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behind it were concerned with heart disease, not obesity. They presented no dramatic scientific data to support their beliefs, only ambiguous evidence, none of which addressed the efficacy of low-fat diets in weight loss. What they did have was the diet-heart hypothesis, which proposed that the excessive consumption of fat in our diets—particularly saturated fats—raises cholesterol levels and so causes atherosclerosis, heart disease, and untimely death. The proponents of this theory believed that Americans—and later the entire developed world—had become gluttons. Americans ate too much of everything—particularly fat—because we could afford to, and because we could not or would not say no. This overnutrition was certainly the cause of obesity. Eating too many calories was the problem, and since fat contains more than twice as many calories per gram as either protein or carbohydrates, “people who cut down on fat usual y lose weight,” as the Washington Post reported in 1985.
    A healthy diet, by definition, had suddenly become a low-fat diet. Beginning in the late 1980s with publication of The Surgeon General’s Report on Nutrition and Health, an entire research industry arose to create palatable nonfat fat substitutes, while the food industry spent bil ions of dol ars marketing the less-fat-is-good-health message. The U.S. Department of Agriculture’s (USDA’s) booklet on dietary guidelines, and its ubiquitous Food Guide Pyramid, recommended that fats and oils be eaten “sparingly,” while we were now to eat six to eleven servings per day of the pasta, potatoes, rice, and bread once considered uniquely fattening.

    The reason for this book is straightforward: despite the depth and certainty of our faith that saturated fat is the nutritional bane of our lives and that obesity is caused by overeating and sedentary behavior, there has always been copious evidence to suggest that those assumptions are incorrect, and that evidence is continuing to mount. “There is always an easy solution to every human problem,” H. L. Mencken once said—“neat, plausible, and wrong.” It is quite possible, despite al our faith to the contrary, that these concepts are such neat, plausible, and wrong solutions. Moreover, it’s also quite possible that the low-fat, high-carbohydrate diets we’ve been told to eat for the past thirty years are not only making us heavier but contributing to other chronic diseases as wel .
    Consider, for instance, that most reliable evidence suggests that Americans have indeed made a conscious effort to eat less fat, and particularly less saturated fat, since the 1960s. According to the USDA, we have been eating less red meat, fewer eggs, and more poultry and fish; our average fat intake has dropped from 45 percent of total calories to less than 35 percent, and National Institutes of Health surveys have documented a coincident fal in our cholesterol levels. Between 1976
    and 1996, there was a 40-percent decline in hypertension in America, and a 28-percent decline in the number of individuals with chronical y high cholesterol levels. But the evidence does not suggest that these decreases have improved our health.
    Heart-disease death rates have indeed dropped over those years. The risk of suffering a severe heart attack, what physicians cal an acute myocardial infarction, may have diminished as wel . But there is little evidence that the incidence of heart disease has declined, as would be expected if eating less fat made a difference. This was the conclusion, for instance, of a ten-year study of heart-disease mortality published in The New England Journal of Medicine in 1998, which suggested that the death rates are declining largely because doctors and emergency-medical-service personnel are treating the disease more successful y. American Heart Association statistics support this view: between 1979 and 2003, the number of inpatient medical procedures for heart disease increased 470 percent. In