Butter or Parkay: How Medical Studies Confuse Doctors about Diet

“The truth is it’s a low tier, low credibility piece of trash observational study that belongs in the trash basket. You can learn nothing from this garbage study…. It’s a great example of the blind spot in academia, when academia is against MAHA and RFK Jr. they have a blind spot, they will publish any crap article that supports their view and that fights back.”

-Vinay Prasad, MD, Cancer Researcher at Washington University St. Louis, on the new article in JAMA Internal Medicine trouncing on butter and supporting seed oils.

Someone asked me once: it’s so hard to know what the best diet is. But really, it’s not too hard. We know how people eat who live far longer than we do—even without the trillions of medical care tossed at us. We know scientifically which diets reduce inflammation and thus reduce our vulnerability to chronic disease, cancer, heart attacks, and even death. But speaking with doctors, or surfing the internet, the benefits of diet seem to be confusing or even insignificant.

Just a few facts. Doctors receive no training in nutrition unless they pursue it on their own. They are often told in their training that fat and carbs are bad, and that diet is important but will never be enough. While many medical societies allude to diet as being important, doctors typically give lip service to that reality and instead leap upon the “let’s do some tests and give drugs and do procedures to fix what we find wrong” mentality. Where has that gotten us? The lowest longevity in the industrialized world, the most chronic diseases, the longest gap between disability and death, the worst COVID outcomes, and by far the highest cost. And somehow we celebrate our system as being the best in the world? We are the best at doling out drugs and filling our patients with metal objects like stents and defibrillators, and always telling our patients how sick they are by measuring numbers that we seek to fix, but somehow that doesn’t translate into good outcomes, just high profits for doctors and other players in the medical industry.

Conducting good studies on nutrition is tough, and so the studies that do emerge are often observational and junk. Back in the day, academic doctors were well paid to manipulate studies for the good of the food industry. Now most of their manipulation comes at the hands of the pharmaceutical industry, but too the food industry and even politics play a large part in determining what doctors research and what medical journals publish. In the 1950’s and 1960’s academic doctors conducted manipulated research at the bequest of the sugar lobby, the details of which we delineate and reference in our book A Return to Healing. They “proved” that fat and cholesterol were dangerous, leading to a proliferation of toxic products (such as margarines like parkay) and increased sugar consumption, all of which led to more chronic illness, more death, more medicines, more profit. The myth of a low-fat diet has largely persevered. But by turning to artificial fats, sugars, and not consuming health fats like eggs and nuts and oils, we’ve become sicker.

But there is a silver lining: sickness truly benefits the medical industry. Sickness equals profit. Not that doctors are deceiving their patients for money, but the information they are being fed and that they spread (as thick as parkay is spread on white bread) without vetting it has led to a proliferation of testing and drugging and procedures and hospitalizations, all putting money in the pockets of doctors and other players in our healthcare system. As one doctor in an audience told me when I gave a lecture about diet in heart disease: It’s a waste of time and money to talk about diet, easier to give a statin and some tests and then everyone is happy. In fact, a recent medical blog sent to me was entitled: “Is Wellness bad for Healthcare.” Well, yea it is, but it’s very good for your health, two goals that are often in binary opposition.

A recent study in JAMA shows the level of deception that has led doctors to disseminate bad information. I had written this blog before hearing a podcast from one of the smartest academic doctors in the nation, Vinay Prasad, and our views align, as do the views of any doctors with common sense and critical thinking skills. You can hear his podcast here, and it’s interesting on many levels if you listen to the whole thing. But the main issue that he and I address about this study is its conclusion that butter is more dangerous than seed oils, which we know is simply not the case.

What are seed oils? These are oils made of certain seeds, like rapeseeds (Canola Oil), corn, and soybeans. They are highly processed, inflammatory, and toxic. There is no doubt that they detract from good health. And yet they are healthier than butter?

Since the demonization of animal fats during the low-fat craze, nutritional science has done a full reversal. Fake fat—margarine—and seed oils are toxic, but animal fat is les so. Butter is animal fat, and while not necessarily contributing to good health, it is not dangerous. In fact, especially when grass fed, it can contribute to a good diet by steering us away from sugar and by filling us up so we don’t eat as much.

The JAMA study is utterly flawed on many fronts. First, it isn’t randomized. When it compares people who eat butter to those who eat more oils (including seed oils) it doesn’t analyze if the two groups of people differ in any other salient ways. We know from prior studies that many health-minded people may stay away from butter due to advice from the media or their doctors, but they exercise and don’t smoke and are generally healthier than butter eaters. It’s not the butter that causes bad health; it’s the other stuff associated with butter consumption. Just like a past blog that showed that Subaru drivers have fewer heart attacks than drivers of F-150’s—no, the car doesn’t make you healthier, but the demographics of Subaru drivers is far different than the people who tend to buy large pick-up trucks—the fact that something is correlated to bad health doesn’t mean it causes bad health. That’s the problem, which is why we need randomized prospective studies rather than junk observational studies like this one.

Second, while the study suggests that seed oils are safer than butter, they never determined if the only oils consumed were seed based. In fact, close analysis of the study shows that olive and avocado oils were also in the oil grouping, and those oils are anti-inflammatory and healthy. The very title of the article is deceptive since we don’t know how many seed oils are consumed in this study vs the other healthy oils.

Finally, it is clear that this study has political overtones, as are many studies published these days. The very fact that we are so focused on measles in kids—which has killed a tiny handful of unvaccinated kids—although kids are dying of so many other preventable causes every day is clearly far more political than medical. We should focus on true determinants of health rather than twist health outcomes to demonize a political appointee, which is what seems to be going on. Yes, let’s make it clear: Robert Kennedy believes that real foods like butter are healthier than processed foods like seed oils, but just because you don’t like him doesn’t make him wrong or justify a deceptive study. While we don’t know if this is why JAMA published this misleading trash, I can’t think of another reason, other than the fact that JAMA loves garbage nonrandomized observational studies which are easy to do, lead to stark results, and thus always get into the mainstream media.

So, when my patients lament that they don’t know what comprises a healthy diet, that’s upsetting. There is an amazing path to health through good eating, and those of us who have studied nutrition and who understand the mechanism of food as medicine know what that is. Doctors don’t, not only because it’s not on their radar and they receive no instruction in it, not only because it gets in the way of the prime directive of number-fixing and drugging patients, but also because of these studies.

The media is just as guilty. It simply buys what it is fed, it is largely financed by the drug and food industry, and it likes to scare people and be sensational. The result is more cost, worst health, but alas, more money for the medical industry. If your doctor doesn’t know about nutrition, or if she simply parrots what she is fed and can’t explain the mechanism of health derived from good food, don’t listen. Many good books exist about nutrition. My favorite is Fiber Fueled, but as we list in our newsletter, there are at least a half dozen more. Read the books, understand nutrition, and ignore these bogus studies that obfuscate the truth and confuse patients. Food is medicine. It’s the best medicine. But you have to understand why and how food works, something hard to ask your doctor or ascertain from the media.