? anything toh kay touches 31: How I feel right now? annoyed that i have to be in school 32: Someone I love? my old boss malick 33: My current relationship status? w/ R 34: My relationship with my parents? i’m not in a therapy session so i don’t have to answer 35: Favourite holiday? Valentine’s Day?  36: Tattoos and piercing i have? just ear lobes 37: Tattoos and piercing i want? I really don’t want any and I don’t want to say my tattoo ideas here anyway 38: The reason I joined Tumblr? I was trying to learn how to talk genuinely w/o any of my friends saying i was experiencing normal teen rebellion 39: Do I and my last ex hate each other? yes 40: Do I ever get “good morning” or “good night ” texts? no 41: Have I ever kissed the last person you texted? no 42: When did I last hold hands? a couple days ago i think 43: How long does it take me to get ready in the morning? 10 minutes if i’m trying 44: Have You shaved your legs in the past three days? monday for class 45: Where am I right now? bedroom 46: If I were drunk & can’t stand, who’s taking care of me? deborah 47: Do I like my music loud or at a reasonable level? both 48: Do I live with my Mom and Dad? no 49: Am I excited for anything? doing potluck movie nights 50: Do I have someone of the opposite sex I can tell everything to? EVERYTHING? you can never tell someone EVERYTHING you think about them, so that always ruins it 51: How often do I wear a fake smile? I don’t work in customer service anymore 52: When was the last time I hugged someone? when i got to chemistry lab earlier today 53: What if the last person I kissed was kissing someone else right in front of me? i would be so confused lol 54: Is there anyone I trust even though I should not? yes 55: What is something I disliked about today? all of the school 56: If I could meet anyone on this earth, who would it be? davey mac 57: What do I think about most? school, anarchism, acne, friendships 58: What’s my strangest talent? yesterday my kind-of mentor said i was his mentor 59: Do I have any strange phobias? no 60:Do I prefer to be behind the camera or in front of it? i definitely don’t want to be behind it but i only MIGHT want to be in front of it 61:What was the last lie I told? don’t remember 62:Do I prefer talking on the phone or video chatting online? phone, don’t have to worry about angles 63:Do I believe in ghosts? How about aliens? No ghosts, no opinion on aliens 64:Do I believe in magic? No and i find it really irritating when people do 65:Do I believe in luck? idk what that means, i guess not 66:What’s the weather like right now? i’m inside 67:What was the last book I’ve read? i’m in the middle of Walden and Conquest of Bread 68:Do I like the smell of gasoline? yesss 69:Do I have any nicknames? yes but very few people use them 70:What was the worst injury I’ve ever had? none 71:Do I spend money or save it? save 72:Can I touch my nose with a tongue? no 74:Favourite animal? James 75:What was I doing last night at 12 AM? watching TV 77:What’s a song that always makes me happy when I hear it? when nirvana comes on the radio 78:How can you win my heart? talk to me often and about stuff i like, or have that Mysterious Something, or do vlogs 79: What would I want to be written on my tombstone? i’d be ashamed of myself if i had actually thought of an answer 80:What is my favorite word? probably either... Christmas... Valentine... Birthday 81:My top 5 blogs on tumblr? glumshoe 83:Do I have any relatives in jail? not that i know of 84:I accidentally eat some radioactive vegetables. They were good, and what’s even cooler is that they endow me with the super-power of my choice! What is that power? my first instinct is to say persuasion but not like manipulating other people’s will just make me really persuasive.  86:What is my current desktop picture? i never changed it from the default 103:Am I a vegetarian/vegan? no, I kind of disagree w/ making those strict decisions, but i do try not to eat much meat and very very little red 109:Been outside my home country? yes, several countries in europe and once to guadeloupe 110:Gotten my heart broken? yeah haha twice when i was a kid 114:Been to prom? no 118:Had a crush on someone of the same sex? don’t think so, at least not the kind that makes you want physical contact w/ them 119:Learned another language? made good progress w/ french 123:Dyed my hair? blonde ends, green ends, pink ends, black ends, green all over, dark red all over 124:Voted in a presidential election? a big secret is that i voted for Mitt Romney when I was 18 haha 127:Met someone famous? Matt Shultz and Tomas Kalnoky 129:Peed outside? yes 130:Been fishing? yes 131:Helped with charity? i prefer working at non profit places than for profit 132:Been rejected by a crush? i never went after anyone to be rejected, but i’ve definitely wanted to be w/ people who didn’t want to be w/ me 134:What do I want for my birthday? everything 135:How many kids do I want and what will be their names? maybe 5 or something, give or take 2. Probably name the first ones Tomas and Tavi 139:Favourite Tv Show? shameless 140:Where do I want to live when older? maybe Frederick 141:Play any musical instrument? not anymore, took violin in highschool/middle school for a few years 142:One of my scars, how did I get it? i had a wart on my knee removed lol 143:Favourite pizza topping? pineapple or veggie pizza 144:Am I afraid of the dark? not in and of itself 145:Am I afraid of heights? moderately 147:Have I ever tried my hardest and then gotten disappointed in the end? what kind of emo question is this  148:What I’m really bad at? anything someone with really long thin arms would be bad at 149:What my greatest achievements are? the stuff i’m most proud of would sound like i have a hero complex if i just wrote them here. writing a whole book. 150:The meanest thing somebody has ever said to me? they were going to kill me lol it didn’t happen though 151:What I’d do if I won in a lottery? if i answered i’d either sound like a goody two shoes or a doodoohead in a guy fawkes mask 152:What do I like about myself? I am very smart 153:My closest Tumblr friend? I don’t think i have any left!  154:Something I fantasise about? having a house outside a city w/ willow trees and magnolia trees and bamboo and a few weird looking dogs
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sachigram · 5 years ago
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Infinity, With Coffee Rings: Chapter 3
((click here to read on ao3))
Craig is steadily stacking some shitty 3X6 beige subway tile up a shower wall when his phone goes off. He hums and looks over at it, wondering if it's a text or one of those stupid notifications on Facebook he gets sometimes. “On this day, three year ago you posted...” He keeps meaning to turn those off, but he always forgets.
Deciding to take a quick break, he crosses the small room to his phone, which he keeps on top of his toolbox while he works. It'd be a pain in the ass if he kept it in his pocket and dropped it in his bucket of mud or something. He works with way too much water for that to ever be a good idea.
The notification turns out to be a text from Clyde, and it's in all caps. Clearly Donovan means business on this fine Tuesday morning.
FUCK YOU AND FUCK TWEEK YOU'RE DEAD TO ME
Craig tries to think of anything he's done to warrant those strong words and can't. Well. At least he hasn't done anything lately.
What
His phone rings immediately upon sending that simple message.
“Hey, fucker,” Clyde says scathingly.
“You're feisty today,” Craig replies. “I know I'm an ass like eighty percent of the time, but what'd Tweek do to you?”
“He put his weird vegan thoughts into Bebe's brain! She wants me to eat fucking cauliflower for dinner. Like breaded and baked in a weird imitation of chicken? What's that even about?”
Craig snorts. Clyde would get up in arms about food. It's easy to forget sometimes that Clyde used to be the second fattest kid in South Park.
“Tweek is a vegetarian, firstly. And it's rude to pin it all on him. Bebe's been wanting you to eat more vegetables for years. Of course she's feeding you cauliflower. For some reason, she wants you to be healthy.”
“You never take my side!”
“Untrue. I sneak you junk food all the time, you pathetic baby.” Craig looks towards the wall he's stacking and frowns, noticing one of the tiles is drooping.
“Whatever.” There's shuffling on Clyde's end. “I'm going to kick Tweek's ass after I get off work.”
“That classifies as bullying. He's tiny. I'll have to kick your ass if you kick his ass.”
“I have cancer. THAT classifies as bullying.”
“Fuck, you're right. Okay, Bebe can kick your ass. She'd do it, too.”
“Speaking of Tweek,” Clyde says, and Craig's insides clench a tiny bit. Clyde has been acting all superior lately when Tweek's name in mentioned, like he knows Craig and Tweek text and Snapchat an ungodly amount, usually until Craig passes out because Tweek never sleeps, apparently.
“What about him?” Craig asks, deciding to work while he talks and risk any phone related mishaps. He fixes the crooked tile that was bothering him.
“Isn't it almost time to come back and see him and satisfy your little crush or whatever?”
Craig scoffs. “I was just there. Stop making it about Tweek and just admit you can't function without me.”
Clyde's pouting is almost audible. “I'm functioning. I just miss you, you asshole.”
“I know. I miss you too, honey,” Craig says, and Clyde laughs a bit. “I'm working now, though. You want me to call you later?”
“Nah, going on a date with Bebe after work. I'll text you.”
After they hang up, Craig snaps a picture of the wall he's working on and sends it to Tweek, who is undoubtedly awake and probably has been all night. Craig is starting to understand Tweek's fucked up sleep schedule and recognizes that Tweek is up almost all the time, only napping a little between shifts at the coffee shop. Then Tweek will have a day where he sleeps almost nonstop, usually around twelve hours or so, then he'll be back up to repeat the cycle. It's not healthy, but Craig can't exactly preach about healthiness. He pulls all-nighters all the time, not even because he can't sleep, but just because he'd rather finish some shitty Netflix show, or finish a job that could easily wait until morning.
Tweek replies almost instantly, like he was waiting to hear from Craig. Another of Tweek's habits is that he never texts first, but he always texts back. He probably thinks it's annoying to make contact with someone first or some other weird reason, but Craig doesn't mind.
Looks very symmetrical!
That's the whole point of my job. Craig sends. Tweek responds with an emoji, of course. Then a picture of Espresso, who is balled into the corner of his cage, sleeping. Another thing Craig has noticed about Tweek is Tweek really likes taking pictures. Sometimes of himself, but never from the front angle. Tweek will send pictures of his shoes, of half his face while he snaps a picture of something behind him. Yesterday Tweek sent a picture of Eric Cartman making rude gestures at Kenny McCormick in the coffee shop, then another picture of Cartman pointing threateningly at the camera while Kenny made a face in the background. Craig doesn't like the idea of Tweek hanging out with those guys even still, a remnant of all the trouble they caused in the past. Kenny was always pretty cool, though.
Craig reluctantly puts his phone back on his toolbox and gets back to work. The woman he's tiling this shower for is a pain in the ass, and she expects it done faster than he'd like to do it. She doesn't seem to understand the mud has to dry before he can do much. It's not uncommon to work for customers from hell, he just doesn't really possess the people skills or the patience to handle them well. He only gets work because he's damn good at his job. Everything else is background noise to him, which apparently, a lot of people don't like. He had a reputation in school for being cold and unfeeling, but he thinks he cares about plenty of things, just not things other people care about.
He finishes a few more rows and then decides it's as good a time as any to take a lunch break. He tidies his things and grabs his phone before popping into the living room to tell the woman he'll be back in a little bit. Luckily she's on the phone and doesn't bombard him with questions about the timeline.
As soon as he's in his work truck, his phone buzzes with a message from Jack, one of his fellow installers. Jack is in the area on another job and wants to meet up for lunch. Craig sighs and accepts, because Jack is okay most of the time, and Craig can always use needing to get more work done as an excuse to leave early if he needs to. They agree on a local burger spot, and Craig plugs his phone into the AUX cord so he can jam to some metal while he drives.
Jack is waiting for him when he arrives. Both of them have spots in their clothes from dried mud that won't ever wash out, but Jack's hands are actually covered in it too. Craig raises his eyebrows.
“Anyone ever told you you're supposed to get that stuff on the tile?” he asks. Jack flips him off. Craig knew he got along with Jack for a reason.
“Had some mishaps. Not a lot of sleep last night.” Jack leads him into the restaurant, some dinky little joint with the best damn burgers Craig has ever had. They order at the counter, and Craig doesn't see much on the menu without meat in it except some salad and fries. He knows exactly what Tweek would order here, probably with a hot cup of coffee, too.
“So what are you working on, man?” Jack asks when they settle into a booth. They have to wait for their order number to be called, and Jack insisted on paying this time.
“Shitty subway tile for a rich bitch,” Craig says. He takes a sip of his Sprite. “She won't leave me alone.”
“Rich bitches usually don't,” Jack agrees.
“What about you? Anything worthwhile?” Craig asks.
“Nah, stupid remodel. Barely even worth the commute, but my wife keeps wanting fancy dates, so I guess I need to keep finding work no matter how mundane.” Craig glances at Jack's wedding ring, which is clean considering how dirty the rest of Jack's hands are. Craig has met Jack's wife, Rachel, a heavyset redheaded beauty. They're one of those sickeningly sweet couples to be around.
“Can't relate,” Craig says. “The only bills I pay are mine.”
“Yeah, you should really get out more. Nice girls don't just fall from the sky.”
Craig shrugs. “Even if they did, I wouldn't be interested. I'm not really the dating type.”
“Well, no one is, until they start actually dating, jackass.”
“You should meet my friend Clyde. The two of you could really bond over me not having any romance in my life. Both of you are also little bitches, so.”
Jack rolls his eyes. “Real mature. Just keep it in mind. You don't want any regrets later for not putting yourself out there more, right?”
Their order number is called, and Craig jumps out of the booth to retrieve it before Jack can, mainly because he's starving, but also to get out of this pointless conversation. Craig doesn't think it's possible to get through life without regret, but he highly doubts he'll be on his deathbed lamenting about not going bar to bar banging everyone he sees just to say he did. He's never really been into any of that, and he gets the feeling other people just assume he thinks he's better than them, which isn't true. He's had a few one night stands and didn't feel anything for any of them. It always just felt like a chore.
Jack doesn't bring up the dating thing again, and they end up talking about work while they eat their burgers. Craig's phone chimes a few times during the conversation, but he doesn't check it right away, because as good as his burger is, it's fucking messy. He finally finishes and wipes his hands with a paper towel before digging into his pocket to see who's blowing his phone up.
Surprisingly, it's Tweek.
Why does Clyde want to kill me? What'd I do?
He seems really mad!!!!!
Craig tell him I didn't do anything!
Well I didn't do anything on PURPOSE but maybe I did on accident?
Craig snorts and sends a quick response about Clyde just being a baby and not wanting to eat cauliflower. It's heartening on Clyde's part, really, because he has other more important things to worry about, and yet cauliflower is what he's choosing to be up in arms about.
“Is this the infamous Clyde texting you?” Jack asks.
“Nah. But it's Clyde-related.”
“Is Clyde the one with the cancer?”
It's a valid question, but it still makes Craig's stomach twist in knots the way people ask it like Clyde has the sniffles. It always rubs him the wrong way, and he regrets ever mentioning it to any of his coworkers, but he had to in order to dip out when Clyde needed him without too many questions.
“Yeah,” Craig answers shortly.
“But he's doing better, right?” Jack asks, and Craig relaxes a little.
“He's doing great.”
By the time Craig is cleaning up his trash, he realizes he's been gone over an hour. It's not the longest lunch he's taken, but his client is a real killjoy, and he'll undoubtedly hear about it upon his return. He says bye to Jack and gets in his truck, and he does his best to drive quickly, though he's already expecting the worst. Sure enough, the woman is waiting for him, and she gives him a real earful about how she's paying him to lay tile, not go on breaks. He doesn't bother arguing with her, as it's proven fruitless in the past, though he could remind her he's a person, not a machine, and breaks are necessary if she wants her shit to look good in the end.
It's later than he'd like it to be when he returns home that night, and he makes sure to send his boss a message saying under no circumstances should he be the one to return to her house after this project is done, even if it's his work that needs repairing. He doesn't make it a habit of hating people, but she's awfully close to challenging that.
The next few days are some of the longest of his life.
Getting up early, working later, and dealing with the increasingly hostile demands are taking a toll on him. Craig always considers himself to be pretty good at dealing with emotions, all things considered. Sure, he was an angry kid, but most kids in South Park were angry. It was almost impossible not to be. He finds himself wanting to blow up on the woman repeatedly, though he bites his tongue, because it's not worth it. He works as fast as he can, really beginning to not care about quality. He just wants the project to be done.
Normally he'd already be done with a basic shower install like this, but he keeps hitting snags that take some time to deal with. And then he reaches his quota of dealing with the lady who he begins to really despise. It's been a long time since someone made him feel anger like this, and by the time the week is up and the shower is drying, if the bitch died in front of him, Craig might find himself believing in God. She has complaints about his work, mainly because she doesn't like him either, and Craig finally tells her point-blank he's not fixing anything else, and she can hire another installer.
He sits in his truck for a long time and cools down. When his phone rings, he isn't surprised that it's his boss, and Craig sighs before he answers.
“Hello?”
“Just got a call from Mrs. McGovern. She's pretty pissed at you.”
“Yeah, she stays pissed. Where the hell is her husband anyway? Never saw the guy once this whole time. Maybe he'd be easier to deal with.”
“Her husband is the one signing the check, so you don't have to worry there. Sounds like he's always gone to not have to deal with her.”
“What a wuss.”
“You don't have to worry about going back. From the sound of it, there aren't any flaws she can find. She's just a complainer.”
“Nice. I'll see you in a bit. Coming to drop of my truck.”
When he arrives at the shop, he parks his truck and goes inside to turn his work order in. His boss waves at him to enter his office, so he does, expecting some kind of lecture.
“Sorry you had such a rough week. I'm astonished you didn't tell that crazy shrew to fuck off.”
Craig actually laughs. He can't help it. His boss, Mr. Darby, is a tall, lean man with thick glasses. He swears about as much as Mother Teresa, so it's incredible to witness.
“It's okay. It happens sometimes. Can't make every customer happy,” Craig says.
“Still. We stand behind you. You haven't had many repair calls and we all know better than to think you did faulty work.” He studies Craig for a moment. “It's looking pretty slow starting Monday, unless you want some new construction houses.”
Craig frowns. He hates new construction. It's always a muddy mess, and it's twice as long to set equipment up since there's no power or water in the house.
“Why not take some time off? You've got vacation built up,” Mr. Darby says.
“You trying to get rid of me, old man?” Craig snarks.
“A break would be good for you. I can't have you getting burned out. Besides, you can go see that friend in South Park for a while.”
Craig finds himself agreeing. Seeing Clyde would be good. And Tweek is there. Still, something is nagging him.
“I'm not in trouble, right? For her calling the shop and bitching about everything?”
“No, not at all! You're one of our best guys. This really is just a suggestion. If you want work next week, you have it.”
“Okay,” Craig says. “Then I'll take some PTO. I actually do need a break. If one more person tells me a tile is crooked when it's straight as hell, I'm going to break my own neck.”
He could call Tweek and tell him he's coming. But he doesn't. He goes home to pack a bag, and then he's driving, calling Clyde to tell him the news on the way.
A couple hours and one fast food stop later, Craig is pulling in front of a familiar house, but it's not Clyde's. He'll go there next. First he wants to see and surprise Tweek, who hasn't messaged him much today.
When he knocks, it's not Tweek who answers the door, it's his mom, who blinks at him, clearly taken aback.
“Well, Craig Tucker, it's been ages. How have you been?” she asks, pulling him into a hug. She's short. Tweek clearly takes after her, not that her husband is much taller. Everyone seems kind of short to Craig, though.
“I've been better. Is Tweek around?” he asks.
“Oh, yes. He's in his room with that guinea pig. I heard you bought it for him? How kind of you.”
He remembers what Tweek said about his parents not approving of pets, and he wonders if she's being sarcastic, though she still seems friendly enough. Either way, best to avoid an argument.
“I'm sorry, I know he said you didn't like pets. But it seems...good for him. And he's doing a great job at being a pet owner. I just wanted to get him a gift after so long apart.”
Her eyes soften and she pinches his cheek playfully. “You're a good boy, Craig. You always have been. But Tweek isn't like other people. I just don't want him heartbroken when he kills the poor thing.”
“Why would he kill it? He's doing fine,” Craig says, still in a foul mood and not liking her tone. Before she can respond, Tweek is coming down the stairs, a smile on his face.
“Craig! You didn't say you were coming!” He bounds towards Craig and is quickly pulling him up the stairs. “Come see Espresso, he's still so happy!”
“Dinner will be ready in a few minutes, Tweek,” his mother calls. Tweek nods and yanks Craig into his bedroom.
“Sorry. I hope she wasn't lecturing you about Espresso. She's been a real jerk about it. Dad, too.”
“It's okay. I didn't mean to cause trouble, but I guess I've done worse, slightly more illegal things than buy someone a damn guinea pig,” Craig says. Tweek scrutinizes him.
“What's wrong?” Tweek asks.
“Nothing. I'm just tired. And your parents treating you like an invalid makes me mad.”
“It's more than that. You kind of just came out of nowhere, not that I'm complaining. I like having you here! But you seem...upset.”
“I had a bitch of a week. It doesn't matter though. It's over now.”
Tweek fidgets a bit, and then he does something so fucking cute that Craig practically has an aneurysm. He shuffles forward and pulls Craig into a hug, patting his back.
“It's okay. You can talk about it with me. I always complain to you, but you never tell me about how you feel. I'm good at listening!”
Craig laughs, hugs him back, and leans entirely against him.
And he talks.
***
In the aftermath of bitching about the woman, his busy schedule, and everything else he's been thinking about lately, he decides he does feel better. It's not that he's against talking about feelings and shit—he knows people have feelings. It's just that he usually can block everything out and focus on what matters, which is work and being there for Clyde.
“But who's there for you?” Tweek had asked, and Craig didn't have an answer. He doesn't like bothering Clyde when he has so much going on. And he knows Clyde would hate knowing that, so he never mentions it.
Jesus. When did everything get harder?
Tweek disappears for a while when dinner is ready. Craig already ate, so he decides to just chill in Tweek's room and wait for him. He doesn't think being at the table with Tweek's parents is a good idea right now. He knows they love their son, but their ideas really stunt him, and Tweek doesn't even know it. Craig's always found them screwy.
He lays on Tweek's bed and closes his eyes. And when he opens them, he finds it's hours later, and he passed the fuck out.
“You're up,” Tweek says. He's sitting on the floor with Espresso. “You were snoring.”
“Shit—I don't even remember closing my eyes. What time is it?”
“Around three in the morning.”
“Of course you're still up.” Craig groans and rubs his eyes. “Clyde is probably freaking out.”
“No, I texted him you were here. He said he was going to bed a couple of hours ago.” Tweek picks up the guinea pig and deposits him on the bed, and then sits beside Craig. “You can go back to sleep. You still look really tired.”
“Says the insomniac,” Craig counters.
“Yeah, but I'm used to never sleeping. Besides, I was going to go to sleep soon anyway! Want me to take the floor? I think we have extra blankets.”
“Nah, dude, your bed is big enough for us both. Unless you have like...a phobia or something. I don't wanna make you uncomfortable.”
Tweek laughs.
“Funnily enough, you haven't made me uncomfortable once yet. We can both take the bed.”
He puts Espresso back in his cage, and then turns off the light before he climbs into bed beside Craig. There are glow stars on the ceiling that glow faintly, and it's endearing in ways that make Craig's chest clench.
“Goodnight,” Tweek says, and he has his back to Craig. Craig scoots closer to him and throws an arm around him, uncaring of any and all implications.
“Night,” he says. Tweek doesn't move away.  The sounds of Espresso moving around in his cage remind him of Stripe so long ago, and he falls asleep easily.
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134 questions
1: Name - Joel 2: Age - 18 (19 in June) 3: 3 Fears - being alone, not making anything of myself, and bugs lol 4: 3 things I love - My Sweet and Wonderful Boyfriend, music and making music, chocolate 5: 4 turns on - the back of my neck, it's really sensitive… when the other person takes control… that's all you get for now ;) 6: 4 turns off - biting, roughness lol, uncomfortable positions, boobs (lol) 7: My best friend - Sterling 8: Sexual orientation - Gay (duh XD) 9: My best first date - pizza place with my current boyfriend 10: How tall am I - 5’6” 11: What do I miss - my boyfriend. And music camp tbh 12: What time was I born - not sure… the afternoon maybe? 13: Favorite color - Teal 14: Do I have a crush - very much so 15: Favorite quote - not my favorite but I love it cuz it's hilarious “...the people that put the chemicals in the water that turned the friggin frogs gay!” - Alex Jones 16: Favorite place - Sterling's house (and now anywhere with my boyfriend :) 17: Favorite food - Mac n’ cheese. Also chicken 18: Do I use sarcasm - nooooooo I neeeeever eeeeeeever use sarcasm (lol) 19: What am I listening to right now - my Mom has some cringey Christian radio station on... 20: First thing I notice in a new person - kindness 21: Shoe size - 10 (12 women's XD) 22: Eye color - blue 23: Hair color - dirty blonde 24: Favorite style of clothing - sweaters with or without buttons, clothes with buttons in general. Fall clothes 25: Ever done a prank call? - once… it was so cringey but he actually fell for it
27: Meaning behind my URL - theboywiththepinkfloralpurse was my first blog where I really needed someplace to make venting emotional posts and I'd just gotten a tacky pink purse with flowers lol. a-random-gay-bunny is pretty self explanatory lol 28: Favorite movie - ahhhhhh I'm so bad at picking favorites for most things…. I do really like V for Vendetta tho. Seen it many times, and the entire X-Men series. 29: Favorite song - too many to pick… 30: Favorite band - except this… I can say for sure it's Pentatonix. I've seen them in concert twice, I love them so much 31: How I feel right now - happy, but I wanna hold my boyfriend and kiss him 32: Someone I love - My boyfriend John 33: My current relationship status - very taken <3 34: My relationship with my parents - much better than a couple years ago, still a little rocky but pretty good 35: Favorite holiday - probably Christmas 36: Tattoos and piercing I have - none 37: Tattoos and piercing I want - I'm not sure, but I would like a tattoo or a few one day 38: The reason I joined Tumblr - to vent my feelings to the void lol 39: Do I and my last ex hate each other? - don't have one 40: Do I ever get “good morning” or “good night ” texts? - everyday :) <3 41: Have you ever kissed the last person you texted? - this question is weird lol, but John's the last person I texted and the only person I've kissed :) 42: When did I last hold hands? - yesterday 43: How long does it take me to get ready in the morning? - depends, I can get ready really quickly if need be though 44: Have You shaved your legs in the past three days? - nope. Last I shaved was a week ago I think 45: Where am I right now? - at home on my couch 46: If I were drunk & can’t stand, who’s taking care of me? - either Sterling, John or both, but I don't plan on getting drunk ever. I guess it could happen but probably won't be drinking in the future 47: Do I like my music loud or at a reasonable level? - both, usually slightly loud though 48: Do I live with my Mom and Dad? - yeah… hopefully not for too much longer 49: Am I excited for anything? - seeing my boyfriend on Saturday, and going to camp in 52 days, and hopefully passing my driver's test in 107 days. 50: Do I have someone of the opposite sex I can tell everything to? - sort of? I feel like I can tell Tabby everything 51: How often do I wear a fake smile? - not too often, only in situations where I feel uncomfortable but feel I need to smile. 52: When was the last time I hugged someone? - couple of hours ago 53: What if the last person I kissed was kissing someone else right in front of me? - I'd be vereh sad and I'd want to know why. But he wouldn't do that :) 54: Is there anyone I trust even though I should not? - I'm a really trusting person so probably 55: What is something I disliked about today? - I couldn't see my boyfriend and kiss his cute face 56: If I could meet anyone on this earth, who would it be? - uhhh… I dunno… maybe Tyler Oakley cuz I bet that would be really fun 57: What do I think about most? - heehee, my boyfriend. And also getting a job and figuring out plans for things, always running through plans in my head. 58: What’s my strangest talent? - I'm not sure, but the fact I can sing so low and so high is a pretty strange talent I guess 59: Do I have any strange phobias? - I'm very afraid of getting water in my eyes 60: Do I prefer to be behind the camera or in front of it? - behind it 61: What was the last lie I told? - I told my Mom I understood when she told me that my having a boyfriend is very difficult and awkward for her. I really don't understand 62: Do I prefer talking on the phone or video chatting online? - definitely on the phone, but before my boyfriend I would've said neither 63: Do I believe in ghosts? How about aliens? - I'd like to believe in aliens, but I dunno. As for ghosts I don't believe in them at all really. 64: Do I believe in magic? - kind of? I think people can and have been able to connect with demons and been controlled by them. I don't think it really happens today much anymore. I think it might tho? 65: Do I believe in luck? - not really, sort of in a cutesy way tho 66: What's the weather like right now? - slightly cloudy, but the sun has mostly set anyway 67: What was the last book I've read? - all the way through? Animal Farm. The last book I opened and read from was a book Sterling gave me. 68: Do I like the smell of gasoline? - Oh god no, do some people like that smell? 69: Do I have any nicknames? Dork, pianoman (from this strange sports camp where everyone had a nickname) 70: What was the worst injury I've ever had? - had a car hood slam on a couple fingers, they didn't break tho surprisingly. Never had a broken bone 71: Do I spend money or save it? - spend… I shouldn't, I need to make money so I can start saving 72: Can I touch my nose with a tongue? - just barely the bottom of my nose 73: Is there anything pink in 10 feet from me? - yes, my old pink purse and probably some other stuff 74: Favorite animal? - besides cats and bunnies, red pandas 75: What was I doing last night at 12 AM? - talking to bae 76: What do I think is Satan’s last name is? - I don't think he has one? Strange question lol 77: What’s a song that always makes me happy when I hear it? - you'll be in my heart by Phil Collins 78: How can you win my heart? - genuinely caring about me :) 79: What would I want to be written on my tombstone? - Here lies the gayest gay to ever gay 80: What is my favorite word? - maybe bitch lol 81: My top 5 blogs on tumblr - a bunch of furry blogs lol 82: If the whole world were listening to me right now, what would I say? - …..hi?... anybody wanna give me free money and help me see my boyfriend more?.... 83: Do I have any relatives in jail? - no. Unless I have distant relatives in jail 84: I accidentally eat some radioactive vegetables. They were good, and what’s even cooler is that they endow me with the super-power of my choice! What is that power? - teleportation 85: What would be a question I’d be afraid to tell the truth on? - not many, but one is “have you cheated on school assignments” 86: What is my current desktop picture? - my cat Loki 87: Had sex? - nope 88: Bought condoms? - nope 89: Gotten pregnant? - NOPE XD 90: Failed a class? - no 91: Kissed a boy? - yee 92: Kissed a girl? - nononono 93: Have I ever kissed somebody in the rain? - not yet ;) 94: Had job? - not yet :( 95: Left the house without my wallet? - plenty of times lol 96: Bullied someone on the internet? - maybe? When I was like 13/14 I might've, but not really, I made cringey YouTube comments. 97: Had sex in public? - nope lol 98: Played on a sports team? - nope 99: Smoked weed? - nope 100: Did drugs? - nope 101: Smoked cigarettes? - nope 102: Drank alcohol? - nope 103: Am I a vegetarian/vegan? - nope 104: Been overweight? - nope 105: Been underweight? - ...yeah 106: Been to a wedding? - many… many 107: Been on the computer for 5 hours straight? - HA plenty of times XD 108: Watched TV for 5 hours straight? - probably 109: Been outside my home country? - no 110: Gotten my heart broken? - yeah 111: Been to a professional sports game? - actually yeah… it was boring 112: Broken a bone? - nope 113: Cut myself? - no, I considered once but immediately decided against it because I know someone close to me who did 114: Been to prom? - nope 115: Been in airplane? - a few times 116: Fly by helicopter? - nope 117: What concerts have I been to? - Oh lots, a bunch of em were when I had a scholarship that allowed me to see concerts for free 118: Had a crush on someone of the same sex? - plenty lol, better question would be had a crush on the opposite sex. Which the answer would be… once 119: Learned another language? - sorta? Not fluently no lol 120: Wore make up? - nope, I don't like stuff on my face like face paints and makeup and stuff 121: Lost my virginity before I was 18? - nope 122: Had oral sex? - nope 123: Dyed my hair? - no, but I want to someday. Like a fun color 124: Voted in a presidential election? - yeah 125: Rode in an ambulance? - nope 126: Had a surgery? - nope 127: Met someone famous? - kinda! 128: Stalked someone on a social network? - a few times... 129: Peed outside? - yeah, hasn't everybody at least once? Right? 130: Been fishing? - once… super boring 131: Helped with charity? - not yet, can't afford to yet lol 132: Been rejected by a crush? - once 133: Broken a mirror? - don't think so 134: What do I want for birthday? - always a difficult question. But definitely want to see my boyfriend :)
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tea-and-toblerones · 8 years ago
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I hijacked this.
1: Name:: Deanna 2: Age:: 24 3: 3 Fears:: spiders, being told I love you when they really don't, utter failure 4: 3 things I love:: Video games, music and art 5: 4 turns on:: Dorkiness, awkwardness, kindness and a sense of humor 6: 4 turns off:: flip floppy behavior, narcissism, arrogance, and thinking yo ass is better than everyone else. 7: My best friend:: @bestiejessie 8: Sexual orientation:: Hetro, but with an appreciation for the female form 9: My best first date:: pff, I'll let you know when that happens, yeah? I've never really been taken out 10: How tall am I:: 5′7" 11: What do I miss:: being as carefree as I was 12: What time were I born:: Monday, August 24, 1992 at 9:18 PM 13: Favourite color:: Red. Blood red. 14: Do I have a crush:: My heart only poops it's pants for celebs and fictional characters at the mo'. It's easier that way. 15: Favourite quote:: “I may be an asshole, but I'm not a 100% Dick" Peter "Star Lord" Quill 16: Favourite place:: By the water. On the water. Floating in the water. I love water. 17: Favourite food:: PIZZA IS LIFEEEEE 18: Do I use sarcasm:: Nah mate, not at all. 19: What am I listening to right now:: The Final Fantasy VII Soundtrack 20: First thing I notice in new person:: eyes, scent, timbre of voice, and their vibe 21: Shoe size:: 8 22: Eye color:: gunsteel blue 23: Hair color:: medium brown. For now. 24: Favourite style of clothing:: Grunge queen in the fall/winter Cute and lacy in the spring/summer 25: Ever done a prank call?:: not that I'm aware. I have terrible anxiety 27: Meaning behind my URL:: I just love tea and toblerones mate. 28: Favourite movie:: Howl's Moving Castle 29: Favourite song:: Yellow by Coldplay 30: Favourite band:: Imagine Dragons 31: How I feel right now:: Chill/excited 32: Someone I love:: EVERYONE. Cept for one single person. 33: My current relationship status:: Emotionally attached to a fictional character cos I'm trash. That answers that, eh? 34: My relationship with my parents:: Me and my mam are tight. My dad...nah mate, not so much. 35: Favourite holiday:: HALLOWEEN BITCHES! 36: Tattoos and piercing I have:: My gauges. 37: Tattoos and piercing I want:: Sylleblossoms and a sword from FFX, Calcifer from Howl's Moving Caste, a sea scape, trees, a dragon... 38: The reason I joined Tumblr:: I needed an Ed outlet before my friends murdered me. 39: Do I and my last ex hate each other?:: He cut his face open to be more like Ed so I would take him back. I don't hate anyone, but that boy is pretty damn close to it. 40: Do I ever get “good morning” or “good night ” texts?:: My brother texts me WAKE UP from time to time. Do those count? 41: Have I ever kissed the last person you texted?:: Texted, yeah. Messaged, nah, just licked their face. 42: When did I last hold hands?:: romantically? Last year. In general? Last night. 43: How long does it take me to get ready in the morning?:: pff what is this morning you speak of? 44: Have You shaved your legs in the past three days?:: Sure have. 45: Where am I right now?:: In the FFXV/Ed trash heap where I belong. 46: If I were drunk & can’t stand, who’s taking care of me?:: Jessie if they're not already passed out. 47: Do I like my music loud or at a reasonable level? :: loud 48: Do I live with my Mom and Dad? :: unfortunately 49: Am I excited for anything?:: THIS WEEKEND 50: Do I have someone of the opposite sex I can tell everything to?:: yes 51: How often do I wear a fake smile?:: 25% of the time? Ish 52: When was the last time I hugged someone?:: earlier today 53: What if the last person I kissed was kissing someone else right in front of me?:: I be surprised he grew a spine and kissed a girl other than me, but that's about it. Probably cheer him on. Get him a drink. I'm such a bro 54: Is there anyone I trust even though I should not?:: nah mate, I hardly trust anyone 55: What is something I disliked about today?:: almost falling outta a chair cos I fell asleep 56: If I could meet anyone on this earth, who would it be?:: Ed Sheeran 57: What do I think about most?:: that I'm trapped in a stagnate place and I'll never get free from it. 58: What’s my strangest talent?:: I can remember exactly how people/ feel. Like their skin and whatnot, like I'm physically touching them, but im not. And their scent and their voice. And their eyes. Is that a talent? 59: Do I have any strange phobias?:: the snuggle bear creeps me the fuck out. 60: Do I prefer to be behind the camera or in front of it?:: behind 61: What was the last lie I told?:: that I was gonna go to bed early. Does it count if it's to yourself? 62: Do I perfer talking on the phone or video chatting online?:: video chatting cos I have a fear that people can't understand what I'm saying due to the fact I used to have an impediment with a lisp so at least they can read my lips. 63: Do I believe in ghosts? How about aliens? :: sure do. Seen em. Felt em. Have one thats attached to me. He's cool. Chases away the bad stuff. And yeah this universe is way to big for us to be the only ones 64: Do I believe in magic?:: yep 65: Do I believe in luck?:: very much so 66: What’s the weather like right now?:: kinda coldish? But not terrible (I'm horrible at judging how cold it is. I never wear a jacket) 67: What was the last book I’ve read?:: King Killer Chronicles 68: Do I like the smell of gasoline?:: I'm weird so of course I do 69: Do I have any nicknames?:: Nanna (which I always go by) 70: What was the worst injury I’ve ever had?:: um, well one of my insides got very angry with me and hurt and I couldn't move and was fevered and puking and made my back hurt. I was too stubborn to go get checked out so I dunno what happened but it got better on its own. 71: Do I spend money or save it?:: both. Usually save though 72: Can I touch my nose with a tounge?:: I've got quite the long tongue, I can actually stick it up my nose if I tried. (Drunk me has) 73: Is there anything pink in 10 feets from me?:: Not that I can see 74: Favourite animal?:: Foxes, Ravens, and raccoons 75: What was I doing last night at 12 AM?:: Partying with my ladies getting ready to bar hop with the band 76: What do I think is Satan’s last name is?:: Morningstar. He owns a nightclub called Lux in LA. 77: What’s a song that always makes me happy when I hear it?:: Thrift Shop 78: How can you win my heart?:: by being an adorable awkward dorky nerd like me 79: What would I want to be written on my tombstone?:: something utterly ridiculous probably 80: What is my favorite word? :: probably a swear. 81: My top 5 blogs on tumblr @weareedsobfg (imma cheat too) @ferskendag, @tenerife-lucy @lordedsheeran, uh....I'm sure there's more I'm forgetting 82: If the whole world were listening to me right now, what would I say? :: pterodactyl noises and arm flaps cos social anxiety 83: Do I have any relatives in jail?:: it would be quicker to list the ones that weren't. 84: I accidentally eat some radioactive vegetables. They were good, and what’s even cooler is that they endow me with the super-power of my choice! What is that power?:: the power of imagination (whatever I can imagine happens) 85: What would be a question I’d be afraid to tell the truth on?:: How do you feel 86: What is my current desktop picture?:: A picture of graveyard I took in New Orleans 87: Had sex?:: yeah 88: Bought condoms?:: yeah 89: Gotten pregnant?:: no 90: Failed a class?:: math. All the math 91: Kissed a boy?:: yeah 92: Kissed a girl?:: yeah 93: Have I ever kissed somebody in the rain?:: I have in the snow 94: Had job?:: yeah had job 95: Left the house without my wallet?:: almost everytime 96: Bullied someone on the internet?:: Nah mate 97: Had sex in public?:: Sure have 98: Played on a sports team?:: INDOOR PERCUSSION BITCHES 99: Smoked weed?:: Not smoked it, but had some pretty delicious banana nut pot bread. 100: Did drugs?:: besides the pot bread, nah mate 101: Smoked cigarettes?:: No 102: Drank alcohol?:: Oh yeah 103: Am I a vegetarian/vegan?:: Once upon a time 104: Been overweight?:: very much so 105: Been underweight?:: when I was born 106: Been to a wedding?:: I've been to so many 107: Been on the computer for 5 hours straight?:: ALL DAY, ERRYDAY 108: Watched TV for 5 hours straight?:: I'm a binge watching mofo 109: Been outside my home country?:: no but I wanna 110: Gotten my heart broken?:: yeah 111: Been to a professional sports game?:: Yes and I don't even like sports. 112: Broken a bone?:: surprisingly no 113: Cut myself?:: all the time on accident 114: Been to prom?:: no, I was the weird loner outsider kid. You know the one. 115: Been in airplane?:: Sure have 116: Fly by helicopter? :: no but I've been in one 117: What concerts have I been too?:: Alice Cooper and Watch Them Rot 118: Had a crush on someone of the same sex?:: Kinda ish. 119: Learned another language?:: I used to know a lil Spanish but now, not so much 120: Wore make up?:: every time I leave the house even though I don't need it anymore cos I got my eczema under control (the miracle of aloe yall) 121: Lost my virginity before I was 18?:: Nope 20 122: Had oral sex?:: I have 123: Dyed my hair?:: so much. 124: Voted in a presidential election?:: No 125: Rode in an ambulance?:: Nope 126: Had a surgery?:: Nope 127: Met someone famous?:: uh, mickey, minnie, goofy and pluto? 128: Stalked someone on a social network?:: who hasnt? 129: Peed outside?:: so many times 130: Been fishing?:: yep 131: Helped with charity?:: yep 132: Been rejected by a crush?:: *laughs to infinity* CAN'T BE IF YOU NEVER TELL EM (yes, yes I have. Indirectly) 133: Broken a mirror?:: So many I'm cursed forever 134: What do I want for birthday?:: the same thing I wanted last year. A hot ginger. (And video games. Always video games) 135: How many kids do I want and what will be their names?:: 2 boys. And maybe like William or James or something weird cos I love weird names 136: Was I named after anyone? :: Deanna Troi from Star Trek: the Next Generation. 137: Do I like my handwriting?:: yeah it's pretty okay 138: What was my favourite toy as a child?:: MY PINK POWER RANGER ACTION FIGURE 139: Favourite Tv Show?:: Supernatural, Sherlock, Doctor Who, American Horror Story, Arrow, Flash, Legends of Tomorrow...don't make me pick one. 140: Where do I want to live when older?:: with someone I care about. 141: Play any musical instrument?:: piano, marimba, xylophone, vibraphone, bells, drums, guitar (not well, I have ZERO rhythm) 142: One of my scars, how did I get it?:: playing with my dog 143: Favourite pizza toping?:: If I had to pick one, pepperoni but mushroom olive and pineapple please 144: Am I afraid of the dark?:: nah, that's where all the stars are 145: Am I afraid of heights?:: nah 146: Have I ever got caught sneaking out or doing anything bad?:: no, I was a mild child 147: Have I ever tried my hardest and then gotten disappointed in the end?:: Oh you mean my life? 148: What I’m really bad at:: everything 149: What my greatest achievments are:: well I stopped someone from killing themselves. I also tend to make people laugh and feel better. 150: The meanest thing somebody has ever said to me:: I only said I loved you so you would stay (though literally already knew it but worst fear right there) 151: What I’d do if I won in a lottery:: get outta debt. Get my friends outta debt. 152: What do I like about myself:: people say I'm sunshine. I like that. 153: My closest Tumblr friend:: @ferskendag and @tenerife-lucy 154: Something I fantasise about:: being happy with someone I care about, being financially stable while doing my dream job and traveling the world. 155: Any question you’d like? Do you know the muffin man?
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mikeandchesterforever · 8 years ago
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I needed a distraction so here’s this
1. Full name: not saying bc I write personal shit on here but my roommate calls me Moca, so lets go with that 2. Zodiac sign: Sagittarius 3. 3 Fears: death, not succeeding in life, and losing the people I love 4. 3 things I love: music, tattoos, and dogs 5. 4 turns ons: 6. 4 turns offs: 7. My best friend: a wonderful human named Chai, who is probably reading this 8. Sexual orientation: Gay af 9. My best first date: definitely my most recent first date. We went to the MFA, and just got lost in there, looking at all of the art. And then we found a spot and just sat and talked for a while and it was incredible. 10. How tall am I: 5'5 and a half 11. What do I miss: my best friend… and my 3 friends that died 12. What time were I born: 5:58pm 13. Favourite colour: Black and neon green 14. Do I have a crush: I sure do… 15. Favourite quote: "Darling you'll be okay" I have it as a tattoo on my wrist in Vic Fuentes' handwriting 16. Favourite place: The beach 17. Favourite food: oh god that's hard…. I have so many. Mac and cheese is definitely one of them 18. Do I use sarcasm: yes but I have a hard time understanding it with other people (depending on who the person is) 19. What am I listening to right now: "Throne" by Bring Me The Horizon 20. First thing I notice in new person: their eyes 21. Shoe size: 9 ish 22. Eye colour: blue 23. Hair colour: brown but about to dye it 24. Favourite style of clothing: gay college kid who loves band merch 25. Ever done a prank call?: nope 26. What colour of underwear I’m wearing now?: black like my soul 27. Meaning behind my URL: this blog was solely for band stuff when I made it, and at the time Linkin Park was my all time favorite band. So yeah. 28. Favourite movie: That's hard… Probably Spider-Man bc he's my favorite super hero 29. Favourite song: Hold On Till May by Pierce the Veil 30. Favourite band: Pierce the Veil, no question 31. How I feel right now: upset, angry, nauseous, tired, sore 32. Someone I love: my incredible best friend 33. My current relationship status: single but crushing so hard on an amazing girl 34. My relationship with my parents: not bad but not perfect 35. Favourite holiday: Christmas - I love being able to buy my friends and family gifts 36. Tattoos and piercings?: 3 tattoos (but I want more), and two earring holes 37. Tattoos and piercing I want: I want a ton of tattoos, mostly song lyrics, and potentially a memorial piece for my three friends. I don’t think I want another piercing. 38. The reason I joined Tumblr: bands and venting… lots of venting. 39. Do I and my last ex hate each other? No, but I don’t know how tf she feels about me so there's that. 40. Do I ever get “good morning” or “good night ” texts? Nope. Haven't in forever. 41. Have I ever kissed the last person you texted? Nope and I'm totally okay with that 42. When did I last hold hands? My birthday dinner. My girlfriend at the time was there, and we held hands almost all night 43. How long does it take me to get ready in the morning? 5-10 minutes, once I actually get out of bed 44. Have I shaved your legs in the past three days? Lmao nope 45. Where am I right now? At my house, on my bed 46. If I were drunk & can’t stand, who’s taking care of me? My amazing best friend - already almost happened once and I wouldn't have wanted anyone else there with me, nor would I have trusted anyone else to make sure I was okay 47. Do I like my music loud or at a reasonable level? Really depends on my mood 48. Do I live with my Mom and Dad? Yes 49. Am I excited for anything? Going back to school and seeing my best friend 50. Do I have someone of the opposite sex I can tell everything to? Sure do 51. How often do I wear a fake smile? More often than I'll ever admit 52. When was the last time I hugged someone? About an hour ago, I hugged my mom 53. What if the last person I kissed was kissing someone else right in front of me? I would be so hurt. 54. Is there anyone I trust even though I should not? I'd like to say no, but lately I don’t even know who to trust anymore 55. What is something I disliked about today? I had to work a 10 hour shift with no break 56. If I could meet anyone on this earth, who would it be? I've met PTV once already but I would meet them again in a heartbeat. If not them, then definitely BMTH 57. What do I think about most? Music 58. What’s my strangest talent? I hear a noise and sometimes I can figure out what note it is. My friends all think I have perfect pitch but idk 59. Do I have any strange phobias? Heights... 60. Do I prefer to be behind the camera or in front of it? Behind it 61. What was the last lie I told? My mom asked how my day was and I told her it was good 62. Do I prefer talking on the phone or video chatting online? FaceTime! 63. Do I believe in ghosts? How about aliens? Sometimes, I guess it depends on the day 64. Do I believe in magic? No but I love the idea of it 65. Do I believe in luck? Yes I do, and I am a very lucky person 66. What’s the weather like right now? It's cold and dark, but it was warm and sunny earlier today 67. What was the last book I’ve read? My classical music textbook 68. Do I like the smell of gasoline? Yes. Very much so. 69. Do I have any nicknames? My roommate calls me Moca 70. What was the worst injury I’ve ever had? I almost got a concussion once, other than that I've broken my arm and one of my fingers. 71. Do I spend money or save it? I try to save it but when I do spend it, it's usually on tattoos and concert tickets. 72. Can I touch my nose with a tongue? Yes 73. Is there anything pink in 10 feets from me? Nope 74. Favourite animal? Hippos!!!!! 75. What was I doing last night at 12 AM? I was talking to my best friend on FaceTime, and we were talking about how we were so ready to go back to school. 76. What do I think is Satan’s last name is? Wtf??? I have no clue?????? 77. What’s a song that always makes me happy when I hear it? Hold On Till May by Pierce the Veil 78. How can you win my heart? Be patient with me, and let me learn to trust you, and we learn who we really are 79. What would I want to be written on my tombstone? At this current moment in time, I want "so long and good night" 80. What is my favourite word: indeed 81. My top 5 blogs on tumblr: all the blogs I follow bc they are all wonderful 82. If the whole world were listening to me right now, what would I say?: don’t ever give up. Life gives you so many options - don’t you dare make giving up one of them. You'll always be okay, even when you think the world is ending around you. 83. Do I have any relatives in jail? Unfortunately yes…. 84. I accidentally eat some radioactive vegetables. They were good, and what’s even cooler is that they endow me with the super-power of my choice! What is that power? Mind-reading. Then I'd know how people really feel about me. 85. What would be a question I’d be afraid to tell the truth on? I don’t know tbh 86. What is my current desktop picture? A picture of PTV that I love bc it's cute 87. Had sex? Nope 88. Bought condoms? Nope 89. Gotten pregnant? Nope 90. Failed a class? Almost 91. Kissed a boy? Yes 92. Kissed a girl? Yes 93. Have I ever kissed somebody in the rain? No but I want to so bad 94. Had job? Yup 95. Left the house without my wallet? Yeah… 12/10 do not recommend 96. Bullied someone on the internet? Never 97. Had sex in public? Nope 98. Played on a sports team? Yeah, when I was younger I played baseball. And I played ultimate frisbee in high school and for half a semester in college 99. Smoked weed? No 100. Did drugs? No 101. Smoked cigarettes? No 102. Drank alcohol? Yes 103. Am I a vegetarian/vegan? Nope 104. Been overweight? Mhmm…... 105. Been underweight? Nope 106. Been to a wedding? Yup, and I was in it too 107. Been on the computer for 5 hours straight? Yeah 108. Watched TV for 5 hours straight? Yes but only when I am sick 109. Been outside my home country? Yup, twice 110. Gotten my heart broken? Oh yeah... 111. Been to a professional sports game? Yup! 112. Broken a bone? Yeah, I broke my arm when I was 7 and I broke one of my fingers when I was 8 113. Cut myself? Oh yes. More than I'd like to admit, actually. I struggled with it for a really long time. 114. Been to prom? Yup 115. Been in airplane? Yes! I like them a lot actually 116. Fly by helicopter? Nope 117. What concerts have I been to? Linkin Park, Avenged Sevenfold, Bon Jovi, Stone Temple Pilots (with lead singer Chester Bennington), Warped Tour, A Silent Film, Demi Lovato, Pentatonix, and my loves Pierce the Veil (4 times to be exact). 118. Had a crush on someone of the same sex? Oh yes. 119. Learned another language? Yup! I'm not fluent in it though 120. Wore make up? Yes… but most recently it was for a play I did and I needed to look like a dude 121. Lost my virginity before I was 18? Haven't lost it yet 122. Had oral sex? Nope 123. Dyed my hair? Hell yeah and doing it again 124. Voted in a presidential election? Yup 125. Rode in an ambulance? No 126. Had a surgery? Yup, my wisdom teeth, and I'm p sure they had to surgically fix my arm when I broke it 127. Met someone famous? Yes! I met PTV 128. Stalked someone on a social network? Yes…. 129. Peed outside? Nope 130. Been fishing? Nope 131. Helped with charity? Yes 132. Been rejected by a crush? Yes…. 133. Broken a mirror? No 134. What do I want for birthday? To not spend it alone like I did this year 135. How many kids do I want and what will be their names? I don’t know 136. Was I named after anyone? Yes but I really don’t want to get into that 137. Do I like my handwriting? Not really but it's okay I guess 138. What was my favourite toy as a child? I had a stuffed cat and I named her Daisy, after my cat 139. Favourite Tv Show? NCIS, no question 140. Where do I want to live when older? Idk… Maybe near Boston, maybe not. 141. Play any musical instrument? Yup - tuba, bass trombone, alto sax, drums, piano, euphonium, guitar, and now I am learning bass guitar. 142. One of my scars, how did I get it? I have a scar on my arm from getting burned 143. Favourite pizza topping? Pineapple bc I'm a nerd 144. Am I afraid of the dark? No 145. Am I afraid of heights? Yes I fucking am 146. Have I ever got caught sneaking out or doing anything bad? No 147. Have I ever tried my hardest and then gotten disappointed in the end? Lmao did you mean my life 148. What I’m really bad at: being organized 149. What my greatest achievements are: actually living to see my 20th birthday 150. The meanest thing somebody has ever said to me: "You know what? If you're going to hurt yourself go ahead. Go right ahead." 151. What I’d do if I won in a lottery: Make myself and my loved ones financially stable - so my parents, my sister and brother in law, my brother, my best friend, and myself. 152. What do I like about myself: my eyes, my hair, and my music taste. 153. My closest Tumblr friend: I don’t have anyone that I only know from tumblr and no other context 154. Something I fantasize about my ex: her and I being together and happy… so, so happy. Going on dates, spending time together, and just loving each other so much. But it's never going to happen.
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shapesnnsizes · 6 years ago
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RHR: The Truth about Saturated Fat, with Zoё Harcombe
In this episode, we discuss:
Why you need to eat fat
Why the Paleo diet template makes sense
Where these misguided ideas about fat came from
The Seven Countries Study
Zoё Harcombe’s research on fat
Why you should be skeptical of some news headlines
Why dietary guidelines don’t work
The epidemiological evidence
Conclusions about saturated fat
Show notes:
The Obesity Epidemic: What Caused It? How Can We Stop It?, by Zoё Harcombe
“Evidence from Randomised Controlled Trials Did Not Support the Introduction of Dietary Fat Guidelines in 1977 and 1983: A Systematic Review and Meta-Analysis,” by Zoё Harcombe
“The Nitrate and Nitrite Myth: Another Reason Not to Fear Bacon,” by Chris Kresser
USDA Food Composition Databases
“Re-evaluation of the Traditional Diet-Heart Hypothesis: Analysis of Recovered Data from Minnesota Coronary Experiment (1968–73),” by Christopher Ramsden
“The Challenge of Reforming Nutritional Epidemiologic Research,” by John Ioannidis
youtube
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Hey, everybody, Chris Kresser here. For the past 50 years we’ve been told that eating meat, saturated fat, and cholesterol is unhealthy. Recently, a growing number of people are turning to a vegetarian or vegan diet with the goal of improving their health.
But is it really true that meat and fat are bad for us? And are vegetarian and vegan diets a good choice for optimizing health and extending lifespan? If not, what is the optimal human diet? Join me on the Joe Rogan Experience on Thursday, September 27th, as I debate these questions with vegan doctor Joel Kahn. You can tune in live at 12 noon Pacific Time at JoeRogan.live. That’s J-o-e-r-o-g-a-n.live, or you can catch the recording at podcasts.joerogan.net, on YouTube, or in iTunes or Stitcher.
If you’d like to receive updates about the debate, including links to the recording and new articles and information I’ve prepared on this topic, go to Kresser.co/Rogan. That’s Kresser.co/Rogan and put your email in the box.
Okay, now onto the show.
Welcome to another episode of Revolution Health Radio. This week I'm very excited to welcome Dr. Zoë Harcombe as the guest on the podcast.
Dr. Harcombe is a Cambridge University graduate with a BA and MA in economics and math. Zoë enjoyed a successful career in blue-chip organizations before leaving corporate life in 2008 to pursue her passion. Her early career involved international roles and management consultancy, manufacturing, and marketing in global organizations from FMCG to telecoms before specializing in personnel and organization. At the peak of her career, Zoë was vice president for human resources for Europe, Middle East, and Africa. Having written three books between 2004 and 2007 while being head of people, Zoë left employment to research obesity full time. This culminated in the publication in 2010 of The Obesity Epidemic: What Caused It? How Can We Stop It?
Zoë returned to full-time education in 2012 to complete a PhD in public health nutrition, which was awarded in March 2016. Her PhD thesis was entitled “An Examination of the Randomised Controlled Trial and Epidemiological Evidence for the Introduction of Dietary Fat Recommendations in 1977 and 1983: A Systematic Review and Meta-Analysis.” A number of peer-reviewed articles have emanated from this work, and the first was the 64th most impactful paper in any discipline in the year 2015. Zoë lives with her husband and rescue animals in the Welsh countryside surrounded by food, a.k.a. sheep, hens, and cows.
Now I'm really excited to talk with Zoë because she recently published a paper critiquing the U.S. dietary guidelines and the U.K. dietary guidelines for the lack of evidence behind their recommendation against eating saturated fat or limiting it to less than 10 percent of calories in the diet. And she, as I just suggested with her bio, has probably spent more time looking at this than anybody else. She wrote her PhD thesis, as the title suggests, on the evidence, or lack of evidence, rather, behind the dietary guidelines around total fat and saturated fat. And she went all the way back to the late 70s and early 80s to look at the studies that were used to create the original dietary guidelines. And then the second half of her paper looked at all of the research that has been published since then through 2016.
And as we’ll discuss in the show, the conclusion is that the dietary guidelines never really had any meaningful evidence behind them to justify restricting saturated fat back in the late 70s and the early 80s. And the same is true today in 2018. So I hope you enjoy this interview as much as I did, and let's dive in.
Chris Kresser:  Zoë, it is such a pleasure to have you on the show. We were just chatting before the show, and I can't believe we haven't connected by now. We walk in many of the same circles, and I’ve followed your work for some time. So I'm really, really grateful that you’re able to join us.
Zoë Harcombe:  Oh, I thank you so much for having me. I’ve just followed you for so long and your “nitrates in bacon” is my just absolute go-to blog. Stop, people, worrying about bacon.
Chris Kresser:  All right. Well, we’re going to talk a lot more about that and there’s so many things we could talk about today. But the main reason that I wanted to have you on the show is to talk about your recent paper critiquing the dietary guidelines both in the U.S. and in the U.K. related to total fat and particularly saturated fat. And everyone who’s listening to this knows that for many, many years, really, I guess about 40 years now, right? It goes back to about 40, 41 years now, we've been told that fat in general, although that's maybe slightly changing in the public perception recently and even in some of the dietary guidelines that fat in general is bad, and particularly saturated fat is terrible.
But as we’re going to discuss in the show, your research has shown that that's maybe not what the evidence actually says. So before we dive into that, why don’t you tell everyone a little bit about your background and how you came to this work.
Zoë Harcombe:  Okay, I’ll do a really quick one because I know you’re not sort of a three-hour podcast man. So I’ll give you a composite history. First fascination came when I was studying at Cambridge University in the late 80s, early 90s and started seeing obesity growing around me. And it was just a fascination to me because it's the last thing that people want to be. People do not want to be overweight, let alone obese, and it was just starting to explode and had already exploded in the U.S. And I was just fascinated.
So I wanted to understand, why do we have an obesity epidemic? When you start looking at why, you go back to looking at when, and you can't help but see, particularly on the U.S. graph, that it just takes off like an airplane at about 1976 to 1980, that pivot point in the NHANES data. And of course, therefore, you go back to look at that period of time. Did anything particularly happen? Did we suddenly start eating 10,000 calories a day and sitting around on our backsides? Well, actually, no we didn't.
Did you grow up hearing that saturated fat would give you a heart attack? You’re not alone. Check out this episode of RHR for an in-depth look at the science surrounding saturated fat with researcher and author Zoё Harcombe. 
And the UK data was particularly interesting. We seem to be eating fewer calories nowadays than we did back in the 1970s, when we were much slimmer. Barely any obesity in the UK by about 1972. And you then start looking at an event called the dietary guidelines, which came in with the Senator McGovern committee in 1977, and of course these were then embedded in the US Dietary Guidelines for Americans in 1980 and then every five years since. And there is debate.
There are people who will say the introduction of the dietary guidelines has nothing to do with the rise in obesity and type 2 diabetes and more beta conditions related to diet and lifestyle. But it at least needs to be looked at. I mean, I say it coincided with the epidemics in obesity and diabetes, and we need to therefore explore was that a coincidence or was it a factor that was material in the changes in our health. And I am one of the people who thinks it is material and that our shift to basing our meals on starchy foods, grains, fruits, vegetables, largely carbohydrates, being encouraged to consume as high as 60 percent of our diet in the form of carbohydrate, the one macronutrient we don’t actually need, I do think it has made a difference. And I’m not alone in that view.
And then of course you look at guidelines and say, well, what were they about? And of course, they were about restricting total fat to no more than 30 percent of calories and saturated fat to no more than 10 percent. And because they were only three things that we ate and because protein is in everything other than sucrose and oil, so it tends to be fairly constant in any natural diet, and the peer study showed this beautifully, nice evidence for this, protein tends to stay constant around 15 percent. So as soon as you set the fat guideline, you’ve automatically set a carbohydrate intake minimum of 55 percent. And that’s what we did.
So I wanted to understand why did we set that total fat guideline. If that was the thing that started everything, why did we do that? And did we get it right or did we get it wrong?
Chris Kresser:  So you have a BA and an MA from Cambridge in economics and math, and then in 2016 you got a PhD in public health nutrition. And what I find really fascinating is what you … tell us a little bit about your PhD thesis.
Zoë Harcombe:  Yeah, so the PhD thesis was using the relatively modern techniques, and they have been around since the 1970s, but we’re really using them a lot now. And that’s the systematic review and meta-analysis. And when we pulled together evidence from randomized controlled trials, ideally, if not from cohort studies, it’s considered to be the pinnacle of the evidence that we could examine. So I approached looking at the dietary fat guidelines in four ways. And one was to say, what was the RCT evidence at the time available to the committee? Had they looked at it back in …
Chris Kresser:  That’s “randomized controlled trials,” for those who are not familiar.
Zoë Harcombe:  Yes. Yeah, so the randomized controlled trial evidence available to the US committee in 1977, and then the UK committee deliberated in 1983, and that allowed one more study available to the UK committee that wasn't available to the US committee, and that was the Woodhill Sydney Diet Heart Study. And also to look at the epidemiological evidence available, had the committee chosen to look it at the time the guidelines were set? So that was the first two papers, the first half of the PhD. And then the second half was to bring it up to date and to say if the committees were deliberating again today and they had all the RCT, randomized controlled trial, evidence available and all the epidemiological evidence available we have today, what would the conclusions be, looking at it in an up-to-date scenario. And that was the four parts.
Chris Kresser:  Yeah, so you’ve spent, how many years did it take for you to get your PhD?
Zoë Harcombe:  Yeah, three and a half. I did it full time. I just decided to stop everything else I was doing and do it full time. And as anyone who’s ever done one meta-analysis knows, to try and do four …
Chris Kresser:  Yeah, that’s a lot of work. But the upshot here is that you have a PhD in public health nutrition. You spent the better part of four years examining the evidence base for the last 40 years connecting fat and saturated fat to health and disease. And this is exactly why I wanted to have you on the show to talk about this topic because it's one thing if you have a kind of armchair critic who's cherry picking one or two studies to make their point, which often happens on the internet, right?
Zoë Harcombe:  Yes.
Chris Kresser:  It's another thing to have someone who's trained at the level that you've been trained at who spent four years objectively looking at this evidence and then publishing on it and showing where it doesn’t add up. So let's dive into that now.
I want to start by talking about some basics because I think they’re really important. I love how you did this in your recent dietary guidelines paper. Just a few facts about fat that maybe not everyone is aware of or has thought about much.
Zoë Harcombe:  Okay, so I shared these in conference presentations and I was really pleased that when I did this, there’s peer-reviewed study. They didn’t get edited out because I thought they might be a bit chatty, if you know what I mean, for a peer-reviewed paper.
Chris Kresser:  Yeah, yeah.
Zoë Harcombe:  But I actually had a couple of nice comments in the margin of people saying, “Oh, good point, I hadn’t thought about that.”
Chris Kresser:  Yeah, yeah. I had the same reaction.
Why You Need to Eat Fat
Zoë Harcombe:  Oh, thank you. So the most important one is that we must consume fat. Human beings must consume fat. We die without consuming dietary fat. We must consume essential fatty acids, that’s why they’re called essential.
“Essential” in nutrition means something that we must consume, not just something that the body needs. And of course we have the fat-soluble vitamins A, D, E, and K, and they come in foods with fat. And they need fat to be absorbed. So that’s pretty vital. When people demonize fat to the extent that they do, they always give the impression that we could get away without eating this stuff. And we couldn’t. I don’t know how quickly we’d die, but we would. So we need it.
Number two, again, that people seem to realize particularly when they demonize saturated fat is that every single food that contains fat, and it’s actually quite difficult to find a food that doesn't contain fat, sucrose doesn’t. But not much else doesn’t. So every food that contains fat contains all three fats. That’s:
Saturated fat
Monounsaturated fat
Polyunsaturated fat
And only the proportions vary. So again, people talk as if we can avoid saturated fat and only eat unsaturated fat, and that is completely impossible unless you're in a lab and you’re trying to create single fats. It is impossible if you’re going to eat food, which I recommend that all people do.
And then the other interesting factoid, I love playing around on the USDA all foods database and just looking at things that add up and things that don’t add up. And it was a real surprise to me when I first started looking at foods that when it comes to food groups, there is only one food group that has more saturated than unsaturated fat, and that is dairy products. So your struggle to find a meat, and I have not yet found one, that has more saturated than unsaturated fat, typically the main fat in meat is monounsaturated fat. And that goes for lamb or steak or chicken.
Chris Kresser:  Even pork.
Zoë Harcombe:  Absolutely. And therefore lard, which I just love, because people just think lard is pure disgusting.
Chris Kresser:  Saturated fat, yeah.
Zoë Harcombe:  Saturated fat.
Chris Kresser:  If you were to put lard or coconut oil together, people would say lard would be the unhealthy choice from a saturated fat perspective. But of course, coconut oil is 97 percent saturated, I think.
Zoë Harcombe:  Yes.
Chris Kresser:  Something like that.
Zoë Harcombe:  And lard is 39 percent.
Chris Kresser:  Right.
Zoë Harcombe:  So nowhere near as bad. And that’s not saying that saturated fat is worse than unsaturated fat. It’s just stating a nutritional fact. The only food group that has more is dairy products. And then of course you’re getting to, “Well, are dairy products bad for us?” And it’s really difficult to think that they are when you look at the nutritional profile of dairy products and the bone nutrients calcium, phosphorus, vitamin D. Look at any profile of any dairy product and you can’t help but think …
Chris Kresser:  And the evidence.
Zoë Harcombe:  Yes.
Chris Kresser:  I mean there’s a ton of evidence suggesting that full-fat, but not nonfat or low-fat dairy are beneficial for both cardiovascular and metabolic health. And there was actually a new study recently published, I’m not sure if you saw it. I am less persuaded by it. Or you mentioned it, the PURE Study.
Zoë Harcombe:  Oh, yes.
Chris Kresser:  Because it has within-country or between-country comparisons, which I think we’ll be talking about later, is problematic. That was an issue with the Seven Countries Study. But it does align with many of the other studies that have been done on this topic previously, showing that when people eat more full-fat dairy, that's associated with lower body weight, with lower blood sugar and better glycemic control, and with lower risk of heart disease based on cardiovascular markers. And that's actually the reason that the full-fat dairy works better than the low-fat or the nonfat dairy in that regard because some of the nutrients that are thought to be beneficial for cardiovascular and metabolic health are in the fat.
Zoë Harcombe:  Yes, amazing.
Chris Kresser:  So if you take out the fat, you take out the benefit.
Zoë Harcombe:  Yeah, yeah.
Chris Kresser:  Yeah.
Zoë Harcombe:  Absolutely, I’m a huge fan of dairy, personally.
Chris Kresser:  Me too. I mean, of course if someone is lactose intolerant or they’re intolerant of the proteins, it needs to be avoided. But for people who are not, what I always say is at least the evidence that we have suggests that it's healthy when it's well tolerated by the individual.
Zoë Harcombe:  Yes.
Why the Paleo Diet Template Makes Sense
Chris Kresser:  So given this, given that fat is essential, that all foods contain all fats and that saturated fat is not even the highest percentage of fat in any food except for dairy, this leads us to some pretty interesting conclusions. You mentioned in your paper, which I loved, and I loved that they kept it in here too, it’s illogical that the same natural food would be both helpful and harmful. Like you can't eat a steak and eat it so that you're only eating the unsaturated fats and not the saturated fats.
Zoë Harcombe:  Yeah, yeah. There’s no other way of putting that. It just, it doesn’t make sense. Whether your belief system is in God or nature, food is provided around us on this planet, and it makes no sense that in that same food that we need to thrive and survive, something has been put that is trying to kill us at the same time as all the things being there that are trying to save us and enable us to live. And we’ve evolved of course over—I’m reading Sapiens at the moment, so there’s an argument over our heritage—but, I mean, we’ve certainly been around potentially since Australopithecus, Lucy, two-and-a-half, maybe three-and-a-half million years ago. And we’ve done pretty well eating anything we can forage or hunt around us.
Chris Kresser:  That’s right.
Zoë Harcombe:  The idea that they came up with in the last 40 years that this stuff is trying to kill us, it’s just so stupid.
Chris Kresser:  It doesn’t add up at all.
Zoë Harcombe:  Yeah.
Chris Kresser:  It doesn’t add up. So another example you used which I love because it really turns nutrition-dominant paradigm ideas on their head is the olive oil versus pork chop example. Tell us about that.
Zoë Harcombe:  Yeah. So I have a little postcard that I leave on the chairs at conferences, as well, so there’ll be many around the world. And I put up a picture of a sirloin steak, mackerel, olive oil, and mention the pork chop. And a couple of interesting, fun factoids. One is that the mackerel has twice the total fat and one-and-a-half times the saturated fat as the sirloin steak, which isn’t a problem because both of them are great foods. But of course we’re told not to have red meat and we’re told not to have oily fish. So that’s illogical.
And then olive oil has 14 percent saturated fat versus a typical pork chop might be only sort of one to two grams, but then people say, “Oh, you wouldn't consume 100 grams of olive oil.” No, but a tablespoon of olive oil has more saturated fat than a 100-gram pork chop. And again, we can make a mockery of nutritional advice when you know something about food.
Chris Kresser:  Yeah, I mean, and it’s easy to see how you could have a salad, if you have a big salad with a couple tablespoons of olive oil and dressing versus a 200-gram pork chop, you’re still eating more saturated fat there.
Where These Misguided Ideas about Saturated Fat Came From
So, I mean, this is so obvious when you look at it this way, and it makes you wonder, how did we get the idea that saturated fat is bad in the first place? I know there are some political and social roots of this, and feel free to talk a little bit about that if you want. But in particular, how did this arise from the evidence? What was your sense of that as you did your PhD and looked deeply at all of this?
Zoë Harcombe:  Yeah, so one of the most important chapters in the PhD is the review of the literature. And you go back in the review of the literature, and of course in this topic area, you’ve got to go back to the Russian pathologists in the early part of the 19th century, when they noticed the cholesterol deposits in the arteries of the autopsies that they were doing. So they started to hypothesize, had these cholesterol deposits actually caused the death of this relatively young person that they were performing an autopsy on, and could they come to any conclusions about those sort of cholesterol stores of fatty deposits?
And many people know this, it’s been said in conference presentations, that at the time they then started experiments on rabbits, feeding them foods containing cholesterol, feeding them purified cholesterol, to try to see if they could mimic the impact that they thought food might be having on the human body. And of course, as some people have worked out, rabbits are herbivores and the only foods that contained artery cholesterol are foods of animal origins. No exception. So you find dietary cholesterol only in meat, fish, eggs, and dairy, which are things that rabbits can't tolerate.
Chris Kresser:  Yeah, it’s strange. In a certain way, this almost supports what we were just saying. Eat a species-appropriate diet. The message there is not “don’t eat cholesterol.” It’s “don’t feed cholesterol to an animal that’s not supposed to eat it and don’t feed humans foods that we’re not supposed to eat.”
Zoë Harcombe:  Absolutely. And very interesting. When they fed purified cholesterol not in animal foods to the rabbits, they didn’t have any problems. And when they fed cholesterol foods to dogs, they didn’t have any problems because dogs are omnivores.
The Seven Countries Study
So we then wind forward to the 1950s, and Ancel Keys gets a bit of a bad rap in our world. I like to look on him in quite a more balanced way because he did some brilliant work, like the research starvation experiment. But he did kind of fall by the wayside a little bit on the fat thing.
So his first exploration was with the Russian experiments in mind to try to see if dietary cholesterol impacted blood cholesterol. And he concluded it did not, and he never deviated from that view. And the best quotation I found on that was from the 1954 symposium on atherosclerosis, and he said, “Cholesterol in food has no impact on either cholesterol in the blood or the development of atherosclerosis in man.” Which was brilliant because he had actually exonerated animal foods. But he didn't make that connection at the time. Maybe his nutritional knowledge just wasn't good enough and he just hadn't quite worked out, “If I’m finding nothing when I’m feeding human subjects,” because you could do that then with ethics, “human subjects massive amounts of dietary cholesterol via loads of animal products, they don’t develop any blood cholesterol problems and they don’t develop any signs of atherosclerosis,” he should’ve concluded, “I therefore just exonerated what I’ve been feeding them.” Which would be:
Eggs
Cheese
Meat
Possibly fish
But most likely meat, cheese, and eggs. But he didn’t. For some reason he was convinced that fat was the bad guy. If it wasn’t cholesterol in food, then it had to be fat in food. And yet again, having given his human subjects animal foods, he should’ve said, “What are the macronutrients in those animal foods? Okay, so it’s fat and protein. Dairy products have got a little, little bit of carbohydrate, but essentially what I've just fed them is fat and protein. So I should turn my attention to the one thing I haven't fed them, which is carbohydrate.” But he didn't do that.
So he was convinced that total fat was the problem, and of course we then had the Mount Sinai presentation in 1953, which gave us that famous Six Countries Graph, which has nothing to do with the Seven Countries Study. And then of course there were a number of countries that he'd left out. And Yerushalmy and Hilleboe found this out and unfortunately published a little bit too late, in 1957, saying, “Hey, hang on, you left out all of these other countries. And if you put them all on there it looks a bit like a spider scatter, that the pattern has gone. But the Seven Countries Study had already started in 1956. And Keys seemed pretty determined that he was going to come to the end of the Seven Countries Study and find fat guilty.
Now interestingly, and this is not terribly widely known, he could not find anything against total fat. So when, as part of my PhD, I pulled the epidemiological studies that were available at the time the guidelines were introduced, and of course the Seven Countries Study was one of those, and you’ve got Framingham and Honolulu, Puerto Rico, the London bank and bus study, and the Western Electric study being the others, none of those six found any relationship between coronary heart disease and total fat. So Keys acted. He went in with the total fat hypothesis. He accepted that it was not total fat. Now he had spent so much time and money on this study, he needed to find something. And he could find an association between saturated fat in the different cohorts, and coronary heart disease in the different cohorts. But at the same time he claimed, and this is in the summary paper, “I found no issue with weight, obesity, I found no issue with sedentary behavior activity, I found no issue with smoking.”
So things that we now know he was wrong about, we give him the benefit of the doubt on the one thing that he did find, which was saturated fat. And the other five peer studies, the ones I’ve just mentioned, did not find anything against saturated fat. And of course, they were all in country studies. So they were right, they were in community studies.
So you take Framingham. It’s a small town, it’s looking at people who eat a certain level of total fat or saturated fat versus people who don’t. So you’ve got all the other factors, or many of them, constant. You’ve got the same GDP, the same politics, the same community, the same access to healthcare. Go to Japan in the 1950s versus the US in the 1950s, you’re comparing efficiently.
Chris Kresser:  Completely different.
Zoë Harcombe:  Exactly.
Chris Kresser:  Not even apples and oranges. We’re not even in fruit category there. I just want to pause here and just highlight this for people who are less familiar with research and methodologies. What Zoë’s saying is that if you … the problem with comparing groups of people between countries is that there's so many factors that vary from country to country and lifestyle, physical activity, the type of foods they eat. Saturated fat comes in lots of different types of food. So what kinds of foods are people eating in the US versus in Japan, where saturated fat would be found in totally different type of food? So comparing between countries just makes the possibility of confounding factors and all of the other issues of epidemiological research, it just amplifies them and makes them even more likely. So typically, especially today, those between-country studies are often discounted or taken with a large grain of salt because it's so hard to control for factors even within the population, much less between different populations.
Zoë Harcombe:  Absolutely. Absolutely yes.
Chris Kresser:  Okay, so, I mean, this is … the crazy thing to me about this, Zoë, and I'm sure this struck you at many intervals throughout your PhD, is just how much of a house of cards the whole evidence base is behind the idea that saturated fat is bad for us. There’s this illusory truth fallacy that we were chatting about before we hit the record button, as well, which is the idea that if you hear something repeated enough times, you just start to believe that it's true, whether it has any basis in fact or not. And we think maybe that researchers and scientists are immune to this illusion. But the fact is, they’re not.
John Ioannides, one of the most famous epidemiologists in the world, one of my favorite quotes of his is, “Claimed research findings may often be simply accurate measures of the prevailing bias.” So, I mean, that sums it. He has all these pithy quotes that just sum it up in, like, 10 words. Which basically means that once you have a certain idea and it's out there because of groupthink and confirmation bias, that idea will often just be perpetuated, even if it was never based in fact in the first place. Because someone will link to that original study that turned out to be erroneous as proof, then someone does a later study and you link to that second study. And then it just becomes a chain of references that all point back to that original study that then it was later shown to be invalid. So it's crazy to me that 40 years of dietary policy has been based on such flimsy evidence.
Zoë Harcombe:  I should declare my own bias, actually, going in, because up until 2010 I’d been a vegetarian for about 20 years. Then my own bias going in was that fat was bad, saturated fat was bad, saturated fat equaled animal fat, which of course I now know absolutely that it doesn’t. All fats are in all foods, especially coconut oil, which is purely vegan. And I believed what I’d been taught at school, that we should be eating low-fat foods and healthy whole grains and plenty of fruit and vegetables. And I believed it too. And I was at a dinner party just a couple of weeks ago, and there were a couple of young people who were engaged and full of life and full of news and full of opinions.
And as we sat down to dinner, they were reliably informing me and my husband that they didn’t eat much meat because it was full of saturated fat, which of course it isn’t, and saturated fat is bad for you, which of course it isn’t. And I said, “You guys work in the finance industry. How did you pick up, how did you become authorities on dietary fat at your tender young years?” We had done a superb marketing job on fat and cholesterol worldwide and people have fallen for it.
Chris Kresser:  Absolutely. Yeah, yeah, and it’s deep. It’s really a form of conditioning. At least, I’m not sure what’s happening with with kids now, but I grew up certainly at a time where butter and eggs and all those foods were really demonized. And it becomes kind of part of your cultural conditioning, and it's so deeply hardwired in the brain, it can be really hard to let go of it. I, as my listeners know, I was a macrobiotic vegan at one point. So I took it about as far as you could go.
Zoë Harcombe:  Wow.
Chris Kresser:  And I remember in high school, I was an athlete and the whole carb loading paradigm. I was eating, like, bagels with nothing on them, like dry bagels and breakfast cereal with nonfat milk for breakfast, and eating pasta and pancakes before my basketball games because the thinking was that would be good for athletic performance and also good for my health.
So I can be pretty extreme when I go for something. I took it to the extreme and when I started to figure out, I mean, it took a very serious chronic illness for me to snap out of that. And even with that, I remember when I was first starting to eat more fat, I had this distinct feeling, like I was doing something wrong or I should do it behind closed doors, or that something bad was going to happen to me. And it took quite a while for that to unwind. So I think there’s that kind of deeper psychological influence happening here too.
Zoë Harcombe:  I’ve read your stuff on that. You write so, like it just happened yesterday. I mean you just describe it, and you just did it then. I could see you running around the track with your bagel. It sort of stays in your mind, doesn’t it, how we felt and what we thought we were doing when we did all of that stuff.
Zoё Harcombe’s Research on Fat
Chris Kresser:  Absolutely. So let's talk a little bit more. Let’s kind of dive in with a little more of a fine-toothed comb on your thesis and your review of the RCTs from 1977, the randomized controlled trials. Which again, if we’re looking at a hierarchy of evidence, it's not that RCTs are perfect or they don't have potential issues, but certainly when compared to epidemiological issues and all of the problems there, which we’ll discuss a little later, they are more reliable. So what did you find in your review of RCTs related to saturated fat and either death from all causes and death from heart disease?
Zoë Harcombe:  So this paper came out in February 2015, and it went nuts. And if you Google it, it was front page in New Zealand and in the UK papers. And I spent the whole day when it came out. The phone was ringing the second I put it on in the morning and it was the BBC, could I come in? And I ended up doing about 20 or 30 interviews that day, just back to back. And it just went nuts. So I think it went nuts because it was the unique part of the PhD that was looking at the evidence at the time. And so people were picking up on the idea that we’ve been eating low fat for 40 years and the evidence wasn’t there at the time to back up the call to do that.
So the major findings from that paper were first of all that there were only six studies, six randomized controlled trials that were available to the UK committee. Only five were available to the US committee, and they’ll be pretty well-known to people. It’s like the Rose corn oil, olive oil trial, the low-fat diet; the Leren Oslo Diet-Heart Study; the MRC soybean study; the Sydney Diet Heart Study; and the LA Vet study. And you pull all of those together, there is no difference whatsoever. Not even to just leak the significance, it was actually the exact same number of deaths in the controlled side as in the intervention side. There was no significant difference in coronary heart disease mortality, it wasn’t quite an identical number, but it was something like 221 versus 219, or something. It was so close. It was virtually identical, again.
A really interesting finding, and this just massively undermined the diet–heart hypothesis and was not a finding that we expected to come across. It just came out. We were able to measure the … Across the polled studies, there was a significant difference in cholesterol being lowered in the intervention studies. But of course that made no difference whatsoever between mortality or coronary heart disease mortality. And I then went on to try to understand why it may have been the case that cholesterol had been lowered by the intervention and not made any difference to health benefits apart from the fact that cholesterol is not bad for us. But why didn’t intervention diets lower cholesterol?
And I think it’s because the main intervention was to swap out saturated fat and to swap in polyunsaturated fat. And a lot of the polyunsaturated fats that they were putting in, corn oil, soybean oil, vegetable oils, contain plant sterols. And plant sterol is effectively plant cholesterol, and it competes in the human gut with the human cholesterol and it replaces it, to an extent. So if you take plant sterols in margarines or spreads or in vegetable oils or indeed in some grain plant products, or some people take them from tablets from the health food shop, which is a really crazy … they will replace your own cholesterol to an extent and lower your blood cholesterol. But I’ve looked at the evidence for the end outcomes on heart disease. I’ve got another paper on that that was published in an editorial, and that shows that actually the overall benefit is not there. It’s actually overall harm of administering plant sterols in the end outcomes of heart disease.
But I think that’s why they lowered cholesterol and perhaps the studies weren’t long enough for the harm from that replacement to actually manifest itself in a difference in outcomes. And I would then expect the interventions to have more deaths from heart disease and more deaths therefore from all-cause mortality.
One of the other really big aspects I think that grabbed the media is the point that we made at the end of the paper, saying that these six studies, when he pulled them together, amounted for fewer than two-and-a-half thousand men, not one single woman had been studied, and not one of those men was healthy. They had all had a heart attack already.
Why You Should Be Skeptical of Some News Headlines
Chris Kresser:  So this is just really key here. You cannot generalize, even if the results were consistent across all these studies, which they weren’t, implicating … Or it sounds like they were consistent in the opposite direction that people thought they were. But even if they had implicated saturated fat as increasing total and CHD mortality, coronary heart disease, that would only be applicable to men.
Zoë Harcombe:  Sick.
Chris Kresser:  With pre-existing, yeah, sick men.
Zoë Harcombe:  Yeah.
Chris Kresser:  Not women and not men that are not sick.
Zoë Harcombe:  Yeah, absolutely, yeah. And interestingly not one study called for change, and studies at the time were far more ethical, I think, than they are today. Far less media orientated, far less trying to get a press release. They would just say things how they were. And a couple of them were a bit nervous about potential toxicity of the fish oil that we’d administered, and they’re the ones that were a bit worried about … the corn oil study had more deaths in the intervention group, and said, “We’re worried about the potential harm from the fish oil intervention.” And the low-fat diet study, the last sentence of that study just cracks me up. It just says, “A low-fat diet has no place in the treatment of myocardial infarction,” which is heart attack.
Chris Kresser:  It's interesting to me what you just said that how much the, both the reporting on studies has changed in the media and also even the way that researchers talk about their findings themselves to the media. I think I was reading an article in Science that was published in 1993, and they were talking about relative risks, which we can get into more detail when we talk about epidemiological evidence. But this is the percentage increase in risk from a given intervention, and they were outside of nutrition, still today in any other field, epidemiologists would consider anything below a 200 to 400 percent increase in risk to be indistinguishable from noise, meaning they would consider anything less than a 200 percent increase in risk to be not significant statistically. And in this article, Marcia Angell, who is a former editor of the New England Journal of Medicine, was quoted as saying that, “They typically didn't really accept a paper unless it had a relative risk ratio of over three for nutrition.” And that just blew me away because today, like IARC's panel about red meat and processed meat causing increased risk of cancer, the percentage increase is 18 percent.
Zoë Harcombe:  Yeah.
Chris Kresser:  That’s not even remotely close to the 200 percent which is the lower end of the threshold. And yet the media headlines are not saying indistinguishable increase in risk observed in people eating more red meat. They come out and just claim causality. They say, “Red meat and eating red meat and processed meat is going to kill you.”
Zoë Harcombe:  And as Bradford Hill would say, “There’s nine criteria and that double is just one of them.”
Chris Kresser:  Yeah.
Zoë Harcombe:  “So hit the double and then you can look at the other eight.” But none of them hit the double, none today get anywhere close.
Chris Kresser:  Nowhere near and yet, and I think this is partly an artifact of the world we live in, just with, like, proliferation of the internet and so many headlines. Everyone's vying to get attention and so you have to … a headline that said, almost insignificant increase in risk observed in people who eat more red meat than other people. But of course there are other diet and lifestyle factors that we’re not considering. That's not to make a good headline, right? Nobody’s going to click on that. And so people want the flashy, clickbait headline saying low-carb diet will shorten your lifespan or eating red meat will give you a heart attack. Even though I would hope that the researchers themselves somewhere deep down know that that’s a gross exaggeration of their findings.
Zoë Harcombe:  Yeah.
Chris Kresser:  And as for the media, I guess it’s just that we don’t have science journalists anymore.
Zoë Harcombe:  We don’t. I do a note every Monday where I look at a paper from the previous week and dissect it. And you can tell, mostly the ones that get into the media have had a press release. And if you look at the press release and you look at the media article, the media have just taken the press release almost verbatim. The press release provides a couple of quotes, they end up in every single article. Completely lazy journalism. Occasionally they might call in the UK me or Dr. Aseem Malhotra or Dr. Malcolm Kendrick and just say, “Do you want to give an opposing quote?” and occasionally they’ll stick it in.
Mostly they’ll just run off the press release, and the researchers should be challenging the press release. I mean, our paper in February 2015 was press released, and I remember having a few toings and froings because I wanted it to be scientific. It’s a big enough claim in itself to say we only studied two-and-a-half thousand sick men, and then we introduced these guidelines for 250 million Americans and 50 million Brits. That’s okay, enough. We don’t need to sensationalize it anymore than that.
Chris Kresser:  Absolutely.
Zoë Harcombe:  So I tried to get it down to the facts that we found and not to put any spin on them.
Chris Kresser:  Yeah. Yeah, to your credit, I mean, that's so hard to do in this crazy media environment that we live in now. And to be fair, there are definitely researchers that make an effort to do that. And you still will see that in reports where, I was reading one on, I can't remember what it was, but it actually stood out to me because I don't see it as often as I do. I was impressed by both at what the researchers were saying and that the author of the article. Because they went out of their way to say this is just an association or correlation. It doesn't prove causality, and here are the reasons why it might not be a causal relationship, and why we need more research. But my sense of that is it's almost like when you watch, if you see a commercial for a drug and then you have like the 20 seconds of side effects after the 10 seconds of the commercial. People have heard that so many times they just kind of tune that out and they’re only really still paying attention to the headline.
Zoë Harcombe:  Yeah.
Chris Kresser:  So let’s talk. So you went back, you reviewed the RCTs from the late 70s that were responsible for creating dietary guidelines that, as you said, applied to hundreds of millions of people around the world and probably affected many more even just by osmosis. Those ideas becoming firmly entrenched in industrialized society, even if they weren’t part of formal dietary guidelines. And then you went back and analyzed all of the research that had been done from, was it from the late 70s to 2016?
Zoë Harcombe:  Yes, so we then took it up to date. And I actually said in the recent paper that’s just been published by the BJSM, the one on is saturated fat a nutrient of concern, and that’s because the USDA is now looking at it again for the next dietary guidelines. And I actually put in that paper that the day that the paper is saying there was no evidence at the time came out, I was astonished that Public Health England came out almost immediately on the day. I said, “Okay, so maybe there wasn’t evidence at the time, but we’ve got plenty of evidence today.”
Chris Kresser:  Right.
Zoë Harcombe:  I was surprised that they were prepared to concede. I thought they said, “No, no, no, this is ridiculous. The Seven Countries Study was marvelous and that’s all we need. And we can ignore everything else.” But they didn’t. They said, “Okay, there was no evidence, but there is plenty nowadays.” And of course it takes so long to get papers published that with my supervisory team, we’d already moved on to the next step, which was looking at the evidence available today. So we had that paper pretty much ready to go. And of course you keep in the original six studies, then you just add in any other randomized controlled trials that have looked at coronary heart disease, mortality, and total mortality. Those were our two outcome criteria so we wouldn’t lose some RCTs that only looked at events, for example. But then that then brought in the Women’s Health Initiative, the DART study, the STARS study, and the very well-known Minnesota Coronary Survey study.
Chris Kresser:  Zoë, before we go on I want to pause there. Let’s talk about why you chose total and coronary mortality as an endpoint and why that's important—to focus on the mortality endpoints versus just the events.
Zoë Harcombe:  Yeah, I’ve got to credit Dr. Malcolm Kendrick with this, and I am such a Dr. Malcolm Kendrick fan, it’s just not true.
Chris Kresser:  Yeah, me too.
Zoë Harcombe:  And I just remember, I mean, I’m fortunate enough to know him and consider him a friend and to meet him on occasions. And just every time I meet with him he says stuff and I'm just, why is this not just the only thing that’s being taught in medical school because it’s so sensible? So he’ll say, “I can guarantee that you won’t die from heart disease by pushing you off a cliff.” And it just, it then sticks in your head. Okay, so the important thing is total mortality because there is no point to reducing heart disease if you increase deaths of something else. So all this stuff going on with statins. Oh, we think we can reduce some events. We could have a whole different program on statins. But would there be any point in making any benefit anyway, even if they could, if they, for example, as they might do, increase your risk of cancer or dementia or mind health, etc., etc.? So it has to be total mortality. The only thing that matters is are you going to help people to live longer, to die later?
Chris Kresser:  Absolutely.
Zoë Harcombe:  That’s what we’re trying to do with health interventions. And so we’ve got to have all-cause mortality in there and then we’ve got to have heart disease mortality and not just events. Because that’s where the dietary fat guidelines came about. They were issued in the name of trying to stop deaths, particularly in men at the time, younger men at the time, from coronary heart disease. So if they’re not going to achieve that, then they’re not even going to achieve what they were introduced for. So why on earth were they introduced?
Chris Kresser:  Yeah, thanks for clarifying, and sorry to interrupt. But I'm banging on this drum all the time. I just want to make sure that people understand it because it's a crucial distinction. You frequently see headlines like “XYZ intervention reduces the risk of heart attack by 20 percent,” which again, as we just said, in an epidemiological study, that's meaningless. We can’t distinguish that from chance anyways.
But even if it's an RCT, then the first thing I’d do is go look at the table to see if they even measured total mortality. Which previously, that was less common. It’s more common now, I'm finding. But then when you look at total mortality, there is often no difference. So that’s where the disease substitution is happening that you were just talking about. The risk of death.
Zoë Harcombe:  A bit of gossip. Malcolm Kendrick wants to die from a heart attack.
Chris Kresser:  Rather than cancer?
Zoë Harcombe:  Exactly. Rather than cancer.
Chris Kresser:  Yeah, that’s what I tell people too.
Zoë Harcombe:  Yeah, he doesn’t want to go early, don’t get me wrong. He probably wants to go at sort of 98 drinking a glass of red wine, playing with his grandchildren when he gets them.
Chris Kresser:  Yeah. You just have a heart attack in your sleep overnight. You don’t wake up one morning. That sounds a lot better to me than dementia or Alzheimer’s or cancer.
Zoë Harcombe:  Yeah.
Chris Kresser:  So you don’t need to belabor this, but it’s really important to point out because I think it's something that people who are less familiar with research may not have thought of. So okay, so you chose total and CHT mortality, and I believe you ended up with 10 RCTs?
Zoë Harcombe:  Yeah. So the original six and then the Women’s Health Initiative, DART, STARS, and the Minnesota Coronary Survey, pull them all together, there’s no difference in all-cause mortality. There’s no difference in coronary heart disease mortality. Again, there was a significant reduction in cholesterol in the interventions that did not meet any difference in coronary heart disease mortality or all-cause mortality.
So essentially, all we did by adding in the former recent studies was that we increased the number of people studied quite dramatically. It came up into the tens of thousands, not least because the women’s health initiative alone brings along tens of thousands of people to the party. And of course it then became more female than male because of all the women in the Women’s Health Initiative. But we still in those 10 only ended up with one study including both men and women that would be a primary prevention study, so people who had not already had a heart attack, and that was of course the Minnesota Coronary Survey. And this in itself found no significant results at the time of publication and of course we then had that brilliant paper where … it should be on the tip of my tongue, the person who went back to look at this, Christopher, I’m thinking. You know the person I mean, who went back to look at the Minnesota Coronary Survey and also went back to look at the Sydney.
Chris Kresser:  Was it Hibbeln?
Zoë Harcombe:  No.
Chris Kresser:  No that’s Joseph Hibbeln and Christopher, they’re both the guys who have done a lot of the critique of the polyunsaturated fat research, or am I thinking of someone different?
Zoë Harcombe:  Oh, I’ll be kicking myself and don’t worry. Stick it in your show notes. But it’s a very well-known team that went back to look at both of those studies and even thought there was no evidence found against the dietary intervention at the time, they found that there was some unpublished data. And it just made it even more robust that we had been demonizing fat at the time. So all the RCTs as of 2016, and there haven’t been any since, and there’s still no more evidence than we had at the time the guidelines were introduced.
Chris Kresser:  Wow, it’s just, it’s really kind of remarkable, actually. And it’s again just going back to this idea that a lot of this evidence is really based on a house of cards. And as an example of the fallibility of these guidelines, the US in 2015 for the first time removed their advisory that we should not be eating dietary cholesterol. Because they finally acknowledged the cholesterol in the diet does not have any relationship with heart disease. And that was kind of like a pretty major thing that just, like, slipped through.
There weren’t really big announcements or any fanfare around that. Like, “Hey, everybody, we’ve been really wrong about this for the last 30 or 40 years and we just want to bring that to your attention.” And I even remember reading editorials written by scientists who were kind of still anti-saturated fat and cholesterol, and were saying things like, “We can’t really make too much of this because the public is going to lose faith in our ability to guide them with diet.” And I have a sense that the same thing is going to happen with saturated fat in the next few years. And maybe already people know this, but they're just not willing to do it yet because if they do, people will absolutely lose faith in the diet guidelines.
Zoë Harcombe:  Yeah, and they need to.
Chris Kresser:  Yeah.
Zoë Harcombe:  I mean, let’s face it, they need to lose faith. The best thing that they could do, the dietary guideline committees, would be to come out and say, “Guys, we were wrong. I’m sorry, we were wrong. And we’re going to get it right from now on.” And that would be the only way that we would start having trust in them again. But all this surreptitious slipping things out, then slipping things in, anyone who’s working in this field is just finding this completely unprofessional and noncredible.
 Why Dietary Guidelines Don’t Work
Chris Kresser:  I mean, this is a whole other discussion, but it’s worth pointing out that the idea of top-down, one-size-fits-all dietary guidelines that will apply to everyone is really not consistent with our understanding, our modern understanding of human biology, biochemistry, and physiology. And I think that this, the whole idea of dietary guidelines that would apply to everyone needs to just die. Because that has led to this reductionist approach, which one researcher calls nutritionism, I like that idea, which is that a nutrient is a nutrient is a nutrient no matter what it's found in.
Saturated fat in candy or pizza or junk food will have the same impact as saturated fat found in a steak or another whole food. And it’s led to this extreme focus on macronutrients and isolated food components rather than looking at the whole context of the diet. And that's starting to change slowly. There have been some pretty good studies in the last couple years. There was one, I’m sure you know which one I mean. It was looking mostly at weight loss and they compared, they designed a study that was comparing the effects of a healthier low-carb versus a healthier low-fat diet. And they found that both were actually pretty effective compared to the standard junk food diet that most people eat.
And we need more studies like that, and if we let go of this kind of one-size-fits-all approach, we might actually be able to start looking at the context of foods we’re eating, and then where maybe one person does need to eat more fat and fewer carbs and another person might do better eating a little bit less fat and more carbs from whole foods relative to that other person. So to me that’s one of the biggest assumptions behind the dietary guidelines that’s not mentioned.
Zoë Harcombe:  Yeah, that was the Gardner study, wasn’t it?
Chris Kresser:  Yeah.
Zoë Harcombe:  I corresponded that enough.
Chris Kresser:  Yes, the Gardner study.
Zoë Harcombe:  Yeah, very good study, yeah.
 The Epidemiological Evidence
Chris Kresser:  So let's just briefly touch on epidemiological evidence. I mean, there’s so many issues with observational nutrition studies. I don't know if you saw John Ioannidis’s recent review. It was published in JAMA and I’m going to pull up a couple choice … It was called “The Challenge of Reforming Nutritional Epidemiological Research.” And I’m going to read the first two sentences because they’re classic Ioannidis in how pithy and direct they are. It says, “Some nutrition scientists and much of the public often consider epidemiologic associations of nutritional factors to represent causal effects that can inform public health policy and guidelines. However, the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.”
Zoë Harcombe:  Oh, I couldn’t agree more. I just couldn’t agree, I mean, I had the privilege of seeing John present at the Food for Thought conference in Zurich, which was arranged by the British Medical Journal and Swiss Re, a reinsurance company, and he gave the, I guess you’d call it the keynote, after-dinner speech by videoconference into the conference hall where we were in Zurich. And it was uncomfortable, shall we say, for some of the audience.
Chris Kresser:  I could imagine. In an audience full of nutritional epidemiologists, probably didn’t like what he had to say.
Zoë Harcombe:  Yeah, largely. I mean, I sat near Nina Teicholz, and we were absolutely loving it. But I won’t mention any names, but a couple of nutritional epidemiologists did walk out.
Chris Kresser:  Yeah, yeah, I’m not surprised. It’s hard to consider, and there are ways that nutritional epidemiology can be done better. We can have more advanced data collection methods and an application of Bradford Hill criteria, which you mentioned, to increase the chance that the relationship between variables is causal. But the way it is now … there’s another critique that I love by Archer and he says, “For results to be scientific, data must be, number one, independently observable. Number two, measurable. Number three, falsifiable, Number four, valid, and number five, reliable. And these criteria distinguish scientific research from mere data collection and pseudoscience.”
And when you look at nutritional epidemiology, they do not satisfy those basic criteria for science because they're relying on data collection methods like food frequency questionnaires, which are just a joke. I mean, they’ve been so thoroughly debunked as a reliable way of assessing what someone is eating. We know that human memory is not an accurate reproduction of past events. It’s just basically a highly edited anecdote regarding what we ate. And we know that these approaches that are used to assess what people are eating in these studies are really not accurate and not reliable and don't fulfill the basic criteria of science.
So, I mean, we could talk a lot more about the problems with epidemiology, but I think let's, given the time constraint, let's just go on and talk with those caveats, those huge caveats. What did the epidemiological evidence suggest if it had been included in the original analysis that you looked at and then also since then?
Zoë Harcombe:  So we covered in some depth at the time that essentially it was just the Seven Countries Study that found anything. None of the six studies found anything against total fat, and then just the Seven Countries Study alone found something against saturated fat. When you bring the epidemiology up to date, and I actually did it, I had to do it in a different way in the fourth part of the PhD because they didn’t have data on current epidemiology and total mortality or coronary heart disease mortality. So there was going to be nothing that I could actually update the original studies with.
So I had to look at different measures of looking at any relationship that I could find with deaths and total fat or deaths and saturated fat separately. Of course they’re not interventions anymore. So you are into just this epidemiological base of looking at the fat intake in different regions or in different studies. So it was slightly different to the other three that were looked at, and they were completely different studies, and probably studies therefore that are less well known to people. They were certainly less well known to me. So things like the Ireland-Boston study, Kushi, the US Health Professionals, Lipid Research study that’s very well known. The Pietinen Finnish counts study, a UK health survey by a couple of people called Boniface and Tefft. She’s not very well known, this new heart study, and then the Gardner Japanese study, which is probably not too badly known within the field. And when you separate it out, look in it, coronary heart disease deaths, so we couldn’t get the total mortality anymore.
But we could at least get the heart deaths and align those to either the total fat, where it was examined, or the saturated fat. There was, again, no significant difference for coronary heart disease deaths and total fat or saturated fat consumption. We were back to a limitation of the pooled studies from those seven that I’ve mentioned being almost entirely male. So 94 percent of the people involved in those studies were male. They were at least mostly healthy. Almost all of them had not already had a heart attack, but there was still no relationship for coronary heart disease deaths and total or saturated fat. So there was then a fifth paper that I published with the BJSM that wrapped up the four studies.
So it went through essentially what we’ve gone through now, which is, what did I do, looking at RCTs then, RCTs now, epidemiology then, epidemiology now? What was found? What wasn't found, which was far, far more. And then an era that I suggest we’ll probably be heading into quite soon was to put what I’d looked at in context of other meta-analyses that had been done. Because I’m a PhD researcher, I was not straight out of finishing my degree. But I’m still just a PhD researcher looking at this evidence fresh in a systematic way.
A number of other people have also looked at the data in this field either for mortality or for events or for interventions or for epidemiology. And I therefore wanted to look at what everybody else had done to say have I found something different. Has everybody found this? Because you have to do that. You can’t come to the end of your PhD and say, “I find if I might drop the toast buttered 100 times out of 100 it falls on the butter on the floor,” if everybody else has found more (audio cuts out 59:06) it doesn’t fall with the butter on the floor. You’ve got to put your own research in context.
Chris Kresser:  That’s another core principle of science. Shapiro, an epidemiologist, said, “We should never forget that good science is skeptical science, and science works by experiments that can be repeated. When they’re repeated they must give the same answer.” So this is another core principle. So what did you find when you looked at these other meta-analyses?
Zoë Harcombe:  So the main ones that were pulled together, and there’s a great table in the paper five, which is one from 2016. I think it's called “Dietary fat guidelines have no evidence base: Where next for public health nutritional advice?”
Chris Kresser:  That’s a pretty straightforward title.
Zoë Harcombe:  Yeah, it is pretty straightforward, actually yeah.
Chris Kresser:  Not beating around the bush.
Zoë Harcombe:  They’re pretty good, actually. They help you with titles. So they come up with catchy ones.
Chris Kresser:  Yeah.
Zoë Harcombe:  And I then went through, for example, I got the tape in front of me, so you’ve got Skeaff and Miller from 2009 who looked at RCTs and epidemiological studies. And they looked at mortality and events for total fat. You’ve got a fairly well-known study with Siri Tarino and colleagues from 2010 looking at epidemiology of fatal and nonfatal coronary heart disease and cardiovascular disease. Mozaffarian, who I had the pleasure of meeting in Zurich over the summer, and his paper looking at just events, not mortality. We might come back to that one. And then of course you’ve got the two well-known Hooper studies, that’s the Cochrane research, which should be the gold standard, but we can take a bit of a better look at that one. And then you’ve got Schwing, Jacqueline, Hoffman from 2014, RCTs, and my own study. And then of course you’ve got the Chowdhury study that looked very interestingly at the four different types of fats, saturated fat, monounsaturated fat, polyunsaturated fat, and they included trans fats in their research looking at coronary disease for both randomized controlled trials and epidemiological studies.
Chris Kresser:  Right, and I’d like to read the conclusion of that one: “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”
Zoë Harcombe:  Here, here.
Chris Kresser:  So that was the Chowdhury, and then, so there were, I think, 39 total reports.
Zoë Harcombe:  Yeah, 35 non-significant. And we don’t shout that often enough.
Chris Kresser:  Yeah.
Zoë Harcombe:  If you stop—and I’ve done this for a Welsh TV program that I was working on—we went to Cardiff, which is the capital city of Wales, and we walked down the main street in Wales and we said to people, “What do you think about fat? What do you think about fruit?” And people would tell you, “We need to eat five a day and fat is bad for us.” So people have got the messages. But what we’re not telling them is when you actually look at all the evidence, 35 out of 39 results were non-significant. No findings. And that has to be the most significant thing that has been found, that we didn't find much. Why don’t we look at that more often? That’s so more powerful to me than the four findings. And if we just whiz through those. In the Chowdhury study that you mentioned, the one finding that they did make was against trans fats, and I don’t think you or I would give them any argument over that one.
Chris Kresser:  No.
Zoë Harcombe:  Mozaffarian, I really liked him in Zurich. But I was involved in a paper that critiqued his 2010 study which said, “You should replace saturated fats and polyunsaturated fats because there’s an impact on CHD events.” And our paper criticized that paper for excluding two studies that were not favorable to polyunsaturated fats, which was the Rose corn oil study and also the Sydney Diet Heart Study. And including, and it’s all bad studies, the Finnish Mental Hospital Study, which was not randomized, not controlled, crossover trial. I mean, just the worst possible trial to try and slip in to pretend it’s an RCT. So we critiqued that paper. I like to think he wouldn't publish that paper if he had the opportunity tomorrow. I can't speak for him, that wasn't right.
And that’s, of course, exactly what the Sax paper did last year, the American Heart Association paper. Again left out two unfavorable studies, the same two. Included the Finnish Mental Hospital Study, they shouldn't have done. And so basically, there were only two findings, and they boil down to one because it was the same research team, Hooper and the Cochrane team, working out of the east of England in the UK. One paper was from 2011 and the other was from 2015. And among 11 known findings for CVD, mortality, total mortality by modified fat, reduced fat, any kind of variation of fat, the only finding they could come up with was for CVD events when they looked at all RCTs for saturated fat reduction intervention. And we can get into that.
Chris Kresser:  Yeah, I mean, I think we can stop here at least in terms of the actual studies because it's, just to review what we've discussed, the randomized controlled trials that have been done since the late 1970s to today have not supported the idea that saturated fat increases the risk of death from heart disease, or any cause. The epidemiological evidence that has been done throughout that period does not support that hypothesis either. And even if it did, we'd still have all of the issues that epidemiological research, that make it problematic, like the healthy user bias and inaccurate methods of data collection, small risk ratios.
We talked about that earlier, how the increase in relative risk is so low that it doesn't really meet the threshold for assuming a causal relationship in any kind of epidemiology outside of nutrition, and even in nutrition 20 or 30 years ago. Other people who've meta-analyzed these data have come to a similar, if not the same, conclusion as you did in your research and your PhD thesis. And I just want to highlight something that you said about how the Finnish study, which is really not a good study at all, has been included in a number of analyses. And you might wonder why that would happen if the researcher is aware of its limitations and that it's not a valid study to draw any inferences from on this topic, why would it be included?
And again I’d like to turn to a John Ioannidis quote, and he says, “Consequently, meta-analyses become weighted averages of expert opinions. In an inverse sequence, instead of carefully conducting primary studies informing guidelines, expert-driven guidelines shaped by advocates dictate what primary studies should report.”
Zoë Harcombe:  Yeah.
Chris Kresser:  Doesn’t that sum it up?
Zoë Harcombe:  He’s so brilliant, isn’t he?
Chris Kresser:  So in other words, we start out with, the way that science should proceed is by doing experiments, and then if any guidelines are made, to make them based on these objective experiments. But the way it actually happens, a lot is we start out with a certain agenda and then we design studies that will return results that support that agenda. And anyone who's worked with data in any capacity knows how easy that is to do.
Zoë Harcombe:  Yeah.
Chris Kresser:  And it's not even conscious all the time. This is where confirmation bias comes in. It’s very difficult to guard against. I have to, and I’m not 100 percent, I’m not saying I’m 100 percent successful. But I can watch even myself. If I go and look for research on a particular topic and I have a certain idea, it's very easy to just skip the studies that don't support that idea. And that happens among scientists. It's a real cognitive bias that is very difficult to guard against. And I think it has a huge effect on research.
Here's another quote, this is from Casazza: “Confirmation bias may prevent us from seeking data that might refute propositions we have already intuitively accepted as true, because they seem obvious. For example, the value of realistic weight loss goals. Moreover, we may be swayed by persuasive yet fallacious arguments.” So again I come back to psychology. It's a real … we’re human beings doing this work, right? All researchers and scientists are not infallible. They’re human beings as well. Many of them have their own ideas and preferences about diet and nutrition. They’ve been influenced by many of the same things that we as laypeople or myself have been influenced by. And it really, really does affect the outcomes of this research.
Zoë Harcombe:  Yeah, yeah. I would agree with you. I mean I went in with a vegetarian, fat is bad, carbs are good bias. I am aware that I was so shocked by the things that I found when I started researching in this field, even before the PhD, you do then get quite skeptical and quite angry. And I now almost trust nothing. So every week I’m taking a paper from any kind of field, though mostly typically nutrition, and the low-carb study was one that I did recently, and then there was a weight loss drug that came out. And then I looked at red meat, the evidence because that was topical for something. And when I’m going in, I just assume that there’s going to be errors, and I’ve yet to find a published paper that doesn’t have something that you can point out as being really quite seriously wrong or disingenuous or open to interpretation.
Chris Kresser:  Yeah.
Zoë Harcombe:  I mean it’s really shocking. I saw on Twitter just a couple of days ago a guy, an academic, got so fed up with all the emails that you do get saying, “Oh, I really enjoyed this paper. Please can you write some papers for us.” Because papers are big spinners for the journals. He got so fed up with all these spam emails that he made up a complete nonsense study using Latin words that made something look really impressive, but it was basically saying something like, “If you do this with excrement, this happens.” I mean it was just, it really was, he was really taking the mickey and it got through peer review and he put it on Twitter. And he said, “I’m delighted to say that my complete nonsense article has just been published by this complete nonsense journal.”
Chris Kresser:  Yeah, and I’ve heard other experiments like that that have been done where a lot of stuff like that has made it through peer review. And there have been a lot of critiques of peer review and why it’s broken and the links to the money in the research industry. Marcia Angell, who I mentioned earlier, in the context of the relative risk who was the former editor of New England Journal of Medicine, has famously said that some, I’m going to paraphrase, but “I now no longer think we can believe any published research,” is basically what she said.
So yeah, I mean, I think it doesn't mean that research is not valuable. It doesn't mean that we have to just become, I think you can go too far with this where we just say, “Oh, forget it. There’s no point in even trying. Let’s just discount all research equally.” Because there are differences in the quality of research and there are still studies that are done well even if they're not done perfectly. And it's the best tool that we have, that we’ve discovered today to try to answer some of these questions, at least on a population-wide scale.
 Conclusions about Saturated Fat
So I want to close by just kind of going through some conclusions here. One, we’ve talked throughout that the evidence against total saturated fat is incredibly weak, if not nonexistent. But something we touched on briefly but I want to highlight here is that even if saturated fat were harmful, you have to consider the source of it in the diet. Get away from this reductionist approach where we think that saturated fat coming in different forms is going to have the identical effect. Because we don’t eat nutrients. We eat foods that have nutrients in them.
 And I love how in your paper you pointed out that pizza, desserts, candy, potato chips, pasta, tortillas, burritos, and tacos accounted for 33 percent of saturated fat consumed in the diets of US citizens. A further 24.5 percent was unaccounted for and collated as “all other food categories,” which is almost certainly processed food. And so as a result, only 43 percent of saturated fat came from natural foods like dairy products, nuts and seeds, and burgers and sausages. Although I'm guessing that the burgers and sausages had highly processed buns and sugary ketchup and other stuff on them too. So how can we even look at those things as being anywhere remotely similar, much less the same?
Zoë Harcombe:  Yeah. I mean I actually took out the processed meat in that section. So I got the natural foods listed down to cheese, nut butter, nuts, and seeds. And collectively together they accounted for 20.8 percent of saturated fat intake. But then I actually made the point it would’ve been ideal for the unprocessed chicken, beef, and eggs to have been separated from the processed meals because they always just lump them together. And they will always put, whenever there’s a study damning red meat, particularly in the US, it will always include hamburgers, which they are very firmly processed food in the UK, but for some reason seems to be considered as some sort of Paleo food in America.
Chris Kresser:  Right, right.
Zoë Harcombe:  And meat-type dishes, or something, which might be a curry.
Chris Kresser:  KFC.
Zoë Harcombe:  Yeah, exactly, Kentucky Fried Chicken.
Chris Kresser:  That’s the way most people eat chicken, KFC or chicken nuggets at McDonald’s. There’s your chicken.
Zoë Harcombe:  Absolutely, yeah. Or maybe a curry takeaway ready meal that you pop in the microwave and if it's got a couple of percent of meat in it, you’ve done well. You bought a more expensive one than the average, which doesn’t even bother putting the meat in.
Chris Kresser:  I mean, I’m … yeah, go ahead.
Zoë Harcombe:  No, and that’s the crazy thing because I want us to be able to have heated agreement. I don’t want to be fighting anyone out there. The whole world is much better if we get on and we’re in harmony than when we’re fighting over anything, whether that’s territory or politics or nutrition or anything else. So I would love for us to find a way forward. And I think there could be a way forward by saying, “Guys, can we have a heated agreement that we can demonize processed food?”
And I know there’s industry conflicts all over the place and we have to expose the industry conflicts with the guidelines set in committee in the UK, they are completely dominated by the processed food industry and grocery retail. I mean, it’s just horrific. If somehow we could get the conflicts out of setting health guidelines, which please, for goodness’ sake, must be objective. We must tell people honestly what is healthy. Not tell them what the food industry wants them to believe is healthy. That’s got to be step one.
Chris Kresser:  Absolutely.
Zoë Harcombe:  If we can get all of that nonsense out, surely then we could agree that real food has got to be better than processed food. And there might be some debate what’s real food. But if it’s found in a field, it’s found growing on a tree, it’s found in the natural environment … I said to my niece when she was five years old, fish swim in sea, fish fingers don’t. Breaded fish.
Chris Kresser:  If it comes in a bag or box, you probably shouldn’t be eating it.
Zoë Harcombe:  Yeah.
Chris Kresser:  I mean, of course, there are exceptions. Butter usually comes in a box, but yeah, that’s a general guideline, right?
Zoë Harcombe:  Yeah, we know what real food is. It’s the best-quality meat, eggs, dairy products, fish you can get a hold of, it’s vegetables, seeds, nuts, fruits in season. There will be some debate over legumes and whole grains and how recently they’ve been part of our consideration set, and I agree with your point, there’s not one diet fits all because some people just cannot tolerate grains and legumes and fibrous products, suffering from irritable bowel syndrome or celiac or other digestive conditions. But somewhere within that real food, total consideration set, surely we ought to be able to set some principles that people can follow that are not based on advice from the processed food industry.
Chris Kresser:  Absolutely, and I mean, I've said this so many times that Sean Croxton, who used to write in the health space, he came up with a diet advice that was JERF, he called it. J-E-R-F, just eat real food, which is, like, look, okay, we can debate about is it better, like you said, whole grains or legumes, in or out, saturated fat higher or lower, carbs higher or lower within this context of a whole-foods diet. But is there any doubt that if everyone ate real foods, we would decrease the burden of chronic disease and early mortality by something like 60 to 80 percent? I mean, I have no doubt of that.
And that’s again where this reductionist focus on nutrients completely isolated from the context of the foods that they come in has been such a disservice. Because imagine if we spent the last 30 or 40 years just hammering home the message that eating real, whole, nutrient-dense foods is really, like, if you want to simplify it for public health, like, that's the message. Don't even worry about those other finer points. And we would not, well there's a whole other discussion about whether people will actually follow that advice if you give it to them and given the influence of our brains with highly rewarding and palatable foods in the food industry and all of that. But there's no doubt that if people really did follow that advice, we probably wouldn't even be having this discussion right now.
The other thing about that is it is possible at least in theory to, like, if we really wanted to answer the question of is saturated fat harmful, the way we would need to do that is we would need to take two groups and they would both have to have the same baseline healthy diet that we’re talking about. Just eating real, whole foods, right? And then in one group, they would eat more saturated fat. And then we would, this is to be a randomized controlled trial, we’d lock them up in a metabolic ward so that we could control all of the variables that we know can influence health, or at least most of them, and then we’d follow them for about 15 or 20 years and see what happens. And the problem is that's never going to be done. I mean, that study would be hundreds of millions of dollars, if not billions, and no, Coca-Cola's not going to pay for it, right? I mean none of the, no drug company is going to pay for that study. So unfortunately, that study is unlikely to ever happen.
Zoë Harcombe:  Yeah, but “just eat real food” would work as a message until.
Chris Kresser:  Exactly.
Zoë Harcombe:  Yeah.
Chris Kresser:  Just eat real food, and then we can use other mechanistic studies and other lines of evidence and maybe even shorter trials to try to answer some of the finer points. And those trials should also include individual, should also pay attention to individual factors or genetic or non-genetic factors that might bear on the answer to that question, so that we don't then extrapolate the findings to everybody instead of just one group of people, for example. We know there are genetic polymorphisms that make some people hyper-responders to saturated fat and that can lead to an increase in LDL particle number. And the clinical significance of that is still controversial and debatable. But we know pretty certainly that that does happen.
So, but then if you were to extrapolate those results to someone that didn't have those genetic polymorphisms, that would not be a valid inference. So yeah, it’s just disappointing that, I mean, we know this and yet we still go on doing the same things over and over again. And I have to throw in one last Ioannidis quote which—from that more recent, or I think from one of his previous papers, and I'm going to paraphrase this one because I don't, let me see if I can find it—yeah, “Definitive solutions won’t come from another million observational papers or small randomized trials.” In other words, that was from a paper he wrote called “Implausible Results in Human Nutrition Research.” So in other words, doing the same thing over and over and expecting a different result is the definition of insanity, right?
Zoë Harcombe:  Absolutely.
Chris Kresser:  So, Zoë, thank you so much for joining me, and I know we went a little long, everybody, but I hope you enjoyed it and got a lot out of it. And I just, I wanted to have one podcast that we could direct people to to really answer this question and look at all the evidence on saturated fat in particular and its relationship with mortality and heart disease mortality. And I think we didn't cover everything, but I think we did a pretty good job of getting the most of it out there. So thank you so much.
Zoë Harcombe:  Oh, thank you. Can I just add one thing, because I think we just about completely nailed everything.
Chris Kresser:  Please, of course. Yeah.
Zoë Harcombe:  When we ran through the 39 results and found that only four were significant, and we dismissed Mozaffarian and we agreed with Chowdhury, and then the two Hooper results, which were just on the CBD events, we can actually put those to bed as well because aside from the fact that they’re events and they’re not mortality and we both agree that mortality is best, the thing that you have to then look at is why did Hooper find something different to all the other people? And when I went in detail, Hooper had actually managed to include four studies which involved only 646 people that were not about cardiovascular disease. And she’d asked the study authors if they happened to have data on cardiovascular disease events. So this was non-peer-reviewed data. That was the first thing.
When, and I owe Dr. Trudi Deakin in the UK, I always credit her for this finding, she spotted in the Hooper paper that when Hooper actually did as she should do, the sensitivity test on that one single finding, it was no longer significant. So the test that had to be done was not just which studies intended to reduce saturated fat or which studies actually did reduce saturated fat.
Chris Kresser:  A key distinction there.
Zoë Harcombe:  That’s really, really important, yeah. So Trudi looked at this and found that it is declared in the paper, but it’s tucked away on sort of page 158, or something.
Chris Kresser:  Right.
Zoë Harcombe:  That when the ones that were tested did actually reduce saturated fat only were included, there was no statistical significance and it was not generalizable because again in the whole of the evidence that was looked at by Hooper in either of those two papers, there was no single study of healthy men and women. But I think sensitivity tests apart from non-peer-reviewed data and apart from events, I think we can actually put that one to bed as well. So when you do that, because that’s the one that the other sites still try to hang onto. That’s the one that came up in the Professor Noakes trial when that’s down there for him as an expert witness. They tried to wave that in front of us and said, “Oh, see saturated fat is bad.”
Chris Kresser:  Right.
Zoë Harcombe:  So we hit them back with an, “Oh, no it isn’t.”
Chris Kresser:  What’s the data?
Zoë Harcombe:  Yeah, we kind of went in on the data. So there just is no evidence, and knowing the facts about fat, it would make no sense if there were.
Chris Kresser:  Exactly. And that reminds me of the recent low-carb study which you and I both critiqued on our blogs. It wasn’t a low-carb study. The people were eating something like 40 percent of calories is carbohydrate, not to mention the fact that they reported a calorie intake that was basically at starvation level, which would invalidate the entire data set. So you don't even need to go any further. I mean we did, but, like, that would've been enough, right? And all it takes is one major error like that, and it casts doubt on the entire data set and makes any kind of inferences that you would draw from it invalid. And I don't think people understand that enough.
Zoë Harcombe:  Yeah, I think critiques, I think the word you used there was quite polite. Actually, I think we both annihilated that study.
Chris Kresser:  Yeah, well it was.
Zoë Harcombe:  And a few other people as well, Nina Teicholz and Georgia Ede.
Chris Kresser:  Several, yeah. I mean, it was frankly like shooting fish in a barrel.
Zoë Harcombe:  Yeah, it wasn’t hard, that one, was it?
Chris Kresser:  Yeah, it was not hard. I’m just actually kind of shocked that that kind of study makes it through peer review and gets published, given all of those issues. So anyways, yes, thank you so much for doing all of the work that you do, Zoë. It’s such a pleasure to meet you, virtually, at least, and to be able to really just concisely and comprehensively go through all of these deficiencies in the evidence and to just make it clear for people that this, despite the fact that they've heard this probably for 30 or 40 years, depending on how old they are, and despite the fact that it still forms the basis of our dietary guidelines, there really is no evidence to support it.
Zoë Harcombe:  Yep.
Chris Kresser:  Fantastic. Well, where can people find more about your work, Zoë?
Zoë Harcombe:  Just ZoeHarcombe.com. So my surname is H-a-r-c-o-m-b-e. So that’s ZoeHarcombe.com. And as I say, I blog every week. That’s my sort of business model. So if anyone wants to sign up and get the newsletter, there is lots of stuff on open view. But if you do that, then you support what I do and you help me to stay independent because I don’t take any money from anyone for anything in any circumstance.
Chris Kresser:  Key. Absolutely.
Zoë Harcombe:  I just work away and come up with what I want to find. And I know some people are on the email list who are quite fans of whole grains, for example. And I know every time I write a newsletter saying I looked at this whole grains study and it really didn’t stack up, I know that I’m upsetting some people who are subscribing, but I have to go with where the evidence takes me and I have to report as I find. So that’s what I do.
Chris Kresser:  Yeah, yeah. I’m disappointing my readers all the time with my opinions and it’s important, I think, to stay true to what the data is showing and be as objective as possible about it. You’re one of the few people that I do follow regularly. I love reading your stuff, so everyone who’s listening to this, go check out the blog. It’s one of the most thorough and insightful sources on all of these topics that we discussed today.
And Zoë, we didn’t get a chance to go into much detail on red meat above and beyond its saturated fat content, which as we know is less than its polyunsaturated fat content. But Zoë has recently tackled that, the evidence behind red meat being associated with high risk of heart disease and death. And i'd really recommend checking that out too, because that's another persistent myth that continues to this day.
Zoë Harcombe:  Indeed.
Chris Kresser:  Okay, everybody, thanks for listening. Continue to send in your questions at chriskresser.com/podcastquestion, and we’ll talk to you next time.
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