In his recent book Good Calories, Bad Calories (Knopf, 2007) Garry Taube debunks the hypothesis that a low-fat diet is the solution for good health. This severe case of mistaken consensus, Taube explains, was foisted on us by a process called "cascade" in which a few highly placed individuals with sufficient self-confidence and clout are able to establish ideas that lack sufficient evidence.

Decades ago, it was predicted that switching away from fats and replacing them with carbohydrates would solve most of our cardiovascular problems such as heart disease, hypercholesterolemia, obesity and more. This view became one of 10 commandments of modern nutrition enshrined in Canada's food rules, which also emphasized cutting back on meat and fat, and increasing carbohydrates. But the massive evidence reviewed by Taube in his book shows that none of these goals have been realized. Instead, we have an even worse pandemic of obesity, cardiovascular disease and diabetes. But why is this surprising? If you need 2,000 calories a day yet follow low-fat eating regime, you have to make up these calories by eating other foods and these will usually be carbohydrates: sugars and products derived from refined flour.

The low-fat diet favored by medical institutions in the United States and Canada has increased the average intake of sugar and refined carbohydrates but has not eliminated disease. To the contrary, the evidence is massive that the major villain in degenerative disease and weight gain was and always will be sugar and refined foods that are converted into sugar in the body too quickly and absorbed too quickly. The modern diet is also characterized by too few of all important nutrients.

How could such a massive error have been made and imposed on the world? This is what makes Taube's book so interesting and valuable; it traces from the beginning the influences that led to this debacle. There was a relatively small clique of nutritionists, who, according to Taube, were neither scientists nor clinicians yet spearheaded the low-fat diet movement. The group included Professor Fred Stare from Harvard who once wrote that people would be much healthier if they doubled their average sugar intake from 125 to 250 pounds per person per year. Dr. Stare received very large annual grants from food industry giants whose products contained huge amounts of sugar. This clique also included Professor Jean Mayer, who, along with Dr. Stare, was violently opposed to orthomolecular medical concepts. These two doctors were as incorrect in their ideas about orthomolecular medicine as they were about the "benefit" of sugar-enriched diets.

In contrast to the low-fat theory that eventually became entrenched, prior to 1940, clinicians usually advised that one should decrease the amount of sugar and refined carbohydrates such as white flour and polished rice. Dr. TC Cleave was one such advocate; he was emphatic that a sugar-rich diet was responsible for a variety of conditions that he called "The Saccharine Disease". Taube provides an excellent review of Cleaves research and adds to it, referring to sugar's connection to the metabolic syndrome that is now so common.

Ever since reading Dr. Cleave's book many years ago, I have advised my patients to follow a sugar-free, refined-carbohydrates-free diet. If we all followed the dietary concepts of Drs. Stare and Mayer - two leaders in the nutrition field at that time - we would be eating tons of sugar, white flour and white rice; we would eat little beneficial fats and rarely any vitamins or minerals. Our chronically sick population would increase, the current financial sickness crises would get worse, and I would be even busier at my orthomolecular consulting practice.

Dr. Hoffer, now in private practice as a consultant at the Orthomolecular Vitamin Information Centre in Victoria, BC, was recently awarded the inaugural Dr. Rogers Prize for Excellence in Complementary and Alternative Medicine for his work using nutrition and vitamins to treat disease. www.orthomolecularvitamincentre.com

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