CNN Op-Ed: Enriching the Debate On Dietary Fat

Dr. David Ludwig
3 min readOct 6, 2016


Normally, science advances by trial and error. When an experiment fails, researchers question assumptions, formulate new ideas and then design better studies. But the field of nutrition is having a hard time of this when it comes to the low-fat diet debacle.

As I noted last week in JAMA, conventional wisdom used to be that cutting back on fat would make us lean and healthy. However, things have not quite worked out that way, and Americans are struggling to adjust to a new dietary reality.

Fifty years ago, we consumed a high-fat diet, with whole milk, rich sauces and spreads, full-fat salad dressings, regular peanut butter and fatty meats. But this eating pattern came under persistent attack, as preliminary research suggested that the fat in our food would make us gain weight and clog our arteries. . .

Please follow this link for the full text of this op-ed at

For the related scholarly article, follow this link to JAMA

Additional References

On recommendations from the low-fat diet era to decrease all fats and increase all carbohydrates:

  1. Blundell JE, MacDiarmid JI. Fat as a risk factor for overconsumption:
    satiation, satiety, and patterns of eating. J Am Diet Assoc. 1997;97(7
    Suppl):S63–9. PMID: 9216571
  2. Hill JO, Prentice AM. Sugar and body weight regulation. Am J Clin Nutr. 1995;62(1 Suppl):264S-273S. PMID: 7598083
  3. Gibney M, Sigman-Grant M, Stanton JL Jr, Keast DR. Consumption of sugars. Am J Clin Nutr. 1995;62(1 Suppl):178S-193S. PMID: 7598076
  4. Astrup A, Raben A. Obesity: an inherited metabolic deficiency in the control of macronutrient balance? Eur J Clin Nutr. 1992;46(9):611–20. PMID: 1396479
  5. Stubbs RJ, Mazlan N, Whybrow S. Carbohydrates, appetite and feeding behavior in humans. J Nutr. 2001;131(10):2775S-2781S. PMID: 11584105

Recent systematic reviews showing superiority of higher fat diets:

  1. Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr. 2016;115(3):466–79. PMID: 26768850
  2. Mancini JG, Filion KB, Atallah R, Eisenberg MJ. Systematic Review of the Mediterranean Diet for Long-Term Weight Loss. Am J Med. 2016;129(4):407–415.e4. PMID: 26721635
  3. Sackner-Bernstein J, Kanter D, Kaul S. Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis. PLoS One. 2015;10(10):e0139817. PMID: 26485706
  4. Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):968–79. PMID: 26527511
  5. Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178–87. PMID: 23651522

Other related reviews

  1. Ludwig DS. Lifespan Weighed Down by Diet. JAMA. 2016;315(21):2269–70. PMID: 27043490
  2. Mozaffarian D, Ludwig DS. The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat. JAMA. 2015;313(24):2421–2. PMID: 26103023
  3. Ludwig DS, Friedman MI. Increasing adiposity: consequence or cause of overeating? JAMA. 2014;311(21):2167–8. PMID: 24839118
  4. Mozaffarian D, Rogoff KS, Ludwig DS. The real cost of food: can taxes and subsidies improve public health? JAMA. 2014;312(9):889–90. PMID: 25182094
  5. Ludwig DS, Willett WC. Three daily servings of reduced-fat milk: an evidence-based recommendation? JAMA Pediatr. 2013;167(9):788–9. PMID: 23818041
  6. Ludwig DS, Ebbeling CB, Livingston EH. Surgical vs lifestyle treatment for type 2 diabetes. JAMA. 2012;308(10):981–2. PubMed PMID: 22968885
  7. Willett WC, Ludwig DS. The 2010 Dietary Guidelines — the best recipe for health? N Engl J Med. 2011;365(17):1563–5. PMID: 22029977
  8. Ludwig DS. Technology, diet, and the burden of chronic disease. JAMA. 2011;305(13):1352–3. PMID: 21467290
  9. Ludwig DS, Ebbeling CB. Weight-loss maintenance — mind over matter? N Engl J Med. 2010;363(22):2159–61. PMID: 21105799
  10. Mozaffarian D, Ludwig DS. Dietary guidelines in the 21st century — a time for food. JAMA. 2010;304(6):681–2. PubMed PMID: 20699461
  11. Ludwig DS, Nestle M. Can the food industry play a constructive role in the obesity epidemic? JAMA. 2008;300(15):1808–11. PMID: 18854543
  12. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, Ludwig DS. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138–45. PMID: 15784668
  13. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002 ;287(18):2414–23. PMID: 11988062



Dr. David Ludwig

Physician, Nutrition Researcher, and Public Health Advocate. #1 NY Times bestselling author ofALWAYS HUNGRY? and ALWAYS DELICIOUS