True Health Initiative Releases White Paper on Seven Countries Study, Work of Ancel Keys

The True Health Initiative (THI), a 501c3 non-profit, and a global coalition of experts and influencers in lifestyle medicine and public health, has released a White Paper on the Seven Countries Study, and the work of Ancel Keys. Ancel Keys is among the most influential of nutrition researchers in modern history. His seminal Seven Countries Study in the middle of the 20th century was among the first to indicate that heart disease is potentially preventable by lifestyle means, and not an inevitable consequence of aging. The study further suggests a link between dietary sources of saturated fat, elevated blood cholesterol (LDL) levels, and coronary heart disease.

Long celebrated as a hero of modern public health, and appearing as such on the cover of TIME Magazine in 1961, Keys has been vilified in recent years in popular narratives in best-selling books and on the Internet for promulgating a “false” link between dietary fat and heart disease, and for promoting misguided dietary guidance encouraging a low-fat approach. In similar contexts, the Seven Countries Study has been criticized for biased methods and selective representation of the data and study findings.

The following four allegations are widely circulated, and routinely repeated: (1) countries were selected and excluded based on the desired outcome; (2) France was purposefully excluded because of the “French Paradox;” (3) dietary data in Greece taken during Lent introduced a distortion; and (4) sugar was not considered as a possible contributor to coronary heart disease. These allegations have been used to discredit Ancel Keys and the Seven Countries Study, and are routinely invoked in arguments disputing the association between saturated fat intake and cardiovascular risk.

Because of the importance of these matters to nutritional epidemiology, dietary guidance, and major public health objectives, the True Health Initiative commissioned a White Paper to examine the historical record and primary source material.

The roughly 50-page paper, written by a nutritionist and several Council members of the True Health Initiative, was reviewed and critiqued through multiple drafts by co-investigators of Keys from the U.S., and several other countries.

Primary source material and…

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