It’s sad that after doing such a good job explaining the importance of proper studies and science in the selection of how one should eat, Minger concluded the book with recommendations based on her personal experience, and logical analysis along with anecdotal evidence, which she accurately states indicates no cause and effect relationship.

Obviously, I can only offer my opinion, which I formed reading research from all sides.
It doesn’t mean much in the grand scheme of things, but it’s all I have to offer.

“In your opinion, what changed starting in the late 1970s, when the modern obesity epidemic really takes off?”

In my view, fundamentally, overeating happened. Plain and simple. Of everything. Healthy and unhealthy.

In more details, I think a great many households stopped being responsible for preparing their own food and started to rely on external food sources to feed their owns. Prepared/processed foods, instant this/frozen that, dehydrated this/packaged that, restaurants, fast foods restaurants, take-out restaurants, etc.

People stopped buying their own ingredients, stopped preparing their own meals and started relying more and more on the food industry to supply their nutrition.

This probably happened as more and more women joined the workforce and found themselves in need of quick solutions to household nutrition. (http://www.npr.org/templates/story/story.php?storyId=120146408)
[Not blaming women here ; men should be equally held responsible for the nutrition of their families.]

Once this situation was established, market economics brought the concept of “food quantity to price ratio”. Food chains and food providers in general started to compete based on that quantity/price ratio. Consumers started to seek the highest quantity/price ratio, mostly following the prompts of advertising and “common sense” (Why wouldn’t you patron a restaurant that serves you twice as much food for the same price?).
This competition escalated to the point where people lost track of what normal servings truly are. Who really consumes 3/4 cup of cereal in the morning? Who does really consider a 4-ounce steak a “normal” serving of meat? (I once heard a patron yell at a waiter when he was served a steak that was less than 8 ounces.) You could go on with such examples until kingdom come.

All this overeating obviously led to ill health in its most common forms, obesity, diabetes, CVD, food allergies, food-borne diseases. The food industry did what it does best, it started to produce foodstuffs that hit all the bullet points highlighted by experts. Alas, you don’t go very far when you address the symptoms rather than the root cause. Granted, the food industry has nothing to gain by telling consumers to eat less or to take ownership of their food supply instead of relying on any industry for something as vital as nutrition.

So, there you have it, that’s my theory. I could show you a lot of graphs that correlate all of it, but correlation is a trivial way to “prove” anything.
In the end, you have to ask yourself, is that something that rings possible? What you do after that, is yours and yours alone to decide.

EF: Good points all the way around, although I would not be so quick to find the standard “high carb/low fat” nutritional guidelines to be blameless. How people follow/interpret recommendations in the real world is another good question. Being the paleo/primal type that I am, I would say any increase in population-wide grain consumption is almost by definition an increase in industrially processed foodstuffs, regardless of how the original recommendations were phrased.

I agree that people (on average) merely added more of the recommended foods and increased their total calorie consumption, rather than replacing meat/dairy with grains. So the question becomes: when people (on average) started eating more of the recommended foods and kept eating just as much of everything else, why didn’t all those extra calories make us feel full?

Are cholesterol/fats per se good or bad for us? Naturally-fatty _whole foods_ containing fats and cholesterol amongst many other nutrients appear to be quite good for (most of?) us for several reasons–these foods are nutrient-dense, are consumed whole or relatively unprocessed, and are quite satiating to the appetite.

In your opinion, what changed starting in the late 1970s, when the modern obesity epidemic really takes off? I ask this not just to be argumentative, but because I think this is a genuinely important question.

The recommendations may have increased the consumption of whole grains, seeds and seed oils, but the consumption of refined sugars, industrial, processed foods and artificial food stuff increased dramatically as well. The recommendations were not to eat more of that and keep eating as much of everything else. :)

I do not believe there is any “evil” food, be it fat or sugar, but ascribing an effect to a set of recommendations very few people actually follow consistently…is disingenuous.

In fact, I would say this: Even if you ask the Paleo or LCHF people to write the next food pyramid, the population at large will continue to eat as they always have.
30 years from now, will you be able to blame the Paleo/LCHF pyramid for a set of recommendations no one strictly followed?

All fad diets work using a combinations of these 3 approaches:
1) They remove something. (e.g., fat, sugar, carbs, meat, whatever…)
2) They add something. (e.g., some low caloric density food…containing lots of roughage)
3) They replace something. (e.g., fat with fruits, carbs with lean meats, candy with milk, whatever)

Without banning any particular food category, you can get positive results by studying where your daily calories come from. Logging your nutrition for 2 weeks will be an eye opener for most people.

Finally, yes, there are plenty of special cases, some IR people who should avoid carbs or fast carbs, some people who will do better being vegetarians for various medical reasons, some people who may not have the capacity to digest this or that nutrient for other medical reasons, etc. This being said, you cannot address entire populations using remedies that make sense for special cases.

Science is always waiting to be found faulty. If any of it stands the test of time, it becomes confirmed Science.
What you see happening these days is this: “Damn, cholesterol or fats were never linked to CVD! (which seems to be quite true) Ergo, cholesterol and fats must be good for you and should be preferred!”
Between these 2 statements, there is a leap from one “faith” to another. Yet, Science is not about believing, it’s about challenging beliefs.

We’ve had a concerted campaign of doctors and public health officials telling people to eat more grains, grain products, and seed oils. People today (on average) consume more of these foods than they did in the 1970s, both as a total amount and as a % of calories. So…the recommendations “worked” in one sense that people are consuming more of the recommended foods. What Minger points out is that these recommendations were based on faulty science to begin with, and have given us a raft of unintended consequences since then.

The usual caveats about correlation and causation.

In general, you can establish any recommendation, which most people won’t follow, because most people go for what is cheap to buy and fast to prepare, and then assign any ill-health to the recommendation.

That last part (avoid sugar & processed foods, eat nutrient-dense foods) is somewhat of a common ground between paleo/primal folks and vegans. Haven’t read the book yet, but it’s on my list.

Just read the critic of Denise Minger’s book linked to on healthylongevity blog, it itself is contains errors and misleading analysis. I believe the healthylogenvity blog is the one with the unhealth bias.

Thanks for sharing that. My general take as a non-expert on nutrition looking from the outside is that nutrition is fraught with disagreement and for anyone who takes one position there are others who will attack it and defend a different position. Some of the debates seem to get rather vicious. It’s one of the reasons why I rarely ever write about nutrition here – I have not read all of the literature and have no authority for giving out advice.

The reason why I liked Minger’s book is because I don’t feel that she advocated strongly for any one type of diet. She basically said that we are all a bit different and that prescribing a single diet as best for all people is not a wise approach. I felt that she took three somewhat different diets that seem to benefit people and essentially looked for what they have in common. She tied this in with historical data to give some general guidelines that people can experiment with. Never did I feel she was telling me I must eat meat (or abstain from it), go vegan/vegetarian (or not do that), or eat a Mediterranean diet. The only point I feel she made strongly was to minimize sugar, processed foods, and PUFAs. And to eat nutritionally dense foods.

http://healthylongevity.blogspot.com.au/2014/02/death-by-food-pyramid.html