New study puts final nail in the “saturated fat causes heart disease” coffin

coffin

For more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.

Almost every day I read or hear about someone proudly that they have a “healthy” diet because they don’t eat butter, cheese or red meat or any other foods high in saturated fat (nevermind that red meat isn’t particularly high in saturated fat, but that’s a subject for another post). Or I might overhear someone at the grocery store saying how much they prefer whole fat yogurt to the low-fat version, but they eat the low-fat stuff anyways because they want to make the “healthy” choice.

What most people don’t realize is that it took many years to convince people that eating traditional, animal fats like butter and cheese is bad for you, while eating highly-processed, industrial vegetable oils like corn and soybean oil is good for you. This simply defied common sense for most people. But the relentless, widespread campaign to discredit saturated fat and promote industrial oils was eventually successful.

What if I told you that there’s no evidence to support the idea that saturated fat consumption causes heart disease? What if I told you that the 50+ years of cultural brainwashing we have all been subject to was based on small, poorly designed studies? And what if I told you that a review of large, well-designed studies published in reputable medical journals showed that there is no association between saturated fat and heart disease?

Well, that’s what I’m telling you. We’ve beed duped. Lied to. And we’ve suffered greatly as a result. Not only have we suffered from being encouraged to eat packaged and processed foods made with cheap, tasteless vegetable oils and refined carbohydrates (low-fat cuisine), but these very foods we were told would protect us from heart disease actually promote it!

The recent review I’m talking about is a meta-analysis published this week in the American Journal of Clinical Nutrition. It pooled together data from 21 unique studies that included almost 350,000 people, about 11,000 of whom developed cardiovascular disease (CVD), tracked for an average of 14 years, and concluded that there is no relationship between the intake of saturated fat and the incidence of heart disease or stroke.

Let me put that in layperson’s terms for you:

Eating saturated fat doesn’t cause heart disease.

There. That’s it. That’s really all you need to know. But if you’d like to read more about it, John Briffa and Chris Masterjohn have written articles about it here and here.

I wonder how long it will take for this information to trickle down into the mainstream culture? Unfortunately it’s not going to happen overnight. Paradigm shifts don’t work that way. But I’ve seen some positive signs, and I do believe the tide is turning. Let’s hope it doesn’t take another 50 years.

To read more about heart disease and cholesterol, check out the special report page.

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Heart Disease

Comments Join the Conversation

  1. says

    Totally agree with your comments. The only problem is that the margerine manufacturers don’t, and guess who has more money to buy more influence?

  2. Suzi says

    I’ve been doing low carb for about 15 years, and whenever I go off, I feel terrible. When I go off, I notice swelling and my joints hurt – I’m wondering how many people with fybromyalgia (or who think they have it) might be helped with a low carb diet. The gluten thing may be related too. What it all comes down to for me is that Nature or God or whoever you believe in seems to provide the best food for all animals – we would naturally eat meat and vegetables. Bread, rice, pasta (especially refined ones) are not a natural source of food – we created them, not to mention the fake fats, as you mentioned. Sure, the best way is to eat a balanced diet, but if I’m going to cheat, I think I’m better off with something high fat than something high carb. I think we’re going to see a lot more of these studies refuting the high fat myth.

      • Eddy says

        Suzi is probably trying to say that, relative to the meat, vege & fruit cavemen diet, bread, rice & pasta are relatively new & unntarual, as cavemen didn’t plant crops to harvest for wheat, to be further processed into such relatively modern food items.

      • Bon says

        it depends what kind of rice you get at the store. White, par boiled rice is junk… sorry but it is. Brown rice that hasn’t been touched is better, or brown sprouted rice is even better. Or the untouched rice of different variety, like wild, African black, etc.

      • dianne p says

        Unless you get your grain and rice direct from farmers you trust, none of these foods are natural in that over the years…they are manipulated and not worth eating if you are the kind of human than has no sugar nor gluten problems.
        The term ‘natural’ has become very very contentious to those of us who support farm to table eating. The middle guy like the giant food manufacturers will never provide natural foods unless they are non GMO and are committed to organics etc. I do trust a few manufacturers like Nutiva because I cannot make my own coconut oil…. and they do a great job.
        In other words…know your manufacturer.

    • dianne p says

      I had the same issue… dropping carbs that included grains, even whole grains made me feel weak and that is why I would go off my low carb eating. However, after eating clean for a few years, I still had some belly fat…so I dropped ALL wheat grains and traded for legumes. Raw nut snacking throughout the day with berries and make some dark chocolate from france.
      The belly fat is gone and believe me when I say I will never eat that way again.

  3. mary says

    high carb. diet
    and too much sugar intake, makes my body ache.

    if i eat a lot of sweets before bed, i wake up with a back ache

    • Nads says

      Oh my goodness, the same thing happens to me, I thought I was being silly, but glad to see someone else has the same outcome!!

  4. Anonymous says

    Not sure what research you’re reading but I think you’ll find there’s good evidence that diets high in sat fat OR processed foods are equally detrimental to health. Fresh ingredients, cooked from scratch in moderate amounts is the way to go – not very exciting I know but that’e where the REAL scientific evidence leads.

    • Anonymous says

      KTJS–most of the studies of which you speak are epidimiological studies–studies that demo correlation, not causation. If people are told year-in, year-out that saturated fat is bad for them, the only people that will eat saturated fat are people who are otherwise unhealthy (smoking, drinking, leading sedentary lifestyles, etc.) In other words, it is unhealthy people eating saturated fat, not saturated fat making people unhealthy that leads to study results that perpetuate a myth that had very little to do with promoting human health in the first place.

    • Sam says

      Why are you not sure what research Chris is referencing? It’s right in the article above. Numerous studies show NO link between saturated fat intake and heart disease. Do a search…..there is literally NO legitimate study that links saturated fat to heart disease.

    • Bill says

      Instead of being spoon fed the conclusions of these studies it might behoove you to dig into the internals and check their methodology. With an honest look you will see the bad logic and dishonest approaches- Bad Science. Salt was killing us according to the Gov and so called experts backed by scientific studies. What a laff- new studies show many not getting enough salt and most needed no reduction. Salt does not cause many of the things they claimed. Beware of holding to these feel good causes because disproof is around the corner.

  5. says

    Chris,

    I am 4 days into my 80-100 grams of sat fat per day diet. I got the bloodwork you recommended PRE diet but I will have to pay out of pocket to get it post. I may knock a few of the more expensive tests off of there sadly. It’s going well though feeling good. I just have to eat coconut milk to help me get the numbers because I am not hungry enough to eat that much grassfed beef. I will post an epic video of my feasts and the numbers as they come in. Thanks for all you do.

  6. Dwayne says

    Not to mention how good coconut oil is for you and its a saturated fat. But heres the kicker theres no cholesterol in it what so ever. And people that consume it loose huge amounts of weight.

  7. says

    Please, PLEASE show me a diet that includes SATFATS and is PROVEN to stop and reverse my heart disease.

    I am 51 years old and have TWO stents in my arteries after two “mild” heart attacks. I ate the usual fast food, american diet. Whether, my CVD was caused by SATFATS or REFINDED FLOUR? or TONS OF OIL? …I dunno. Probably all three. Please read on.

    After my first sent, in 2003, I started on the usual statin, low-fat lifestyle. But, after reading The Great Cholesterol Con and visiting http://www.westonaprice.org/ I was CONVINCED (just what I wanted to hear) this SATFAT thing was BS and I went on to joyfully eat copious amounts of butter, burgers, steaks, chicken, pork and any other kind of meat. Burgers twice a day? Why not? SATFAT is not gonna harm me. It’s ALL been a lie. Gorge yourself in SATFATS because they are harmless AND as the study shows above, there is “no relationship” between SATFATS and CVD.

    Last month I had another mild heart attack and another stent put in my RCA.

    Good times.

    Now, AGAIN, was it the SATFATS? GENES? WHITE FLOUR? REFINED OILS? Not sure. But, after reading the above article, I am “reassured” that I can go right back to eating burgers..as fatty as I can get them. Right?

    Isn’t that what the study and article implies?

    I am currently following a low-fat NO OIL (none period) vegan diet promoted by the book PREVENT and REVERSE HEART DISEASE by Dr. Caldwell Esselstyn. Vegetables, fruit and whole grains. Only.

    I won’t go into detail here, but his LONG TERM study of 18 patients with SEVERE, heart disease showed that following this way of eating STOPPED and REVERSED, yes I typed REVERSED, their heart disease. PROVEN. PERIOD. END OF STORY.

    Trust me, I am NOT a “pro-animal” nut job. (although I do love my two german shepherds) In fact, if you (Chris) or any one else can show me a PROVEN diet, PROVEN, that allows me to eat beef, fish, chicken, pork or any other creature and will STOP and REVERSE MY HEART DISEASE, I will start chowing down on the nearest animal near me. (except my two german shepherds)

    Unless and UNTIL there is such a diet that includes saturated fat (and oils) and can CURE me of my CVD. Then I don’t want to even BOTHER with the debate anymore. This diet will CURE me. Period.

    For those of you who will undoubtably respond with, “..I never said that SATFATS are harmless!” or “…well you ate TOO much SATFAT.” Well, I say which is it? Moderation? Which could mean a moderate amount of CVD? Or, if you think it was the OILS and not the SATFATS, well olive oil has 2 grams of saturated fat per tablespoon. So are oils good or bad?

    If you go by studies using the brachial artery tourniquet test, oils and satfats DO harm the endothelium of the the arteries.

    Look, it may be unclear what EXACTLY are the foods that cause or contribute to heart disease, but, this diet that I am on is the ONLY diet, that I am aware of, that will stop and reverse heart disease.

    Dave

    • Chris Kresser says

      You became aware of the WAPF and then ate burgers with refined flour buns cooked in vegetable oil twice a day, and you blame your subsequent heart attack on saturated fat? Sorry, that does not compute.

      There is no “END OF STORY” from a study of 18 people. Period.

      There are copious studies – which I’ve written about all over this blog – showing that saturated fat does not cause heart disease. Please show me a single study that shows a causal relationship between the two. You can’t, because there isn’t

      You can’t even show me long-term studies indicating that saturated fat consumption raises cholesterol levels. They don’t exist.

      I have many patients – including my father – who have reversed all indicators of heart disease by following a high saturated fat Paleo-type diet.

      Want proof this is possible? In this study in American Clinical Journal of Nutrition, they separated women into 4 groups according to saturated fat intake. Guess what? The women who ate the least saturated fat (and the most carbs) had the highest rates of heart disease, and the women who ate the highest amounts of saturated fat actually reversed their atherosclerosis.

      I’m sorry to hear of your struggles with heart disease, but you can’t blame it on a high-fat diet free of refined flour and seed oils, since that’s not what you were doing. There are many, many people doing just that who are thriving without heart disease.

      • says

        Chris:
        They study concludes: “In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression.”

        Less progression. Not halted.

        Chris, I have documented heart disease. You are comfortable with telling me that I can choose a diet high in saturated fats, (but with no refined carbs or sugars) and my disease will stop and reverse?

        Dave

        • says

          BTW, Chris Esselstyn’s program forbids simple carbs (flour) and vegetable oils. Not just saturated fat. So he is trying to eliminate all factors.

          I agree, I turned a blind eye to the “white flour buns” and “vegetable oils”, and I do agree with the studies you mention above. In fact, Anthony Colpo and I have exchanged emails often on the SATFAT/HEART DISEASE paradigm.

          I made an attempt in my original post to acknowledge that I am UNSURE about what dietary factors continued my CVD. Plus, I do miss eating animal fats.

          Still its hard for me to ignore studies that show, “The consumption of high-fat foods causes damage to the endothelial cells, inhibiting nitiric oxide production, and begins the cascade of events leading to heart disease.” ~ Dr. Esselstyn

          Read more at Suite101: A Single High-Fat Meal Impairs Cardiovascular Function | Suite101.com http://www.suite101.com/content/a-single-high-fat-meal-impairs-cardiovascular-function-a370227#ixzz1SKiUFZlI

          It’s hard to keep a clear path with so many conflicting studies.

          Dave

          • Chris Kresser says

            That is exactly why Esselstyn’s program works to the degree that it does: because it removes flour and vegetable oils.

            And that is why you can’t draw any conclusions from studies that don’t control for confounding variables, like Esselstyn’s and Ornish’s. Sure, if you take a bunch of people on a Standard American Diet and put them on a vegetarian diet that removes flour, seed oils and sugar, they’re going to feel a lot better. But that doesn’t prove it had anything to do with removing saturated fat. In order to know that, you’d have to have a control group that also removed flour, seed oils and sugar, but continued to eat saturated fat. And guess what? We do have a few studies like that. They compared the Mediterranean Diet with the Paleo diet, and the Paleo diet produced more significant improvements in blood lipids, blood sugar and other cardiovascular risk factors. Here’s one, and here’s another.

            Esselstyn’s claims don’t hold water, because they’ve never been verified in well-controlled studies. If saturated fats “lead to the cascade of events causing heart disease”, then why (after more than 40 trials) are there no studies that show any causative relationship between the two? And how is it possible, then, to have traditional cultures like the Inuit and Masai who get between 70-90% of their calories from saturated fat, and have no heart disease whatsoever? There are so many problems with Esselstyn’s argument it’s hard to know where to start.

            • Heather says

              this is old and maybe someone already posted: that article about the high-fat meal impairment? The high fat meal was a sandwich consisting of bread, whole milk (12g of sugar per 8oz. and ice cream – which is loaded with sugar). Yet it was the fat that impaired.

              The risks associated with one high-fat meal

              The study in the Journal of the American College of Cardiology evaluated systemic arterial compliance at regular intervals following the consumption of either a low-fat or high-fat meal. Arterial compliance is the measurement of the arteries’ ability to expand in response to increases in blood pressure as the heart pumps. Participants in the study were separated into two groups. The first group consumed a meal consisting of 67% of calories from fat in the form of a ham and cheese sandwich, whole milk and ice cream. Significant impairment was seen within six hours after the consumption of the high-fat meal as arterial compliance fell 27%.

              The second group consumed a meal consisting of cereal, skim milk, and fruit, a meal consisting of 10% of calories from fat. At six hours, there were no significant changes in arterial compliance in this group. This study highlights the detrimental effects of a single high-fat meal on cardiovascular function. Despite its surprising findings of the effects of one high-fat meal, this study does not stand alone in its implication of a high-fat diet and cardiovascular disease.

              Read more at Suite101: A Single High-Fat Meal Impairs Cardiovascular Function | Suite101 http://suite101.com/article/a-single-high-fat-meal-impairs-cardiovascular-function-a370227#ixzz2M28EXJX8
              Follow us: @suite101 on Twitter | Suite101 on Facebook

        • Chris Kresser says

          Here’s a slide from one of my presentations with a chart from that study. Notice that in women in the fourth (highest) quartile of saturated fat intake, the progression of atherosclerosis reversed.

          Yes, I’m completely comfortable telling you to eat saturated fat with heart disease. Heart disease is caused by inflammation and oxidative damage – not by saturated fat. I’ve written an entire series on how to minimize dietary and lifestyle risk factors that cause inflammation and oxidative damage. That is what you should be focused on. But you have to make your own decision, of course. I don’t provide medical advice to individuals over the Internet, and this should not be construed as such. I am simply educating you and explaining what the (good) research says.

          • says

            I think oxidation and inflammations are key here to notice.

            However, we, humans can’t avoid oxidation completely. Even the air we breathe oxidizes us which means we progress towards death from the day we are born.

            Having said that, I have been reading about “anti-oxidants” such as water, omega acids, fish oils (salmon,cod) , green tea, Tulsi , Turmeric and few other herbs that slow down the oxidation process.

            How is your take on these “anti-oxidants”?

        • Mary says

          Dave you must do independent research. Most people with heart disease have normal cholesterol levels. Heart disease is caused by inflammation. This is why so many diabetics risk developing heart disease as well. Cholesterol protects against inflammation but many people, especially doctors remove this protectant, exposing themselves to more inflammation.

      • Rob says

        “You can’t even show me long-term studies indicating that saturated fat consumption raises cholesterol levels. ”

        Kris,

        I don’t know nor do I care if there are any such studies. I KNOW for a fact that saturated fat raises MY cholesterol, especially my LDL. It was never more clearly demonstrated than when I was on a LCHF diet. I kept my carbs around 50g/day. Over the years, I’ve kept copies of all my blood tests. I can see plainly how diet affects my test results. For me, that is the ONLY “study” that matters.

        • Mary says

          Rob, I would love to see copies of your blood tests. Show me that your cholesterol / triglyceride levels worsened. Note that I said worsened.

      • Casey says

        Chris, you comment that you can’t give medical advise on over the internet. Shouldn’t you disclose that you should not give MEDICAL advise to anyone since you are not qualified?

        Also, you put down the fella who had a study with only 18 in it yet you preach on and on about a pale study that had fewer than that and even rave about a study (a small on that is more of a hypothesis driver than one to rely on) about postmenopausal women who already have heart disease. (for those who don’t know, how you metabolize nutrients depends heavily on your state of insulin resistance, age and hormones) So this study hardly apples to anyone.

        Maybe you should post some high quality studies that clearly demonstrate that diets high in saturated fats are good for the heart? What is that you say….you can’t

        • Casey says

          Lot of studies suggesting the negative impact of saturated fats on lipids and chemical mediators and messengers. The difficulty is when we look at epidemiological data and how it bears out. I fully agree with you and saturated fats though. All the data on exchanging polyunsaturated fats for saturated fats suggests that you are better off with more Polys and less saturated. I would also like to point out to anyone who does believe that saturated fats may not be that bad that just because you don’t think they are bad means that they are good. There is no data to suggest that.

    • Richard says

      Dave you are going in the right direction….stick to that whole plant-based diet with 5 to 10% good fats like flaxseeds, walnuts or a small amount of wild salmon once a week and you will reverse your heart disease besides lowering your cholesterol and blood pressure.
      The above article has too much BS in it to separate the wheat from the shaft so it is just best to ignore the whole thing and still with your plan. Esselstyn and Ornish have been successful in reversing heart disease and did not do it by pushing any kind of fat or simple carbs. Maybe this or that is wrong in their plans and they restricted too much but better to get the right results and learn twenty years later exactly what caused your arteries to gum up…

      • Jenny says

        I think you mean “separate the wheat from the chaff”.

        It might be helpful to go back and review the process of plaque formation, since you seem to have the wrong idea if you think arteries “gum up”.

    • feo says

      Your tendency to use ALL CAPS indicates anger…… you might want to check into the connection of emotions to heart issues. The connection is much stronger there.

    • dianne p says

      Hi Dave…
      My doctor thinks I have heart disease because my sugars were elevated but pre-diabetic, although she is black and white about that. She wanted me on a statin and I asked how long and she said forever. Well, that did not sit well with me.
      I embarked on a 4 year health turnaround.
      Like yourself, I tried low carb, high carb, low fat, high fat when i did Atkins.
      For 20 years I had elevated blood sugars and cholesterol yet no progression. This time I was on a reverse pre-diabetes.
      It was simple actually…. use stevia, NO sugar, no aspartame, hence NO soda pop. Yep, I drink water with lemon or lime now.
      I eat clean almost exclusively …. fruits, veggies, raw nuts, organic eggs, plain greek yogurt (can make your own heaithy smoothies with berries and veggies (fruit trumps veggies when it comes to making smoothies that taste good, organic milk, 100% nut butters, make my own humus and always eat a fat with every meal or snack. Instead of grains I eat legumes.
      My only fats are virgin coconut oil for hot foods, non fake olive oil for cold foods. I do eat other saturated foods like avocados.
      I hope this gives you the perspective that only you can design your health diet for life.
      Read labels and do not buy packaged foods frozen or otherwise.
      Learn about pH and why eating alkaline stops diseases.
      Learn about GMO foods and why they are dangerous, especially corn, soy, sugar, canola etc.
      Basically I eat the mediterranean way of eating.
      If you think it is too restrictive, play with herbs, and high fiber foods.
      I have 2 desserts but sparingly; figs and dark chocolate and believe me when I say, love my food.
      A respected doctor who understands nutrition said it is 80% diet and 20% exercise.
      Last year the head doctor read my chart as I had to see him and not my regular doc… and he made my day, week, month and year when he looked at me and said your diabetes is gone.
      You have no choice but to find your own way now…. and trust your body…. it will respond to your not eating food that is not really food such as the fillers and chemicals that are lurking in all packaged foods.

  8. Ali says

    I’ve listened to your long podcast on cholesterol and sat. fats. It was good, but i am concerned that there might be some information missing that readers might need to be aware of in order to make an informed decision about consumption of sat. fats. In the podcast, your guest explains that the problem essentially starts in the membrane of the LDL particle. He says that polyunsaturated fats in that membrane incur oxidative damage which then makes them a danger. But he then skips to talking about the relative safety of sat. fat anf doesn’t fully address PUFs. If PUFs are in the membrane, are they there naturally? What is the normal composition of the membrane and how does eating sat. fats improve the membrane’s resistance to oxidation? Because if the membrane is normally composed of PUFs, then i am concerned that eating sat. fats isnt really helping anything, and may actually harm you because of the increase of cholesterol in circulation.

  9. Ali says

    I would also like to ask whether there are clear “PREREQUISITES” for eating sat. fats. I feel there are a lot of people out there debunking “conventional wisdom” on the issue, but not providing clear guidanceas to what you need to do BEFORE it is safe to consume a half pound of bacon at breakfast. And if we, in our modern world, are simply unable to meet all those prerequisites, can we still say it is safe to consume sat. fats beyond a certain level? For instance , if driving daily in LA consistently and predictably elicits a stress response that negatively impacts the true causes of heart disease, then would it be better for those people to avoid eating a lot of sat. fats? Or if a person is unable to keep a proper balance of Omega 6 & 3 because of cost and unavailability of healthy foods, should he or she be consuming sat. fats? Or would other dietary recommendations be more appropriate.

    • Mary Titus says

      THe point is saturated fats are healthy so “YES” to saturated fats. No, to omega 6s/ I have no problem consuming bacon, cream, butter, coconut oil, palm oil and my health thrives from it. If you can’t afford the good stuff, just begin buying less. Many doctors put their patients on a diet high in sat fats to prepare for open heart surgery.

  10. kim says

    Doctors who have done bypasses inquired about patients diets & let^s say this,it wasn^t exactly rich in fruits & vegetables.Remember its the oxidization of cholesterol that is a threat. How do we prevent oxidization ? Alcohol in moderation—increases HDL,reduces small particle LDL,reduces c reactive protein,thins blood,anti inflammatory.Then there^s Vitamin C,powerful anti oxidant that prevents the oxidization,found in fruits & veggies.As far as meat goes,yes enjoy but in moderation

  11. Anonymous says

    The Inuit and Masai have short life expectancies – so I am not gonna rush and go on either one of their diets, sorry. However, water quality etc may also play a part.

    You are making a subject even more confusing than it actually is. The key is a disease free and disability free longevity. You will not find many people collectively who consume high amounts of saturated fats living a disease free and disability free life. Long livers are people that thrive on natural unprocessed foods, period. And if they have meat or dairy, it is A) usually their own animal b) milk is from their own animal c) it is in extreme moderation.
    I have heard all the bling blang about saturated fats not causing heart disease, but seriously, you just won’t find hardly any people who only eat quality saturated fats with no vegetable oils, flour or refined sugars. It is alos too difficult for the average person to obtain quality saturated fats – and to understand it! When people eat crap, they eat it all – and when people are healthy, they stay away from it. The first time I heard someone convincing me that it is the fruit that makes people fat, not the meat, I almost fell over laughing -Particularly when she was fat herself!! Yep, that saturated fat thing sure is working.
    Chris – simply spread the message of bugger all saturated fats, no crap vegetable oils and back off processed foods. Stick with plant based foods, its easy, EASY.

    • Chris Kresser says

      That’s not accurate. We have examples of cultures that consumed saturated fats in significant amounts without processed food, such as the Kitava in Polynesia, and they’re free of heart disease. There are a number of factors that go into life expectancy, and nutrition is only one of them. The Masai and Inuit are both free of the modern diseases which are killing us every year. If they had our sanitation and trauma/emergency medical care, which is what has primarily extended our lifespan (although living an extra 10 years in a diaper and a wheelchair is of debatable value, IMO), their life expectancy would surely be longer. Hunter-gatherers are known to live to comparable ages as so-called “civilized” people, provided they escape violent or traumatic deaths earlier in their lives.

      • Tim says

        Debatable value?? I know what you mean here but to some people an extra ten years (which is a mighty long time) is of huge value. Time enough to see grandchildren or great grandchildren grow up, time enough to find more appreciation in life, to learn and see more. I wouldn’t say no to longer life even if it was in diapers as you put it.
        I don’t think saying that 10 years of life in diapers is of debatable value is a particularly astute thing to say.
        In reference to the saturated fat not inducing heart disease, what about other health problems such as diabetes, obesity, cancer to name a few, are there any links here? What about life expectancy and saturated fat intake? Correct me if i’m wrong but do not people following diets based on the Mediterranean diet, vegetarians and cultures with diets based on fish have longer life expectancies?
        If the focus is on heart disease alone and saturated fat does not increase the risk well that’s fine, but what about other health conditions? From what i’ve read saturated fats certainly don’t decrease the risk of heart disease.

        • Tracy says

          I think by the 10 years in diapers, Chris was implying that the mind was malfunctioning along with the body. So to imply that one would need diapers yet still enjoy full awareness and cognition is a stretch.

  12. says

    Chris, thanks for the info, i totally agree with you about the benefits of the paleo diet and am in the process of making the transition from low to moderate carb diet to the paleo diet. i want to note i studied human physiology at the university of oregon and am certified fitness trainer. i do have one question tho. is there a distinction between general vegetable oil and high quality olive oil, and how about avacados?

  13. Jack says

    I have some confusion about sat fat. If we eat excess carbs and it turns to sat fat, it becomes dangerous? Is it because the body then has to convert LDL? Does this sat fat eventuall get converted to TG?

    Thanks!
    Jack

  14. Josiah Lorentzen says

    Chris,

    I’m training a GI doc right now and have been debating back and forth on the Sat Fat issue. I actually linked this post and a few others by Masterjohn and he immediately saw some issues with this study and sent me this rebuttal. Would you mind letting me know your opinion of this rebuttal?

    http://db.tt/fOGhdJDt

  15. Sifter says

    Hi Chris, great blog! I admit I’m also confused. I find Dr. Esselsteyn’s book mentioned above persuasive due to documented and photographic evidence of plaque reversal. BUT, I also find logic in eating habits similar to what you suggest, notably Dr. Davis’s ‘track your plaque blog’ which agrees with cutting bread (wheat primarily), sugars, and veggie oils. What’s an intelligent middle aged non-medical individual to do? Sat fat from fries and chips are bad due to Omega 6 oils, etc, but sat fat from cheese and milk is fine… am I hearing you correctly? ……

  16. Neil says

    Nutrition is nothing short of confusing at the best of times…
    The big push these days is about Cholesterol and animal fats seem to play the biggest role in this.
    It would be great if someone put out a list of foods you should eat and foods you shouldn’t eat and then at least we have an easier way to identify what goes in.
    Then we only have to look at quantity of food intake and daily activity… this should make it easier to maintain a healthy weight especially for these like myself that don’t lead a very active lifestyle.

    • AaronH says

      Nutrition is easy. Avoid anything processed or in a package. Grains have to be processed in order to even make them edible, avoid them all. Eat a large variety of whole foods (plenty raw) in order to ensure you get all the chemicals your body needs. Simple.

  17. John Thomas says

    If dietary fat does not cause heart disease, what does? Every cell in the body makes cholesterol – what causes them to go haywire and raise cholesterol levels?

  18. Sifter says

    Just today, NYTimes has an article “The Island Where People Forgot to Die” about centenarians on the Ikarian island 30 miles off of Turkey. Little to no saturated fats, dairy and meat, the latter only for festivals. Lots of wine, homegrown veggies and some fruit. Also they DO eat bread, lots of ‘stone ground’ bread.

    These people, more importantly, wake up when they feel llike it, take a good long afternoon nap, go to be late, and don’t live by the clock. They have one fourth! the dementia found in the USA, and a fraction of cancer and heart disease. Reading this , I have trouble simply dismissing sat. fat as cause for coronary disease.

    • Dee says

      of course if you have a diet high in antioxidant fruit and veg and little refined/processed products you will be healthy, that does not mean that taking away saturated fat is more beneficial for your health

    • David Cole says

      The article stated that they eat larded pork a few months a year. And goat’s milk everyday. They do eat bread but not at every meal it seemed and I’m guessing it’s nothing at all like the bread we eat. In addition these people are quite stress free, and they eat almost nothing with processed sugar. Sounds to me like they eat a very balanced diet with lots of the stuff Chris recommends like sleep, exercise, hobbies, social engagement, play, don’t overeat, and eat lots and lots of veggies.

  19. Luke says

    Chris i know it’s good to reduce the amount carbs, but is eating saturated fats with carbohydrate bad, or would it play any role in heart disease? some people seem to think mixing both is bad for you.
    Thanks, Luke

  20. Jeff says

    I have to agree with Dave who had two stents put in. Just underwent an unforeseen single bypass at 53 several days ago and I’ve been very diet conscious for 15 years. But never to the point where I cut all saturated or non-saturated fats from my diet. But I did limit it far more than most Americans and I ended up with the same result. It seems self evident to me what animal-based foods do to us and what it does to the endothelium.

    If you watch the 20 year old video “Foods That Kill” you’ll see how thick the lipids are in the blood drawn from a guy who just wolfed down a double cheeseburger and a milk shake. It’s disgusting. It looks like goo in the guys blood.

    See 3:15 of this video:
    http://www.youtube.com/watch?v=zG_tn3KAXNE

    Esselstyn’s science is fairly sound and anyone who has read “The China Study” can quickly determine for themselves that the populations with the greatest longevity and lacking diseases that are rapidly killing those of us in western culture (particularly heart disease) are those communities that have no animal-based foods.

    I would also encourage people to view “Forks Over Knives” before making a decision. One thing to realize folks. You roll the dice if you don’t take immediate control of what you’re putting in your mouth every single day.

    • Chris Kresser says

      The China Study is anything but sound science. It’s thinly veiled propaganda under the guise of science. Read this: http://www.cholesterol-and-health.com/China-Study.html

      The “diet-heart” hypothesis (the idea that eating saturated fat and cholesterol raises cholesterol in the blood, and that the concentration of cholesterol in lipoproteins in LDL is what drives heart disease) has been thoroughly discredited. Based on many well-designed cholesterol feeding studies (where they feed volunteers 2-4 eggs a day and measure their cholesterol), it appears that dietary cholesterol has very little impact on blood cholesterol levels in about 75% of the population. Cholesterol in food isn’t well-absorbed by the body. Only “free” or unesterified cholesterol can be absorbed through the gut lining; but most cholesterol we ingest in food is esterified. The remaining 25% of the population are referred to as “hyper-responders”. In this group, dietary cholesterol modestly increases both LDL and HDL, without affecting the ratio of LDL to HDL or total cholesterol to HDL or increasing heart disease risk. [1] On average, then, eating cholesterol doesn’t have a significant impact on blood cholesterol levels, and for the 1 in 4 people that do experience a slight increase in blood cholesterol levels, it is not clinically significant.

      It’s true that some studies show that saturated fat intake raises blood cholesterol levels. But these studies are almost always short-term, lasting only a few weeks. [2] Longer-term studies have not shown an association between saturated fat intake and serum cholesterol levels. In fact, of all of the long-term studies examining this issue, only one of them showed a clear association between saturated fat intake and cholesterol levels, and even that association was weak. [3]

      In addition, studies on low-carbohydrate diets (which tend to be high in saturated fat) suggest that they not only don’t raise blood cholesterol, they tend to have several beneficial impacts on cardiovascular disease risk markers. For example, a meta-analysis of 17 low-carb diet trials covering 1,140 obese patients published in the journal Obesity Reviews found that low-carb diets neither increased nor decreased LDL cholesterol. However, they did find that low-carb diets were associated with significant decreases is body weight as well as improvements in several CV risk factors, including decreases in triglycerides, fasting glucose, blood pressure, body mass index, abdominal circumference, plasma insulin and c-reactive protein, as well as an increase in HDL cholesterol. [4]

      Dozens of studies have been performed over 50 years to examine the relationship between saturated fat intake and heart disease. They attempted to answer the question: does eating more saturated fat lead to more heart attacks. Almost without exception, the answer has been “no”. In 2010 a large review of previous studies examining this question was published in the American Journal of Clinical Nutrition. The researchers looked at 21 different trials covering almost 350,000 subjects for periods ranging from 5 to 23 years. [1] Here’s what they found:

      …there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD [coronary heart disease] or CVD [cardiovascular disease].

      That should settle the question.

      [1] http://www.ncbi.nlm.nih.gov/pubmed/19852882
      [2] http://www.ncbi.nlm.nih.gov/pubmed/12716665
      [3] http://wholehealthsource.blogspot.com/2011/01/does-dietary-saturated-fat-increase.html
      [4] http://www.ncbi.nlm.nih.gov/pubmed/22905670
      [5] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/

      • Webb95 says

        Okay, admittedly I didn’t read all of the examples above, but here’s what I see: None of these studies is 100% scientific. We are not able to repeat these studies (as per the scientific method) because we will NEVER be able to find people that are the same make up (age, genetic makeup, gender, medical history, etc.). We also are not taking untainted specimens (babies) and feeding one group a high fat, low carb diet; another group a low fat, low cholesterol diet; and a control group and study them for 20 years. This is the only way we will have conclusive proof which diet is the healthiest.

        Also, can genetics play a roll? I have a paternal grandfather that ate a diet rich in meat and veggies (not starchy), and a maternal grandfather that is the typical “meat and potatoes” eater. The grandfather that ate meat and veggies died at an age of 85 due to heart failure, yet the “meat and potato” eater is still going strong at 96.

    • Redoran says

      You mentioned that the subject “wolfed down a cheesburger and milkshake. OK, #1, they are both much loaded with carbs. So, don/t you think these carbs caused the problem? I dose myself with 2 tbs of coconut in the morning and evening. I have gone from 217lbs to 208lbs in one month. Wouldn’t we all say I am doing something right?

  21. says

    Hi Chris,
    Hard to argue with the finding of this study, at least when we consider the question- Does saturated fat intake cause heart disease? But does that mean it is good for us and doesn’t correlate in some way? What about, for example, when we look at endothelial function and saturated fat intake, or total fat intake at a meal? The findings below do not suggest an argument countering the findings of the study you mention here, but they do suggest that saturated fat intake maybe harmful to endothelial function and thus undesirable, at least for those of us who want good endothelial function. If someone has cardiovascular disease (for whatever reason) it appears from the studies below, that they would be in more dire straits after a high saturated fat meal. In other words, saturated fat may not cause heart disease (as we know the true cause or causes are multifactorial) but it sure doesn’t look like it would help.

    http://content.onlinejacc.org/article.aspx?articleid=1137827
    http://www.ncbi.nlm.nih.gov/pubmed/14561213
    http://www.nature.com/ijo/journal/v37/n2/full/ijo201242a.html

    These findings match closely the findings of a study comparing Atkins and Ornish diets, where blood flow and arterial health (endothelial function) were measured using brachial artery reactivity testing (BART), also known as flow-mediated vasodilation, a well-accepted direct measure of arterial health and a validated predictor of cardiovascular events. Blood flow worsened on the Atkins diet, and there was a significant inverse correlation between intake of saturated fat and total fat and worsening of blood flow.

    http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_819?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Ornish&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

    The study below, meant to investigate the effect of flavonoid consumption on endothelial dysfunction, even used a high fat meal to cause the problems they were hoping the flavonoids would then help with (which they did)
    http://www.hindawi.com/journals/ecam/2011/796958/

    I guess my point is that the take home message and feel of your post here is that we shouldn’t worry about saturated fat intake and heart disease. Considering what I mention above, I feel we are far from being able to make such a definitive statement.

    • Chris Redmond says

      Dr Chong,

      After reading the study of Atkins and Ornish diets, I have to suggest that those on the Atkins diet will have been required to eat far more than they would normally, and certainly more than their body required and their appetite ‘told’ them to eat.

      Of course I understand that the study was trying to isolate the effects of fat intake without weight loss being taken into consideration, but all this did was throw in another variant, as those on the Atkins diet were basically forced to eat more than they needed whilst those on the Ornish most probably weren’t.

      During the study “They (participants on both diets) were weighed weekly and caloric adjustments made if weight change exceeded 1 kg”, and I know from experience that when undertaking the Atkin’s Diet, weight loss would far exceed 1kg every week even after induction, even when the appetite is quenched, and indeed we tend to not even count calories when on the Atkins.

      It could just as well be concluded from this study that subjects who are forced to eat significantly more than their appetite requires them to have worstened blood flow when compared to those who eat more in line with what their appetite requires them.

      Finally, one of the conclusions of this study states that “In the absence of weight loss, the high fat Atkins diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis…..”

      When weight loss is pretty much a guaranteed benefit of a low-carb diet, with the associated health benefits of weight loss, I can’t help but think that this study is worthless when considering the actual effects on blood flow of anyone undertaking the Atkin’s diet.

      It’s a bit like suggesting that a diet of burgers, crisps, candy, soda drinks and 100% processed meals isn’t really all that unhealthy for us…….in the absence of weight gain.

      • Dr. Daniel Chong says

        Hi Chris,
        Great comments and observations. Unfortunately, because a similar study wasn’t done where participants were allowed to eat as little as they wanted and to lose as much weight as they naturally would on such a diet, I guess we won’t know for sure. Your point does beg the question (which has been raised before) though of how much benefit from an atkins low carb style of diet is simply subsequent to the reduction in calories and not the composition of macronutrients. That all said, my biggest point in my original point had more to do with potential concerns for the direct impact of saturated fat on endothelial function. While the Atkins/Ornish study may not have been the best designed study to assess this issue, the other studies seem to be pretty clear. Therefore, I’m still interested in the Ornish/Atkins study.

        • Chris Redmond says

          Dr Chong,

          I think the Ornish/Atkins study demonstrates once again just how difficult it is to actually design studies from which definitive conclusions can be reached.

          Even when studies are able to prove apparently adverse health effects, we can often find studies demonstrating positive effects on health leaving the reader to ponder if the positives outweigh the negatives or vis verse; it seems very little is clear cut.

          With the Atkins Diet, as you yourself ask, are any benefits due to the reduction in calories or are they due to the composition of macro nutrients?

          In a similar vein, I would ask if it’s the addition of more fats/protein to the diet which brings benefits, or the reduction in carbs/sugar, or the reduction in processed meats, or the reduction in Omega 6, or the increase in Omega 3 and subsequent equalisation of Omega 6 and Omega 3?

          Although I follow a low carb diet myself I know I can’t claim it’s the low carbs aspect which benefits me most, as it may well be the fact I don’t now eat any tinned food and only eat fresh produce, and more fish etc.
          Is it what I’m now eating that benefits me most, or what I’m not now eating?

          Obviously there would need to be multiple studies to look at each of these variables in isolation, and even then other variables would be introduced meaning the number of participants would have to be very large to try and enable the variables to be accounted for.

          At the end of the day however, if saturated fat was definitely ‘bad’ for us in general, it would have been proved by now, and the fact you and Chris can provide opposing evidence in the form of peer reviewed studies does indicate to me that whilst there may be positives and negatives to saturated fats, there is no one aspect which we can point at to demonstrate they are in general to be avoided.

          On the other hand, we can only eat a finite amount of food, if we don’t eat foods containing saturated fats (which tend to be unprocessed) there’s every chance we will instead be eating processed foods high in Omega 6 which we do know are harmful in the long term, because millions follow this western diet and we can see the results.

          Often it is the case that diets are changed when the damage has already been done, and any improvements in health are of course attributed to the new diet whether it is low carb or low fat, but the reality probably is that it’s simply the cessation of eating their former diet which is causing the improvements, and a change to a diet of bread and water would also yield rewards.

          • says

            Hi Chris,
            That was so incredibly well put. Maybe you should write a blog. I’d read it!
            It’s so interesting really. i have been exploring these types of questions about saturated fat (and also low carb/high carb, paleo/vegetarian/vegan, etc, etc) for the last 13 years now and still don’t believe there is a definitive answer. I think the only definitive answer (and I know Chris Kresser feels the same way) is that there are individual differences that will make one person more or less likely to tolerate something than the next person is. However, your point about people possibly benefiting from one diet or another having more to do with what is taken out vs what is still included is such a good one too and should definitely be considered the likely explanation in most cases. That all said, these days I am looking more and more at other things that I feel are very, very under-recognized in the paleo and low carb worlds and that has to do with food as a toxin source, and which foods contain the least. I do not mean things like lectins and phytic acid which some believe are toxins. I am talking more about the nasty ones like PCBs and dioxins. While I do feel some will do best on a LCD, I am growing more and more reluctant to recommend them to my patients and clients because of the fact that animal foods (especially fats) are the most significant route of exposure (http://www.ejnet.org/dioxin/). I am all but certain that, if it does turn out there is a connection between animal fat and cancer, it has more to do with this issue than any other. I am also starting to explore more and more the impact that factory farming has on our environment and it is becoming harder and harder to deny the issue. I am no expert, so I’m sure some out there will disagree with reputable sources to back it up. But what I’ve read is hard to argue with. Sure if we did farming and livestock raising the right way we wouldn’t have near the impact, but when is that going to happen? Add to that the horrendous conditions the animals are in, the contribution the huge amounts of antibiotics used are making towards creating resistant bacteria and we have some huge, huge problems with very few solutions. I’m to the point these days where I just try my best to consider all of these issues. At the same time, I still have patients sitting in front of me in my office, or talking to me on a phone from somewhere, and they want answers to the question of what ails them. Not an easy one to give. I’ll keep doing my best though!!

            • Chris Redmond says

              There’s a very informative link I’ll provide at the end of this short message which includes quotes from various sources regarding the ‘Inuit paradox”, and the point is made that even though they eat more meats and fats than Westerners, their saturated fat intake is probably lower.

              Nods are also given to the Omega 6 to Omega 3 ratio of the western diet compared to the Inuits, so once again we can’t draw definitive conclusions on individual aspects of the Inuits diets although certain aspects do ‘strongly suggest’ correlations only the most pedantic cynic would ignore.

              In a similar vein to what I’ve said before then, is it the high fat, high protein diet (which includes animal organs) which apparently protects the Inuits from heart disease and cancers, or is it the almost total omission of sugar?

              http://www.theiflife.com/the-inuit-paradox-high-fat-lower-heart-disease-and-cancer/

  22. Liz says

    The study mentioned in this article has been criticized for its methods, including the original studies being imprecise, the lack of consideration of replacement of saturated fats with polyunsaturated fats, and not using unadjusted data. I suggest http://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascular_disease_controversy for further reading if anyone is interested in actually seeing a variety of responses on this issue (the study in question here is Siri-Tarino, 2010).

  23. says

    Great article, and interesting comments!

    I’d like to know more about your beliefs on the correlation between LDL cholesterol levels and heart disease. It seems to be coming evident that it’s the inflammation (causing arterial damage) that is the issue as opposed to the cholesterol levels.

    -Adam

    • Richard Younger says

      Adam – if you still frequent this thread and are looking for more answers – research all you can about actual Low Density Lipoprotein particles and particle number. The entire story is likely one about the particles that transport cholesterol in our bodies (Low Density and High Density Lipoprotein particles) and less about the hormone cholesterol itself.
      HIgh sugar consumption will bring about changes in your hepatic (liver) function hence regulating the number of damaging particles up in our bodies.

  24. Steve says

    I got rid of range of health issues when I switched to a raw vegan eating regimen. I began eating 2500-3000 calories before 3pm everyday of fresh uncooked fruit and vegetables. After 3 i would eat a cooked meal for dinner and within a few days I no longer suffer from reflux. My eczema cleared up after about 6 weeks.

    After about 6 months of this regimen, I then stopped consuming animal protein altogether, and that is when I really noticed huge improvements in my energy levels. I am not against meat eating or “paleo”, but I have seen the benefits to plant-only eating in my own health and for that reason I won’t be going back to meat again.

  25. Richard Younger says

    It’s about the sugar. Also – remember the Omega 6′s and 3′s compete for their place in our bodies. In an optimal state 6′s and 3′s are balanced. Too much sat fat drive’s the 3′s down.
    3′s are probably the better of the two – so best not to drive them down. It’s about the sugar! And, just because it’s not sweet – doesn’t mean it is not sugar or recognized by our bodies as pretty much the same thing. Get the sugar, carbs, and refined garbage out – and your vascular disease (it’s really vascular disease – NOT heart disease (that is – until it the lack of blood flow caused by vascular disease starts killing heart tissue.) will reverse. (another caveat here is type 2 diabetes – if you are close to or already past a diagnosis – reversing your vascular disease can become a more challenging scenario.)

  26. Vahagn says

    Yea, the guy totally lost me on the “China Study” being called essentially bogus. I spent years watching my dad telling people to give up meat and animal products and having their diseases go away. Hundreds of people came to my dad and got similar positive results for heart disease and everything else.

    The truth is the Paleo diet hasn’t been around nearly as long as vegetarianism has. And before you start that nonsense of it being around for 2.5 million years, that’s a joke. Paleolithic people didn’t eat the fruits and vegetables we eat today, and they didn’t eat the animals we eat today either. The entire “science” behind it is baloney. The statement that we can’t eat grains and legumes and lentils because our body hasn’t “evolved” over 10,000 years is pure conjecture. Vegetarians who don’t eat meat for 60 or 70 years and then eat a little meat often times get very very sick. If a person can develop an ability to digest meat without ill effects, or lose that ability over 50-70 years, Human Beings can learn to digest grains over 10,000 years.

    The Paleo diet isn’t supported by science. It’s supported by body builders who want a justification for high protein diets, wild theories about what Paleolithic people were like that most Archaeologists disagree with, and peddled by a few doctors to make money.

    I was a vegetarian but still ate lots of dairy and eggs in my life. I had high cholesterol. I completely cut milk and cheese out of my diet and within 6 months my cholesterol went down to normal levels with no medicine or other dietary changes.

    Saying Saturated Fats or Animal Products don’t have a relationship to cholesterol is a joke.

    • Vahagn says

      Hold on, wait a minute, did you really link to the Siri-Tarino study that was supported by the National Dairy Council, with scientists funded by Unilever (a maker of margerine and ice cream) as well as National Cattleman’s Beef Association?

      If there’s anything more obviously funded by special interests, I haven’t seen it, and that’s your research?

      The Paleo diet is one of the least healthy diets as measured by experts – http://www.cnn.com/2014/01/07/health/best-diets-ranked/

      Unfortunately some doctors, referencing studies funded entirely by dairy and meat special interests are attempting to beguile a nation that wants so desperately to believe that eating saturated fats are good. You’re not the first guys to do this schtick, Atkins tried it.

    • Rob says

      Hi Vahagn,

      The truth is, the “Paleo Diet” as it is used these days in the media and amongst its followers is really a misnomer. A true Paleolithic diet cannot be replicated in this age due to the environment, food quality, toxins, lifestyles, etc. Even modern hunter/gatherers can’t fully replicate a Paleo lifestyle, although they would come closest to doing so. They really ought to rename it to something else. Essentially it is a non-grain, non-dairy, whole-foods diet but that doesn’t sound very catchy as a name.

      I remember seeing some slides regarding a study that was done on a hunter/gatherer group and the average monthly kill quota was one large sized animal per month. Our ancestors of that era, like their more modern counterparts of today, would have relied a lot more on plant foods, insects, fungus (mushrooms), fruits and nuts (when available), lizards, small rodents, fish and amphibians (depending upon their proximity to water sources), birds, eggs and last but not least – tubers.

      Personally, my diet is highly plant-based, supplemented with fish several meals per week. I also take fish oil supplements. I rarely use oils of any kind in cooking. I think I may have a problem sticking to a vegan diet, although I have done it for a few months at a time. I used a lacto-vegetarian diet to lower my cholesterol but the dairy products were non-fat milk (skim) and non-fat Greek yogurt. I was also supplementing with phytosterols.

      I see that you decided to drop eggs (I fully understand that) as well as dairy. Did you not consider non-fat dairy as an alternative? Currently, I am making the switch from dairy to almond milk. Dropping cheese was extremely difficult. At least, in my case it was.

      Cheers,

      Rob

  27. says

    My Granddad´s brother worked for 40 years in a farm and he was accustoemd to eat 24 whole eggs a day. 12 of it boiled, the rest was fried on a home made bacon. He died in the age of 82 years. He has never had any problems with high cholesterol or a heart attack. I eat several whole eggs a day too and I eat some 50-100g of home made smoked bacon too. I am a blood donor and docs check out my blood regularly. I am 100% healthy. Maybe because of my genetics, maybe because of the food I eat, maybe cause I do my workout with barbells and kettlebells, or combination of it. I don´t eat bread, I only eat time-to time noodles in a soup some buckwheat and home made potatoes (about 50g a day) I feel great and I am in great shape. I am 190cm tall and 98 kg heavy. When I used to eat oats and cereals I was fatty and sleepy. No I want to “lift up” the Earth, but it doesn´t have ears to grip. ;-)

    • Robert says

      My wife had an aunt that smoked well into her 70s. She began smoking at an early age (early teen years). She lived to 99 years of age. You don’t hear me going around recommending people smoke because it didn’t affect my wife’s aunt.

  28. Adam says

    The study cited is of little use to show any meaningful connection between saturated fat and heart disease. The energy from saturated fat in the various studies ranged anywhere from 7% to 17%. That is just from saturated and doesn’t account for other fats, therefore the total percent calories from fat is probably 30%+. I could tell from Table 3 in the study that no meaningful conclusion would be reached. Modest changes in saturated fat intake are unlikely to produce any significant changes in risk.

    Chris says that there is no evidence on the connection between saturated fat and heart disease, yet a simple search of PubMed reveals many studies finding an association between saturated fat and impaired endothelial function.

    I don’t understand how he can come out and say “case closed” and announce that saturated fat has no association. At this point in time, we haven’t seen enough conclusive evidence to prove either side.

    It seems the tendency is to call any study finding no association a “good” study while continuing criticizing all the rest.

    • Zahc says

      Adam: “The study cited is of little use to show any meaningful connection between saturated fat and heart disease. The energy from saturated fat in the various studies ranged anywhere from 7% to 17%. That is just from saturated and doesn’t account for other fats, therefore the total percent calories from fat is probably 30%+. I could tell from Table 3 in the study that no meaningful conclusion would be reached. Modest changes in saturated fat intake are unlikely to produce any significant changes in risk.”

      Remember that the burden of proof lies on those who claim that saturated fat is harmful. Creating a bunch of ad hoc explanations of why every saturated fat study do not find an association is irrelevant, because it is not evidence of anything.

      Adam: “Chris says that there is no evidence on the connection between saturated fat and heart disease, yet a simple search of PubMed reveals many studies finding an association between saturated fat and impaired endothelial function.”

      Endothelial function is not heart disease, but a surrogate marker of unknown significance. Yes, saturated fat allegedly worsens every surrogate marker on the planet, yet strangely, when put to the test in long-term studies with hard outcomes, it fails…just about every time.

      The evidence on endothelial function is actually inconsistent, and the marker is highly context dependent. There are many studies showing antioxidants improve endothelial function, but little evidence to show that antioxidants reduce cardiovascular events. Changes in surrogate markers do not necessarily translate into risk reduction, which is why studies on hard outcomes need to be done and have already been done.

      Adam: “I don’t understand how he can come out and say “case closed” and announce that saturated fat has no association.”

      Because saturated fat has no association. How many times do you want to keep flogging a dead horse? If you’ve searched for something long and hard but failed to find it, the only logically conclusion is that it is probably not there i.e. saturated fat is not harmful.

  29. says

    Is breast milk bad for infants? Of course not. Breast milk is the best food for an infant. What is in breast milk that is so beneficial? Saturated fat and cholesterol!
    Cholesterol is part of every cell membrane. Cholesterol is a major component of myelin which protects nerves from damage. The highest concentration of cholesterol in your body is in your brain!!
    All of your sex and adrenal corticol hormones are made from cholesterol
    Vitamin D is made from cholesterol.
    Multiple studies show that after the age of 65, the higher your cholesterol level, the longer you live
    Saturated fats increases HDL
    Unsaturated fats decrease HDL
    The active ingredient in fish oil is omega 3 fatty acids – the active ingredient in snake oil is omega 3 fatty acids. Therefore fish oil = snake oil !!!!!!
    Fish oil raises LDL cholesterol. Fish oil lowers your triglycerides by causing liver damage.

    I could go on and on giving you more facts (none of the above is opinion)

    Bottom line – the notion that saturated fats cause disease was made up by the food companies to sell vegetable oils and perpetuated by the drug companies to sell drugs and further perpetuated by supplement companies to sell fish oil

    • Matt says

      I really feel sorry for all of you who are committed to believing that saturated fats are bad for you. The has never been any conclusive proof that it is linked to heart disease. As a matter of fact, your liver produces more bad cholesterol that you can ever eat in a day.

      On top of that I am living proof that saturated fats don’t hurt you. I am a 30 year old male, I work our regularly, I stay away from processed foods, I am at 6.5% body fat, I eat 3 whole eggs every day along with bacon, milk and red meat a few time a week.

      The problems lie with the idiots that eat margarine and other processed foods. Try linking your health to the nature of the foods you eat. The more natural it is, the healthier you become from eating it. Try looking at the ingredients labels on the foods you do buy. The fewer ingredients, the better.

      All in all, if you have high blood pressure or terrible cholesterol, blame the pre-packaged crap and not the saturated fats. They are essential to optimal health.

      • says

        Hi Matt,
        Thanks for the info. I am a nutritionally oriented doc and always interested in real life experiences of patients, etc. Would you be interested in “proving it” by doing some detailed lab testing to clarify that your insides look as good as your outside does? If so, contact me through my website drdanielchong.com and I can help you set up the testing wherever you are. As long as you have health insurance, it would be less than $50 or so, paid to the lab. At the very least it is always good to get some lab work done and check up on yourself periodically. You are at the perfect age to begin doing so. Let me know!!

  30. Kim says

    I am totally on board with the idea that saturated fat doesn’t cause heart disease. However, I am torn when it comes to other types of disease. I’m sorry that I don’t have any specific examples of studies, but I’ve heard about increased risk of disease such as cancer and other negative health effects with higher saturated fat intake. I’m not sure about the validity of these studies though. Could you provide some insight?

  31. Chemistry says

    What about the structure of the fat itself? From a chemical standpoint, saturated and trans-unsaturated fats have a higher tendency to stack on top of each other thus increasing the intermolecular forces between the fat molecules. The linear shape of these molecules allows them to stack upon one another with a high affinity. This stacking of the fat molecules leads to the build up in your arteries. Most unsaturated fats are in the cis conformation, this introduces a kink into the molecular structure of the fat, which decreases these intermolecular interactions and therefore decreases the extent of molecular stacking. Just from this understanding of the chemical structure of fats it would make sense that saturated fats and trans fats help increase one’s risk of coronary heart disease. What say you about this?

    • Mary says

      I am not a scientist…I am an observationist. Observe cultures who rely on a fat laden diet. See how they have thrived in health. Check out traditional diets of Native Americans, Inuits and Aborigines. Then tell me how can science assume that fat is bad? Especially when most consider a high carb low fat diet as being ideal, yet have to deal with weight issues. Most heart attack victims have normal or even low cholesterol levels. What does science say about that? As I look to my own dietary liestyle…I’ve had a ketogenic diet for 14 years. Scientifically I should have died 60 years ago

  32. M says

    Hey, I noticed that your article posts no longer have a date on them. It would be great to get the dates back on these articles so I know how fresh this info is. Thanks.

  33. Karen says

    Like anything “moderation” is the key. I gave up white breads and rice years ago as well if I do use sugar in anything and I cook my meals from scratch it is taw organic unrefined sugar.
    I don’t put a lot of weight in certain studies as it is the large corporations who usually fund research to get the results “THEY” want.
    All the people who try to watch their diets it might be a good idea if they put down the diet soda and sweeteners with Aspartame it is far worse than Satfats!

  34. peter says

    What’s the ‘final nail in the coffin’ bit? The study to which you refer was neither conclusive or scientific. This was simply a cherry-picking exercise of other people’s work. There was no longitudinal or latitudinal work, they simply picked studies funded by animal agriculture to back up a conclusion they’d already decided on. It’s simply absurd to suggest that the overwhelming evidence of the deleterious effects of saturated facts can be set aside.

    • Casey says

      Peter you are correct to question the people who jump on a boat going in the opposite direction. There is no “nail in the coffin” and nobody on here will provide you any good research clearly demonstrating that a high saturated fat diet is good. First lets look at the study. As many on here know there are man questions about the data and there were a few errors in the data when they initially presented the study that have not yet been corrected. However, the problem with this study is that it is a Meta analysis and they are fraught with errors (not all the time). I can go into this much more if needed. You will never get anywhere with mary who posts small articles by persons with agendas mixed with half facts (how about the fact that most american indians didn’t live past the age of 35 and very very few lived past the age of 50.)

      However, lets take the study at face value. Here is what it showed.
      The risk of diets high in saturated fats for coronary disease was 1.03 (that means a slight increase in the risk for coronary heart disease) for 1.0 for monounsaturated 0.87 for omega-3′s (that means a 13% less chance of CAD with a diet higher in omega 3s) 0.98 for omega-6′s. Now the problem with these numbers is that they don’t meet statistical significance. Meaning that even though the trend is exactly as we would have predicted (basically saturated fats are bad, followed by mono and omega 6 then with better outcomes with omega 3′s, certainly makes sense). However, since it didn’t meet the pre determined statistical significance we can’t say there is any difference. HOWEVER, we can say that there was a “trend” for saturated fats being bad followed by MUFA and then PUFAs. This is an important point because what tests are included in this meta analysis are important, makes it more difficult to meet a predetermined end point.

      Lets look at the data more. Here was a study (one of the “nails”) from 2009 by Mente comparing many types of foods with CHD(heart disease). Here is what it showed. I will be using the Relative Risk (RR) which is what the numbers above were (basically the 1.06 in for saturated fats in the most resent trial suggests there is a 6% increase in the risk of heart disease with high saturated fat diets. essentially if your RR is below 1 it is good and above 1 it is bad) Here goes for this study.
      Mediterranean diet RR = 0.66 (holy smokes!!! 34% chance of less heart disease with a low saturated fat high nuts and such diet.) — this did meet statistical significance!
      Monounsaturated fats RR = 0.81 (19% reduction and it met statistical significance)
      Whole grains RR = 0.8 (20% reduction) and it met statistical significance
      Fruits RR = 0.82 (significant)
      Omega 3′s = (excluding ALA) = 0.86 (significant)
      Saturated fatty acids = 1.06 (not statistically significant)

      There are many trials like this one. Most demonstrate or clearly prove that mediterranean diet is good, substituting polyunsaturated fats (preferably omega 3) for saturated fats decreases heart disease AND if you substitute carbohydrates for saturated fats it is a BAD idea.

      With regard to the “nail in the coffin” there is no nail. Look at the data and ALL the trends are clear. Increased saturated fats in the diet is bad. There is NOT a trend at all for improvement in health with saturated fats.

      Peter I really just picked a couple of studies. I can provide a tremendous amount of empirical data as well as personal (anecdotal, which is the worst worst worst sort of data) data

  35. Dan says

    It’s pretty sleazy to use a study funded by the National Dairy Council to convince your readers that saturated fats are safe.

    Along with the other studies funded by the Cattlemen’s association or the Egg Nutrition Council, the information you are giving is biased, deceptive and speaks volumes for your integrity (or lack of).

  36. Lewis says

    People are always searching for excuses to eat all they want. Saturated fats and carbs in large amounts are both deleterious, both cause oxidation. People want to eat them in large amounts, so they rely on diets like ketogenic and extremely low fat diets. They both work at a certain extent, you can eat a lot of whole food carbs if you mantain your fat below 10%, and you can eat a lot of fat if you mantain yourself in a ketogenic state.

    But this accounts for just one meal, both diets would lack nutrients you need. If you mantain yourself in a ketogenic state you have to consume less antioxidants presents in plant carbs, the same way when you make the Ornish and Esselstyn diet you lack vitamin B12, A and D, as well as the good fats, the best one being the good fats.

    The zone diet for me is the one that get close to an ideal diet in terms of nutrition and keeping the oxidative stress under control. And because it has all the ingredients that makes a healthy diet, it needs moderation, cause too much carbs and too much fats cause oxidative stress.

    • Mary says

      We talk about “good” fats as if fat itself is a bad thing. Butter is good fat, unless the animal was fed crap. A crappy fed cow produces crappy dairy. We speak about canola oil as if it were nectar of the gods. Research how it is manufactured. Research the manufacturing of margarines. Seriously you may as well eat Vaseline. Cream, coconut oils even lard is what I seek out as a part of my diet. I also use almond, walnut and olive oils. Fat is the most important nutrient that we consume. So consume it, already.

      http://www.westonaprice.org/traditional-diets/guts-and-grease

  37. Richard says

    Yes, the Standard American Diet (SAD) is so healthy that 80% of the people are dying from cancer and heart disease while some cultures in the world live much longer and more healthy without the meat, eggs and saturated fat.
    Given the large number of studies performed we still do not know what is making us sick specifically. We do know that most Americans over 40 show signs of heart disease…it likely is not the water they drink so I have to think it is the diet.

  38. Britney Caldwell says

    Wow, very interesting article. My husband and I have switched to coconut oil and real butter within the last 2 years as I read myths that canola oil and low fat butter were better for you. Sad thing is, I fell for the lie and our bodies cant break down all the chemicals that all this low fat stuff has. I agree with this article 100%. I wish I was taught this in nursing school!

  39. Richard says

    I have no idea how you go from a controversial study on saturated fat to saying it is great to eat meat, butter and cheese but please show me one long-living healthy culture that survived primarily on meat, butter and cheese????

    Explain how the Abkhozia, Vilcabama, Hunza, Okinawans and Tarahumara were so healthy on a whole plant-based diet that varied among them from 85% to 99%.

    • Casey says

      Richard you are speaking to the wrong group. I don’t mind coming on here posting because it is almost entertaining for me when someone refers me to an “article’ written by another person who is as lost as they are. The real data is not clear because it is difficult to do actual Randomized Controlled Trials when it comes to diet. Most rely on “recall” and that can be terrible when it comes to quantifying saturated fats and PUFAs. The more reliable data comes from people following specific diets like mediterannean, or vegetarian or vegan because then recall is less influenced figuring out meat content. For instance if you said you eat 10 oz. of steak 3 times a week. How much saturated fat is that? Depends on the type. Was it grass fed? Hormones? gets complicated. The data we have on vegetarians vegans pescetarians and metiteranneans is clear (but still not all are RCTs) that they reduce heart disease and cancer.

      Your comment about the data on epidemiology is absolutely spot on. Every bit of epidemiological evidence we have suggests that groups of people who eat highly plant based diets with little meat tend to live longest. Many people want to point to ancient people who may or may not have eaten as they believe. In other words the data they have is very sketchy and not evidenced based at all. Coronoary heart disease has been around since man has been on this planet. It is worse now but it is NOT new. Same with cancer and so on. Take a look at the HORUS study. Some point to inuit and others but the data is only now coming to light that what we thought we knew just aint so. Most of these people never lived long enough to develop disease. In medical school (early on) we had this handout on world life expectancy, cancer deaths etc and we were asked what the healthier place to live was. I chose a small location in Africa because they had almost no deaths from cancer. Turned out the average life expectancy was in the low 30′s and their community didn’t keep good data so if someone died from cancer it probably wasn’t compiled in the data. The point is to know the information you are looking at and know what it means. I have a post above about the “nail in the coffin” with the most recent trial. There is way more to it than I wrote, but those are some of the numbers.

  40. Mary TItus says

    The problem is that we label saturated fat in the diet as controversial. Saturated fat has and will always be a healthy staple in our diets rather if we admit to it or not. Controversy lies in the fats that were made in factories and labled as healthy. Then people were more than happy to consume canola oil and margarine. ALso Asians have a very high incidence of insulin resistance so poor lipid balance must travel side by side with that. I’ve doubled if not tripled my saturated fat consumption over that past 14 years. My kidneys did not explode, my hair didn’t fall out and my cholesterol is exemplary. Back to the Asian culture with high incidence of insulin resistance/ diabetes, I would like to share this link.

    http://aadi.joslin.org/content/asian/why-are-asians-higher-risk-diabetes

  41. says

    I really am glad that found you on here and respect the fact that you post criticism to your blog because I know you could easily just delete it or not allow it. I want reference studies that say that some saturated fats have negative effects on brain function but at the same time all of these studies could be total hogwash, but I don’t know..

  42. Mary says

    Brain injuries, neurological disorders such as epilepsy, parkinsons and dystonia have been successfully treated with a diet that is rooted in saturated and other fats. Better known as the ketogenic diet, there is an organization , “The Charlie Foundation” which was established on the importance of the ketogenic diet in treating epilepsy. Here is a link discussing “Your Brain on Ketones”.

    http://www.psychologytoday.com/blog/evolutionary-psychiatry/201104/your-brain-ketones

  43. says

    I would rather eat high fat than high carb. I agree with the other commenters who say that they feel negative effects when eating sugar and other high-glycemic carbs.
    I also cook with coconut oil every day which is very beneficial to our health and is yet a saturated fat.

    • Mary says

      Melody, I agree. A diet high in saturated fats…and other fats, are healthy and they rev up the metabolism.

  44. mdjd says

    It’s the animal protein that contributes to coronary heart disease and not fat. Check the NIH research done by Dr Colin Campbell .

    • casey says

      Lewis, I think things get complicated for the average person. Many of the recent meta analysis suggest that diets higher in saturated fats may not be statistically worse than other fats. However, as is true with most meta analysis, there are people who question the methods and so on. If you read my comments above you will see that even if we let the data they present as is…..even that data “suggests” (even though not statistically significant) that saturated fats are worse than any other fats but trans fats.

      You are also very correct with the replacement story. Almost all data to date suggest if you replace saturated fats with mono’s or Poly’s you have much better cardiovascular outcomes.

      Perhaps you have read the latest on the inuits? They have always been touted for having a diet high in fats (they do, but not saturated fats so much) and low in heart disease. We have known for a while their risk of strokes was higher than average. New evidence suggests they also have rates of heart disease as high as ours (we already knew they died about 13 years before we do).

      http://www.sciencedirect.com/science/article/pii/S0828282X14002372

  45. Brendan says

    Hi everyone, Im 23. As someone here whos encountered years of horrific dietary SAD in my early years and a past sufferer if manic depresssion\PTSD anxiety as well, I can easily say symptoms of ill health, both mentally and physically have reversed in a 7 month time span due to a High- Carb, Low fat Vegan diet. Symptoms improved in 2 weeks into 80\10\10, and has incredibly changed my life for the bettrr. I no longer in need of Anti depressants and Anti-pyschotics or any form if extra stimulants as i eat this way, primarily Fruits and Vegetables. Its liberating. I come from a meat dominated and processed food background which I can personally say had an impact on my health. Most people, from my perspective and personal exoerience are missing out on the emotional tole fat plays our health, abd well being and i realized it first hand when went High carb lowfat vegan. I even can go a full week without an over-fat and still cycle for 2-3 hours with no fatigue daily. Even eating this way, created so much distance from eating fats at all. I find the taste of any fat more and more repulsive as i eat more carbs. All i know is my body and brain thrive on carbs and its absolutely fixed ny emotional\mental health. Just a thought

    • Mary T says

      Brendan,

      Your symptoms sound more like leaky gut. Do you have any tummy issues like constipation, diahrea, IBS, etc? Eliminating processed food always result in improved digestive issues. Even processed meats. Fat really does not take it’s toll on the brain unless it is rancid or transfat, afterall, the brain is made of fat. SO fats from fresh grassfed meats, coconut oil, butter etc is healthy for the brain. What causes depression when leaky gut is involved is tiny amounts of the intestine leak into the bloodstream and make its way to the brain, causing mental issues.

  46. Richard says

    How has the American public been duped Chris? The Standard American Diet (SAD) includes so much pizza that cheese consumption has doubled from 1970 to 2012.
    http://www.ers.usda.gov/amber-waves/2014-june/trends-in-us-per-capita-consumption-of-dairy-products,-1970-2012.aspx

    From 1970 to 2000 per capita meat & poultry consumption is up 19 pounds a year or about 60%.
    http://books.google.com.ph/books?id=wvZIXf2azKkC&pg=PA42&lpg=PA42&dq=US+beef+consumption+per+capita+since+1970&source=bl&ots=8Tp2XunTrZ&sig=QfBZkmgrTM81_Dde29L8TAXNkpY&hl=en&sa=X&ei=lVypU8S5O8W_kQXXq4DgAg&ved=0CFAQ6AEwCg#v=onepage&q=US%20beef%20consumption%20per%20capita%20since%201970&f=false

    I am not saying it is only or even primarily the saturated fat but since Ornish and Esselystyn were able to reverse heart disease with a particular diet that limited these items please do not be so quick to discard the thought that maybe limiting meat and cheese consumption is a good idea.

    We need much more study about saturated fats and the contents of meat and cheese.

  47. dianne p says

    It took me awhile to understand lipids but I persisted…
    1. Threw out all cheap oils in plastic containers (canola, safflower etc) and replaced with non fake coldpressed virgin coconut oil and olive oil (for hot/cold foods).
    2. I eat raw almonds although I do eat limited amounts of other raw or roasted non salt nuts and seeds.
    3. I eat grass fed beef once a week, fish 2-3 times a week.
    4. I love avocados and was fearful to include in my diet, but I did.
    These changes led me to question ALL processed foods which I have limited over 4 years.
    I lost weight and for the first time in my life I feel well fed.
    My fears are that food manufacturers will make a sham of what is thought to be healthy in present day sense and that could mean it becomes a mess to sort out for most of us.
    The right fats, whole foods veggies, fruits, nuts, seeds and legumes I what I eat without calorie counting.
    Ohh, othe health benefits: AiC is normal, cholesterol numbers are all in range except slight elevation of LDL. The main thing is I feel better.
    It takes a leap of faith to reject what doctors tell you…mine went in a mini doc rage when she asked what fats I eat and I said coconut oil….. but she is old school which did nothing for me nutritionally.
    One more thing…. I do not eat bt corn, bt soy etc. I really believe we are totally duped by chemical companies like Monsanto. This was a true eye opener.

    • Casey says

      PP Link: None of the studies have been very positive when it comes to saturated fats. The problem is when the “meta analysis” is performed and it does NOT show “statistical significance”. I am not certain what your link argues or demonstrates but this study and most studies either show a negative impact on high levels of intake on saturated fats or a “trend” towards bad outcomes (this study included). Even though it doesn’t reach ‘statistical significance’ if you were a betting person you would not bet on saturated fats.

      Here is some other food for thought. The high fat diets that help people stay in ketosis to avoid seizures tend to have negative effects on those persons, which is why they are not a “goto” treatment but rather a last option. High fat diets lead to a HUGE increase in kidney stones, slower growth in children, higher rates of bone fracture among others. The higher rates of bone fractures is now understood to be a negative effect of an increase in saturated fats in the bone. Same is true for obese diabetics who have higher bone densities but an increased risk for fractures.

    • Z.M. says

      I’d suggest to stay away from this “plant positive” guy, because he does not know what he is talking about and has a serious double standard.

      From the link he cites Stamler’s critique. Most of his criticisms were irrelevant to the actual meta-analysis, and those that were relevant (dietary methods, over-adjustment, endpoint) were already addressed by Siri-Tarino:

      http://ajcn.nutrition.org/content/92/2/460.full
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904039/
      http://www.ncbi.nlm.nih.gov/pubmed/20711693

      Next, PP claims that “One concern was that the authors did not distinguish between carbohydrates of different quality”. However, the authors clearly stated that there was insufficient statistical power to assess this question.

      There was a study that tried to answer this question which found that carbohydrates with high-GI in place of saturated fat was associated with a statistically significant increased risk of myocardial infarction, but no significant associations for medium-GI or low-GI carbohydrates in place of saturated fat – http://www.ncbi.nlm.nih.gov/pubmed/20375186

      In other words not only is there no independent association between safa and CVD, there is also no credible evidence that replacing safa with anything else is beneficial. Furthermore, the replacement argument is irrelevant since most people tend to eat a mix of fats or eat saturated fat WITH quality carbohydrates. It’s not an either-or situation.

      • Casey says

        Z.M.: First it is important not to cherry pick the information presented. The meta analysis on saturated fats that we are all speaking of definitely showed a signal (as just about every trial regarding saturated fats has shown) for increased risk with diets high in saturated fatty acids. However, it did not reach statistical significance.
        Regarding the cherry picking. You have selected an article presented in the american journal of clinical nutrition, which is notorious for presenting information strongly supported by industry. In fact all three of the articles you presented are by the same author. Here are Krauss (one of the main authors) disclosures “RMK receives research support from the National Dairy Council, National Cattleman’s Beef Association” are you surprised that they try to put a spin on SAFA are good? Let us assume that we accept the articles and commentaries that YOU have presented. Here is what they conclude “Epidemiologic studies and randomized clinical trials have provided consistent evidence that replacing saturated fat with polyunsaturated fat, but not carbohydrates, is beneficial for coronary heart disease. Therefore, dietary recommendations should emphasize substitution of polyunsaturated fat and minimally processed grains for saturated fat.” However, they also point out that substituting carbs with low glycemic index in place of saturated fatty acids is also likely good. This coming from persons with clear incentive to say SAFA’s are good.

        Let me state that the evidence is very clear that replacing saturated fatty acids with PUFA’s has proven time and time and time again to be beneficial.

        Below are is a link with a snippet from it below the link.

        http://www.hsph.harvard.edu/news/press-releases/saturated-fat-polyunsaturated-fat-cut-heart-disease-risk/
        This link finds “A new study by researchers at Harvard School of Public Health (HSPH) provides the first conclusive evidence from randomized clinical trials that people who replace saturated fat in their diet with polyunsaturated fat reduce their risk of coronary heart disease by 19%, compared with control groups of people who do not.”

        Take a look at current populations who have longevity. They are NOT populations with high saturated fat diets. The diets of the past are fun for conjecture, but there is much debate regarding what they at and in what proportions. We know that ancient man had heart disease, this is not new (look at the HORUS study if you not clear on this point). It seems that atherosclerosis is part of aging. Diet certainly matters, but man currently lives longer than at any time in history, but when you look at populations who live longest they tend to eat little meat, lots of veges and are much more active.

        For more info take a look at the seventh day adventist study with regards to diet. Veges/fish win out every time. This study was important because of the reliability of the diets they followed, unlike most diets which rely on questionable forms.

        • Z.M. says

          Casey: ” However, they also point out that substituting carbs with low glycemic index in place of saturated fatty acids is also likely good. ”

          Casey, the study they cited in support of this found insufficient evidence for it. I repeat, the study found that carbohydrates with high-GI in place of saturated fat was associated with a statistically significant increased risk of myocardial infarction, but NO significant associations for medium-GI or low-GI carbohydrates in place of saturated fat – http://www.ncbi.nlm.nih.gov/pubmed/20375186

          Casey: “Let me state that the evidence is very clear that replacing saturated fatty acids with PUFA’s has proven time and time and time again to be beneficial.”

          It is not clear at all. Check out my review on the topic to save me from a lengthy post – http://diettrialclaims.blogspot.com/2014/07/the-evidence-on-saturated-fat.html

          • Casey says

            Z.M. I am well aware that replacing saturated fats with polyunsaturated fats is “unclear” to you. Your blog is poorly analyzed and omits too many thing or glosses over evidence. You even mention that there were findings that replacing SFA with POLYs might be good but you try to dismiss them. None of your posts answers any of my statements above.
            You cite O’Sullivan but you don’t seem to mention that he found a SIGNIFICANT increase in the risk of mortality with increased meat consumption. What about the post commentary by Skeaff and miller.
            “to examine the ef- fect on CHD death and CHD events of replacing SFA with MUFA, PUFA or carbohydrate. The main finding was a significantly decreased risk of CHD death and CHD events when PUFA replaces SFA. The multivariate-adjust- ed hazard ratio for CHD death per 5% TE incremental substitution of PUFA for SFA was 0.87 (95% CI 0.77–0.97); for CHD events, the hazard ratio for the same fat substitu- tion was 0.74 (95% CI 0.61–0.89). This result from the pooling of observational studies, along with supportive evidence from clinical trials of lower CHD risk in high P/S diets, and the effects of PUFA to lower LDL choles- terol and the total:high-density lipoprotein ratio, led the Consultation to conclude there was convincing evidence of lower CHD risk when PUFA replaces SFA”

            The bottom line is
            1) it is very clear that replacing SFA with PUFA’s is beneficial (or if you don’t like such a firm statement…….the evidence STRONGLY suggest replacing SFA with PUFAs is beneficial.
            2) even if you don’t believe that SFA are that harmful, there is no evidence to suggest they are beneficial. Saying they aren’t horrible is NOT the same thing as saying they are good for you.
            3) epidemiological evidence demonstrates clearly that regions with extreme longevity tend to have a primarily plant based diet with occasional meat, and lots of exercise. Time to provide any evidence of longevity in populations with high saturated fat diets.
            4) take a look at the 7th day adventist study. This is one of the more reliable studies regarding diet because it is not a simple questionnaire taken on one day. The reliability and validity of this study is more powerful than many. They found that 1)not smoking 2) eating a plant based diet 3)eating nuts several times per week 4) regular exercise 5) maintaining normal body weight gave them an average life span of 7 to 10 years beyond the average. Even more if you consider quality of life years.

            The evidence is clear. Smoke, mirrors and misunderstanding or misinterpretation of data can’t change the facts.

            • Z.M. says

              Casey: “You even mention that there were findings that replacing SFA with POLYs might be good but you try to dismiss them.”

              Not exactly, it is more specific than that. The best evidence for PUFA is specifically fish/marine fatty acids. Strong conclusions are not possible even for this for reasons stated on my blog.

              Casey: “You cite O’Sullivan but you don’t seem to mention that he found a SIGNIFICANT increase in the risk of mortality with increased meat consumption”

              Because I’m evaluating saturated fat, not meat consumption, which is another topic.

              Casey: “The main finding was a significantly decreased risk of CHD death and CHD events when PUFA replaces SFA.”

              Look at the actual evidence in their paper:

              1) Intake of PUFA and linoleic acid was associated with increased risks of CHD mortality, but this depended on the type of analysis and the risks were small.

              2) No associations were found for ALA, but long chain n-3 PUFA intake or fish consumption was associated with a lower risk of CHD death.

              3) For trials, no significant effects on CHD death and total mortality were found with either lower-fat diets or high P/S diets. This was despite the fact that the analysis included trials that employed multiple interventions disadvantaging the saturated fat groups, and included a trial with serious methodological problems, which should have been excluded.

              4) Long chain n-3 PUFA intake or fish consumption was associated was a decreased risk of CHD events, CHD death, and all-cause mortality, but only after exclusion of DART 2, a trial with serious methodological problems.

              As I concluded, saturated fat, ALA, LA, and total PUFA showed no convincing relations with risk. Long chain n-3 PUFA intake or fish consumption may reduce risk. In other words, the strongest evidence from their paper is for marine fatty acids specifically.

              Skeaff and Miller is only one review, and you have to put their findings in context with everything else. Taking everything into consideration, it is not possible to come to strong conclusions on fatty acids in general.

              • Casey says

                “Not exactly, it is more specific than that. The best evidence for PUFA is specifically fish/marine fatty acids. Strong conclusions are not possible even for this for reasons stated on my blog.”

                Yup exactly, your blog is a poor reference. I should remind you that just because YOU “ZM” seem to have interpreted data in a very skewed manner and not very objectively hardly is a point for reference. Your first post in this discussion provided 3 references (were they your best?) that as I mentioned refute what you say (please refer back). Now, regarding POLYs and Omega 3′s. 2 points.
                1st: lets assume that your belief is true (it is not) and we aren’t certain whether it is the non omega-3 PUFA or the total consumption of POLYs. Lets say the data isn’t clear which (but it is clear) then your argument should be. “while it isn’t clear that PUFA’s in general without excluding OMEGA-3′s are healthier when substituted for SAFA’s the only evidence we have at this time seems to suggest that substituting POLY’s for SAFA’s seems to be good. However, I personally have a belief that it is the benefit of omega-3 that provides that benefit.” However, this is not your argument, but it is what you are saying.
                2nd: Lets look at just the study of more than 30,000 persons when they compared the CIRCULATING levels of fatty acids in the blood. They compared the top 1/3 of the selected fat versus the bottom 1/3.
                here they are in relative risk.
                saturated fatty acids 1.06
                this means that those who consumed a large amount of saturated fatty acids versus low had about a 6% increase in the risk of a cardiovascular event. (nope, it did not meet statistical significance, but it is consistent with previous studies and is a clear “signal”)
                Omega-3 Highest 1/3 RR of 0.84
                this means there was about a 16% reduction in cardiovascular events in the higher consumers. No surprise there
                Omega-6 highest 1/3 RR 0.94
                this means there was about a 6% reduction in cardiovascular events with the highest consumption of NON omega -3 PUFA’s.
                Here was a meta analysis done in 2010 that made a point of including OMEGA-6 and not omega-3 in their analysis to help distinguish between the two (take a look at it, it has plenty of links to other research that demonstrates the same)
                If that isn’t good enough take a look at the 7th day adventist study
                or perhaps the recent mediterranean diet study
                or any epidemiological data.
                The evidence is clear that replacing SAFAs with POLYs is a good idea if you want to reduce risk of vascular disease.

                “Because I’m evaluating saturated fat, not meat consumption, which is another topic.”

                Not in your blog you weren’t you were promoting the benefits of food from that study that didn’t show a relationship to heart disease. The point of commenting on why you seem to have omitted an important finding is that you have a clear biases and aren’t looking for the truth otherwise you would have commented on that point. I suspect it is because meats tend to be where we get much of the saturated fats in our diet and when people think about saturated fats they think of meats. So lets reiterate. The study you seem to think is helpful to your argument states there was a clear harm from increased consumption of meat.

                Taken as a whole it is very clear that.

                1) replacing polyunsaturated fats for saturated fats can provide risk reduction in heart disease, whether those polyunsaturated fats are omega-3 or n-6′s.
                2) calling a study bad because they disprove what you would like to be true doesn’t help anything.
                3)In almost all of these studies there is a clear “trend” or signal that increasing saturated fatty acids might be harmful. (for those who don’t know when they perform these meta analysis they really are fraught with errors for many reasons, but in general they have demonstrated that there is no clear increase in risk from saturated fats. However, there is certainly a “trend” or “signal” that there is harm. It is sort of like reading about the odds of getting heads when flipping a certain coin. Lets say every study they do with this “coin” does not show a statistical difference between the number of heads versus the number of tails. However, if you look at the trials themselves you see that in almost every one of the studies heads appears more often than tails (lets say 52% of the time on one study and 51% on another and 54% on another and then 57% on another and 52% of the time on another) even though the research doesn’t demonstrate a statistical significance between head or tails you would be a fool to bet on tails. There is probably something wrong with that coin that trends towards heads.

                Again, the best evidence we have is looking at communities or people who seem to live much longer than others. The basics of their lifestyle are….
                1) don’t smoke
                2) exercise
                3) eat primarily plant based diets
                4) +/- drink alcohol in moderation
                5) don’t eat much meat (see it is relevant, hard to get a lot of saturated fat in your diet if you don’t eat meat)

                • Z.M. says

                  Casey, it is tedious replying to your lengthy posts, especially when you are citing the same studies I have already commented on in my blog in more detail. Furthermore, I think the reader would see quite clearly who is really interpreting the data in a “skewed manner” after reading your posts and my blog post on the subject.

                  I initially responded to a specific claim which was misleading, and did not intend to get into an argument with someone who has already made up their mind, and in my view is thoroughly misrepresenting and misinterpreting the evidence.

                  Given this, I’m quite content to let it rest here and let the undecided readers make up their minds.

              • B.Dobson says

                I have to call you out on (I am talking to km) “Casey: “You cite O’Sullivan but you don’t seem to mention that he found a SIGNIFICANT increase in the risk of mortality with increased meat consumption”

                Because I’m evaluating saturated fat, not meat consumption, which is another topic.

                In your blog you write. “O’ Sullivan conducted a cohort analysis on specific food sources of saturated fat, but found no association between butter, milk, cheese, dairy and all-cause/CVD mortality.”

                Comments: Saturated fat showed no convincing relations with risk.”

                You did intentionally omit the evidence that in O’Sullivans study he found that meat was statistically associated with increased risk of mortality.

                On your blog when you use some of O’Sullivans finding to suggest foods high in saturated fats are not bad even though O’Sullivan actually found that increased meat consumption is associated with increased mortality.

                You clearly have an agenda.

                • Z.M. says

                  B.Dobson: “You did intentionally omit the evidence that in O’Sullivans study he found that meat was statistically associated with increased risk of mortality.”

                  For meat intake, the authors rightly did not attribute the small risk increase to saturated fat. So it in fact further supports my case, and as I said before is a different subject.

        • B.Dobson says

          I had to navigate to get to the article you were referencing casey. You may want to post the actual link to the paper itself unless you wanted the article you actually linked to to be read. Very informative. 19% reduction in cardiac events with increasing polyunsaturated fats in place of saturated. Cardiac deaths were decreased by 20%. ZM does have a post about this article but there is nothing beneficial or new to be gained by reading his comments. Everything he says and more is addressed in the commentary. Great study! ZMs links were good too but they did seem to support your (casey) argument.

          • Z.M. says

            B.Dobson: “19% reduction in cardiac events with increasing polyunsaturated fats in place of saturated. Cardiac deaths were decreased by 20%”

            This is Mozaffarian’s analysis. To understand these reviews you have to understand the studies included in it:

            Mozaffarian’s review on trials claimed that PUFA in place of SFA reduces CHD events, but once again it included trials with multiple interventions and a trial with serious methodological problems (24, 37, 38, 50), already recognized by others (29, 32). It also left out other trials without justification (49) and did not have info at the time for cause specific endpoints from one other trial (33). Despite all this, there was no reduction in all-cause mortality.

            Have you ever read the studies included in Mozaffarian’s review? Furthermore, why cherry-pick one review and ignore all other reviews with a fairer selection of trials?

            Thanks for your comment, because it indicates that I should do a review of the individual trials first, then analyze the meta-analyses so the reader would better understand them.

            I do not have an agenda, and have never promoted any particular diet.

            • Casey says

              ZM: Smoke and mirrors. This is a desperate attempt to get people to read your blog. There are methodological flaws in all trials, bar none. You seem to discount the flaws in trial when they approve what you believe, but you embrace the flaws when they are what you do not want to believe.
              When Burt recognized that what I said about you omitting meat from O’Sullivan’s research you said it wasn’t relevant to saturated fats even though on your blog you only included the research because it was ONLY relevant to saturated fats. Now you argue that the “author” discounts the effect of meat, guess what? He does the exact same things for the foods you included in your comments. So why would you include foods from the same trial that did not show an increase in mortality from a trial and say the data and research is good but then omit data from the same trial and say it was bad? Yes the author does recognize the flaws in the research (but you didn’t) so you shouldn’t have included any of it if you didn’t want demonstrate bias. You can’t have it both ways. The bottom line is, if you are going to use O’Sullivan’s research you have to take the good with the bad, but don’t take what you want and then dismiss the rest.

              Regarding “Mozaffarian’s review” You added nothing to the conversation. Nothing. You have little blurb about something, but they discuss all the flaws paper and explain everything as many authors do. The results stand. It is very clear that replacing saturated fats in a persons diet with polyunsaturated fats regardless of whether they are n-6′s or n-3′s (n-3′s are better) lowers both cardiovascular mortality and morbidity. In your blog you provide a link to a paper from 1965 that has no relevance to this research. Do you even read the things you reference? You argue that they didn’t include reasons for inclusion, but you are wrong yet again. Did you even read the paper? They (just like most) included criterion for inclusion.

              Here is the actual link to the research:
              http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000252
              If someone wants to know about the research and the limitations go read for yourself. Never rely on a person telling you what the research says. Avoid at all costs a “blog” summarizing and then giving you their own interpretation of the data or you will end up with important data being omitted, unimportant data being highlighted, research being discounted and conclusions derived by personal opinion. The author’s of most research will tell you the flaws and what you can and can’t take from the research. You can also read critical reviews of research online, but you should only do that from a well established source.

              As it stands:

              Polyunsaturated fats in place of saturated fats will reduce cardiovascular disease.

              Low glycemic index (this is according to YOU) in place of saturated fats will likely lower risk.

              Most civilizations with longevity tend to have extremely low saturated diets.

              Nowhere do you address the fact that persons and cultures that live longest don’t consume much saturated fats.

              • Z.M. says

                Casey: “Now you argue that the “author” discounts the effect of meat, guess what?”

                Meat intake was associated with a small increased risk, and the authors mentioned various possibilities, but did not actually attribute the increased risk to the saturated fat content. Get it? It’s saturated fat we are talking about here.

                Casey: “You argue that they didn’t include reasons for inclusion, but you are wrong yet again. Did you even read the paper? They (just like most) included criterion for inclusion.”

                The exclusion of that 1965 trial was unjustified. This was also noticed by Ramsden et al – http://www.ncbi.nlm.nih.gov/pubmed/21118617

                Casey: “Low glycemic index (this is according to YOU) in place of saturated fats will likely lower risk.”

                Never claimed such a thing.

                Casey: “Nowhere do you address the fact that persons and cultures that live longest don’t consume much saturated fats.”

                The point of the blog post was to evaluate prospective cohort studies, randomized trials and their reviews or meta-analyses, all at the top of the hierarchy of evidence.

                • Casey says

                  KM: I am not certain you understand the research you are presenting. You provided this information
                  “There was a study that tried to answer this question which found that carbohydrates with high-GI in place of saturated fat was associated with a statistically significant increased risk of myocardial infarction, but no significant associations for medium-GI or low-GI carbohydrates in place of saturated fat – http://www.ncbi.nlm.nih.gov/pubmed/20375186
                  In this study that you provided there was (not statistically significant) decrease in MI when you replace saturated fats with low glycemic foods. Perhaps you don’t understand how to interpret the research but here is the conclusion of the author that you recommend we read.
                  “This study suggests that replacing SFAs with carbohydrates with low-GI values is associated with a lower risk of MI, whereas replacing SFAs with carbohydrates with high-GI values is associated with a higher risk of MI.”
                  So I will state again.

                  “Low glycemic index (this is according to YOU) in place of saturated fats will likely lower risk.”

                  I am glad that you concede that you have no evidence that cultures and people who seem to live longest lived primarily on plant based diets.

                  I do find it interesting that you agree that the mediterranean diet (One that is high in PUFA’s and low in SAFA) provides health benefits, but for some reason you don’t believe this has anything to do with the lower SAFA levels in the diet. (The mediterranean diet is essentially replacing both carbohydrates and SAFA with POLY’s and MONO’s, and has clear improvement in cardiovascular outcomes).

                  In reference to your 1965 study. Now I see what you are doing. You are trying to read what other people are writing and copying them. I suspect you haven’t read much of the research. Take a look at Mozaffarian’s paper. It includes the 1965 in a chart and they give reason for excluding it along with 50 + other papers. Before putting faith in what others write you should understand the information yourself.

                  Regarding your understanding of the “meat” controversy. I have no problem with saying that there might have been other confounding causes outside of saturated fatty acids that caused the increased risk of mortality (even though this is consistent with other studies) HOWEVER, this is also what the author says about the dairy not just the meat. So if you want to discount the clear HARM this study found with meat you can’t at the same time praise the lack of harm (not benefit) that came with increased dairy, and that is what you did. You wrote and acted as if this study demonstrated that saturated fatty acids weren’t harmful based on this study while ignoring the harm from meat. If you discount the meat in this study you have to discount the dairy.

                  To summarize:
                  evidence demonstrates that replacing SAFA’s with PUFA’s will likely be beneficial to your cardiovascular system.

                  Replacing SAFA with low glycemic index carbs MIGHT be beneficial.

                  Clear evidence from existing populations with longevity demonstrate high fruit/vege and low meat diets are healthiest.

              • Z.M. says

                There is no reply button to your latest post so I’m replying here.

                Casey: ” This study suggests that replacing SFAs with carbohydrates with low-GI values is associated with a lower risk of MI, whereas replacing SFAs with carbohydrates with high-GI values is associated with a higher risk of MI.”

                I interpreted it correctly because the result for low-GI was not statistically significant. You will notice I said “but no significant associations”. I don’t know if you have read other papers, but other researchers also interpret it the same way I do, because it is not correct to cite non-significant findings to support your case. A consistent standard is imperative to avoid bias, and I cannot come to strong conclusions based on a non-significant result whether it supports my beliefs or not.

                Casey: “I am glad that you concede that you have no evidence that cultures and people who seem to live longest lived primarily on plant based diets.”

                Hmm…why are you always putting words in my mouth?

                Casey: “but for some reason you don’t believe this has anything to do with the lower SAFA levels in the diet.”

                because there is no evidence that the benefits are due to safa restriction.

                Casey: ” Take a look at Mozaffarian’s paper. It includes the 1965 in a chart and they give reason for excluding it along with 50 + other papers. Before putting faith in what others write you should understand the information yourself.”

                It seems that you do not understand Ramsden’s point. By their reason for exclusion (multiple interventions) the STARS study should have also been excluded also for having “multiple interventions”, which can only mean in this context “multiple arms”.

                Casey: ” So if you want to discount the clear HARM this study found with meat you can’t at the same time praise the lack of harm (not benefit) that came with increased dairy, and that is what you did.”

                It’s not about discounting anything, but rather finding evidence for safa’s so called harm. In this field it is very difficult to discount anything because you can always come up with an ad hoc explanation for why no evidence was found, which is why the burden is on those who want to demonize a specific nutrient. So no evidence was found for for the harmful effects of safa whether it was meat or dairy. Since this is the case, non-causation has to be assumed until proven otherwise, or in statistical terms, no evidence against the null.

                • Casey says

                  “This study suggests that replacing SFAs with carbohydrates with low-GI values is associated with a lower risk of MI, whereas replacing SFAs with carbohydrates with high-GI values is associated with a higher risk of MI.”

                  KM: I see your limitation in understanding the research. You “cherry pick” as you like to say data. The statement I made stands. This study clearly “suggests” that replacing saturated fats with low GI value carbs is beneficial (and this is consistent with most trials). Nope it did not meet statistical significance (0.05 P) but there was a clear trend (please read my posts). If you walked away from that trial believing only that high GI foods in place of saturated fats is bad then you really need to start over. Again, the author rightfully argues and even states that this study suggests low GI foods in place of saturated fats was beneficial.

                  I am glad that you concede that you have no evidence that cultures and people who seem to live longest lived primarily on plant based diets

                  You have no response or even any evidence to support the contrary so your omission in a concession.

                  Casey: “but for some reason you don’t believe this has anything to do with the lower SAFA levels in the diet.”

                  because there is no evidence that the benefits are due to safa restriction

                  Interesting way of looking at a diet that makes a point of avoiding many foods high in saturated fats. Allow me to rephrase. The Mediterranean diet, which is one of the only diets demonstrated to provide primary and secondary cardiovascular benefits which also happens to be a diet high in Polyunsaturated fatty acids and lower in saturated fatty acids and is currently a clear favorite for reducing heart disease and also happens to meet the low glycemic index on carbs but it has nothing to do with saturated fatty acids. I might also point out that this points to the fact that almost any culture we look at that has longevity eats this style of diet. How’s that?

                  Maybe this. Even though KM hasn’t seen the P value on them yet every diet that seems to decrease cancer and decreased the risk of cardiovascular disease has lower saturated fat and higher polyunsaturated fat as a staple.

                  with regard to o’sullivan she found “High intakes of meat and processed meat were significantly associated with an increased risk of mortality ” just because there are ways to dance around the fact and say the data could be confounded or whatever you want to say. The fact remains that meat met statistical significance for harm. You even try to state that you can find fault with any study (you can) but you don’t get to praise ones that say what you want and then discount ones that say what you don’t want. I see that you changed your blog on this issue, which was good but your bias is clear. You should have written that she found a statistically significant increase with increased meat consumption but none with dairy.

                  With regard to
                  It seems that you do not understand Ramsden’s point. By their reason for exclusion (multiple interventions) the STARS study should have also been excluded also for having “multiple interventions”, which can only mean in this context “multiple arms.

                  at least now you recognize that they did in fact give reason for exclusion. However, you then try to infer what they meant by multiple interventions. You seem to think it has to do with an “arm” of the trial. Nope. Let me help.
                  In that trial (which you certainly have to know was not a very good trial. poor compliance. They used a P value less than .1, great googly moogly) when they said multiple interventions they meant that in the placebo arm they essentially did nothing. In the trial arms that both tried to enforce a diet and tried to enforce consumption of different oils (as you know the oil compliance was poor at absolute best and the diet part was not likely very good) so each arm had multiple interventions making it difficult to interpret and apply meaningfully.

              • Z.M. says

                Casey: “Nope it did not meet statistical significance (0.05 P) but there was a clear trend ”

                If all you have is a “trend” or a “suggestion” then your evidence is extremely weak and insufficient. Citing non-significant results for your case is simply desperate.

                Casey: “I am glad that you concede that you have no evidence that cultures and people who seem to live longest lived primarily on plant based diets”

                Stop trying to change the subject, and put word in my mouth. I never conceded anything.

                Casey: “You should have written that she found a statistically significant increase with increased meat consumption but none with dairy.”

                Again, the issue here is saturated fat, not meat per se.

                Casey: “at least now you recognize that they did in fact give reason for exclusion.”

                I always knew their reason for exclusion. Again, multiple interventions in this context can only mean multiple arms. STARS was a true “multiple intervention” trial in the normal sense since it involved other changes besides fat intake, confounding the comparison. Whereas the Rose trial was much better controlled since the changes were largely confined to dietary fat. Therefore, they could not have excluded Rose because of “multiple interventions” in the usual sense of the word (unless there are crazy), since STARS is the true multiple interventional trial here, which they included.

                • Casey says

                  WOW, you must be new to research, or you are blinded by a love of SAFA. Lets approach 2 of the topics that seem to confuse you.
                  It is funny that you attempt to suggest that meat and all the other foods included in O’Sullivan’s research is not related to saturated fat. Here is the title of the research.
                  “Food sources of saturated fat and the association with mortality: a meta-analysis”
                  She was attempting to study foods high in saturated fats and determine their association with mortality. You seem to want to report the part you like and gloss over the part you don’t.

                  “Saturated fat showed no convincing relations with risk. Dairy and specific dairy sources are generally not associated with risk, whether high-fat or not (59). O’Sullivan’s analysis is one of the few cohort reviews that reported on total mortality. It is consistent with studies that reported on cardiovascular outcomes as well as total mortality, finding virtually no evidence of mortality increases associated with saturated fat intake”

                  This is from your blog. You say “saturated fat” in the beginning when referring to the dairy part but deny saturated fats have anything to do with meat. Interesting that YOU want do that when the author did not. I would agree that there are issues outside of saturated fat that could be the culprit, but that would apply to YOUR dairy also. You can’t say her research applies to dairy but not meat. You either take the good and the bad or you don’t take either. You cherry pick. Instead of telling the truth you use the word “virtually”. You seem compelled to point out the evidence that when dairy foods are used as a surrogate for saturated fat it did not demonstrate an increase risk of cardiovascular problems. However, from the same author from the same study you discount the absolute statistical significant finding that meat (when used as a surrogate for saturated fat)
                  Here is what O’Sullivan says
                  “High intakes of meat and processed meat were significantly associated with an increased risk of mortality”

                  The second point I want to comment on is your misunderstanding of research. Multiple interventions does NOT mean multiple arms or even multiple risk. The reason rose’s work (besides the obvious for anyone who has read that research) was not included and the STAR was is because of the multiple interventions. Apparently this needs some explaining.

                  In Rose’s work there was a placebo arm (simple enough) the other two arms had multiple interventions BOTH DIET AND OIL intake. There was NO single intervention. This trial would have been included if they had included a 3rd arm that only had diet included. (see, one intervention) Rose had more than 1 intervention in each arm. This has nothing to do with the number of arms. In the STAR trial there were more than one are BUT THEY HAD ONE WITH A SINGLE DIETARY INTERVENTION Hopefully now you go back and understand the research a little better.

              • Z.M. says

                Casey: “In Rose’s work there was a placebo arm (simple enough) the other two arms had multiple interventions BOTH DIET AND OIL intake. There was NO single intervention.”

                First of all, to correct your last post, they used an alpha level of 0.05, which is standard. The increased risk approached the significance level, but was not statistically significant (i.e. p > 0.05). Also, enforcing a diet by replacing animal fats with unsaturated oils is not a multiple intervention in the normal sense, and this is exactly what you want to evaluate (as Rose did). If this is a multiple intervention then all trials should be excluded from the analysis, because all of the other trials also replaced animal/saturated fat with unsaturated oils. Including changes in animal fat AND other factors (e.g. increases in fruit and vegetable intake, reductions in trans fat and processed foods etc.) is employing multiple interventions. Oslo and STARS employed multiple interventions, Rose did not. Get it?

                Casey: “You say “saturated fat” in the beginning when referring to the dairy part but deny saturated fats have anything to do with meat.”

                NO. Dairy is not associated with risk so there is no evidence that saturated fat is harmful there. Meat increased risk but there was insufficient evidence to conclude that this was due to saturated fat.
                I’m looking for evidence that saturated fat increases risk, not meat. After all, I hope you realize that the claim is specific, that saturated fat increases risk.

                • casey says

                  wrong again. Lets try again.
                  In rose’s trial the asked one arm to do nothing (no intervention). Each of the other two arms were asked to do two things 1st they were asked to avoid fried foods, and asked to restrict milk eggs among other things. If they left it at that it would be a “Single intervention trial” the intervention being the diet, the one intervention not included in the placebo arm. Here is where you get confused. They then asked each of the intervention arms to consume a certain amount of oil each, the oil as a substitution is NOT considered a food replacement it is a separate intervention. It is not the same as saying eat more fish and less red meat. It is like saying eat less meat (one intervention) and take this horrible tasting pill. There were 2 interventions neither of which were followed very vigilantly .
                  The results become clouded because it isn’t clear whether the harm or benefit came from addition of oil or restriction of certain foods. Do you see the two interventions? In star they did not do this. There was ONE intervention. If that doesn’t help you might need a class on research. The author of the research and everyone else seems to understand why a paper from 1965 that had multiple interventions, poor compliance and did not reach statistical significance was not included, but KM does not.

                  Wow, you doubled down on wrong.
                  “NO. Dairy is not associated with risk so there is no evidence that saturated fat is harmful there. Meat increased risk but there was insufficient evidence to conclude that this was due to saturated fat.
                  I’m looking for evidence that saturated fat increases risk, not meat. After all, I hope you realize that the claim is specific, that saturated fat increases risk.” Let me rephrase your own sentence, you will see the folly.
                  “I am looking for evidence that saturated fat increases risk, not dairy. After all I hope you realize that claim is specific, that saturated fat increases risk” Pretty silly isn’t it?

                  Lets try again. The researcher who performed the research thought there might be something besides saturated fat when they came to the conclusion regarding both dairy and meat. You don’t get to pick one (maybe in your mind you do, but I will once again quote the author when it comes to meat and will even add the dairy part. You turn milk cheese yougur and butter into “saturated fat” and then pretend like “meat and processed meat” has nothing to do with saturated fat. I don’t care whether you call it saturated fat or not, but you can’t have it both ways.
                  “Pooled relative risk estimates demonstrated that high intakes of milk, cheese, yogurt, and butter were not associated with a significantly increased risk of mortality compared with low intakes. High intakes of meat and processed meat were significantly associated with an increased risk of mortality”

              • Z.M. says

                Casey: ” Each of the other two arms were asked to do two things 1st they were asked to avoid fried foods, and asked to restrict milk eggs among other things. If they left it at that it would be a “Single intervention trial” the intervention being the diet, the one intervention not included in the placebo arm. ”

                If they left it at that it would be called a “dietary fat reduction trial”, not a “fat modification trial”, and if not compensated by other foods weight loss would occur and confound the comparison.

                Rose is a “fat modification trial”, comparing animal/saturated fats to unsaturated fats (in this case from vegetable oils). The diets of both groups were similar with the exception of the fat sources. Given this, Rose’s trial had the ability to evaluate polyunsaturated fat vs. animal/saturated fats. STARS was unable to do this because of multiple confounders (numerous differences other than dietary fat between the groups). Calling oil a “substitution” or “food replacement” is irrelevant, since the point of the trial was to compare different sources of fats, which it did.

                By your definition every trial (not involving weight loss) should be excluded because every trial involves replacing something with something else to maintain energy balance. So every trial would involve at least two interventions.

                Casey: “The author of the research and everyone else seems to understand why a paper from 1965 that had multiple interventions”

                Actually, I’m pretty sure that you are the only one who thinks that Rose employed “multiple interventions”.

                Casey: ” The researcher who performed the research thought there might be something besides saturated fat when they came to the conclusion regarding both dairy and meat.”

                You continue to miss the point. No evidence was found that saturated fat was harmful, regardless of food source. Period, end of story. I am not the one turning milk, cheese etc. into saturated fat. People who demonize saturated fat point to these foods and specifically blame saturated fat. These are the people that turn whole foods into specific nutrients, not me. I am simply refuting these claims, showing that demonizing a specific nutrient is misguided. Don’t you understand that? If you claim that saturated fat is harmful then you have to show specifically that saturated fat is harmful.

                Also, I don’t know why you are referring to me as “KM”.

                • casey says

                  You are hopeless, going back to your clear lack of knowledge about trials and about these trials specifically.
                  Lets go back to square one. The 1965 trial was excluded by the author because of “multiple interventions’ so your statement
                  “Actually, I’m pretty sure that you are the only one who thinks that Rose employed “multiple interventions”
                  demonstrates just how little you know about both works.

                  You also comment
                  “If they left it at that it would be called a “dietary fat reduction trial”, not a “fat modification trial”, and if not compensated by other foods weight loss would occur and confound the comparison.”
                  wrong, please reread the information already provided by me. Also, since it is clear you did not read Rose’s work. IT WAS COMPLICATED BY WEIGHT LOSS. They dismissed it as unexplained. Wow, what great research. There are many reason to exclude this multiple interventions trial. So it seems that you are the only one NOT calling it a multiple interventions trial (i suspect you have never actually performed research).

                  You state that the research demonstrated that saturated fat did no harm and used dairy as an example you can’t do that unless you also claim that saturated fat from animals does harm. You can say, dairy and such don’t seem to increase mortality but meat does. It is disingenuous to say “dairy doesn’t seem to cause harm so saturated fats don’t cause harm but meat causes harm but I don’t agree that it is from saturated fat so i wont include it”. (to use your terms) if you want to show saturated fat is not harmful then you have to show that it is the saturated fat that is not harmful not the dairy. It works both ways. I don’t care whether you say the paper didn’t show anything or that it showed that the specifics on saturated fats might matter (subtype) but you can’t say that since dairy didn’t show harm then we know saturated fats are harmless but because meat showed harm it is meaningless. Did you read the paper? Did you read what the author wrote. So once again you stand alone in your interpretation of the information. Your “agenda” as dobson says is clear.

                  sorry bout the KM thing

    • B.Dobson says

      PP Link. I have a hard time swallowing information from a cite so angled toward a plant based diet. with that said. I do believe a plant based diet is better and after reading the statistics presented by your site and some of the things said by casey and zm I think I need to read more before I comment as an informed consumer. So far I am with ya! Go plants, but can I still have bacon?

      • Casey says

        Burt: The information provided can be difficult to understand. When reading research papers you have to understand a lot about research itself. There are flaws in all research and some research can’t be applied to the general population. For instance early in this blog Chris provide as evidence to support the Paleo style diet a trial that had about 10 people in it and he reports it as fact. That is laughable. A trial that small might, at best, be a “hypothesis generating” trial. Meaning if it finds something it might design a larger trial to determine if it applies to the general population or even a specific population.
        In general the RCT’s are considered the best. Meta analysis are always fraught with errors, but still provide information. Sometimes we have to rely on observational, cohort or other studies to give us information because the data can’t be obtained any other way. For instance, with tobacco smoke we don’t have any real RCT’s to prove that they cause cancer (some would argue that without a good RCT you can’t prove anything, like they do with saturated fats) but it is unethical to make a group of people smoke, which is what you would have to do with a RCT so one will never get done.

        I would like to say that we are lucky to have such a large group of people who are trying to follow the different diets in our current time. They will provide data and evidence to either support their usefulness or they will fall away and disappear like so many do.

        In our hospital we recently had a young woman come into the hospital following the Paleo diet who was in ketosis (no big deal) because she wanted to be in ketosis. She was in great health and had been for many years because she exercises often (runs and lifts weights). However, she ended up in our hospital because after a workout her abdomen was hurting her urine was darkening and her abdomen began to swell. When I saw her she was being treated for Rhabdomyolysis (for those who don’t know this is when the muscle starts to break down and can damage the kidneys. It happens in severe accidents, because of medications, and because of exercise (these are the main ones, there are other causes). However, dehydration lowers the threshold for getting rhabdo and this person because of her diet and exercise was in chronic mild dehydration. The most likely cause (the straw that broke the camels back so to speak) of her rhabdomyolysis was the diet. She had not changed her exercise routine in years, but her diet was new (a couple of months). She didn’t believe that diet played a role went home and drank more water daily and was back in the hospital within a month with rhabdomyolysis. I would like to add that rhabdomyolysis has a high mortality rate.

        • B.Dobson says

          Thanks casey and zm, I read your blog regarding the mente study. I think you (ZM) are trying to do what you think is right, but I came away from reading that trial to understand that the mediterranean style diet is one thing they found to meet the strong criteria. This is the style of diet that casey seems to recommend. It is low in saturated fats and high in vegetables/fruits. I do think the two of you are closer in agreement than it would seem on here. I don’t know how you find the time to understand this material in such detail, it seems confusing and it seems like the jury is still out on most things. The one thing that seems to ring true is that the mediterranean diet is healthy.

            • B.Dobson says

              So much writing since my last visit. I have finished the blue zone and read more of the research the two of you (casey/zm) are quibbling about.
              Casey I see your point on the research either showing the trend toward harm with saturated fatty acids or benefit from substituting. I also see that ZM does appear to look the other way when data isn’t giving him what he wants. I still think he has an agenda.
              ZM: it looks like there is something wrong with most of the research when it comes to diet. Almost impossible to do a good randomized controlled trial. You seem to accept some but reject others when they all seem to have fault. If you think the only thing wrong with that meta analysis is one paper they included and one they didn’t I would say that you are sweating the small stuff. I don’t know if casey is being clear or not, but when I looked at the 2 studies I understood what he and the authors meant by interventions.
              You two should stop with the small stuff.
              I believe based on what I have read is that the studies are incomplete. I also believe that the proof is in the pudding and everything I have read says cancer and heart disease are lowest in those who follow plant based diets. The rest is scientific conjecture based on impossible to design trials.

              • casey says

                Bingo! You have hit the nail on the head. In general we in the world of science (some, not all) want “Evidence based” therapies. Before we believe something you need a “randomized controlled trial” (the gold standard) of trials to see if something works or not. With a medicine it is fairly easy. You blind everybody. Divide the groups into two similar groups in most respects then you give one the intervention and one a placebo or other current therapy. The outcomes provide reasonable evidence. HOWEVER>>>>>>>>

                When it comes to diet it becomes almost impossible to design a randomized control trial that is meaningful because it is difficult to “blind” (can you make half of people to eat tofu chicken and make them think it is actually chicken?) it is also difficult to get compliance. The reporting system isn’t the best (a questionnaire, and sometimes only one a year. What did you eat the day before to reflect what you have eaten all year). Then the problem is so many foods have such a diverse composition. “I ate two eggs yesterday” we can get a general idea of the protein, but what if i fried it or what if it is organic. What about yogurt, the variations in carbs, sugar, protein and fat are tremendous. So the questionnaires while most have past validity tests reliability and generalizability to exact macro and micro content are poor. Just as KM points out (but then manipulates the findings) just because meat demonstrates risk does it mean it is from saturated fat? Just because dairy didn’t show risk how do we know the nutrient value of dairy masked the harmful effect of saturated fats. We don’t.
                When it comes to diet a good RCT if practically impossible except in terms of generalizability. When it comes to specific diets the data is a little different, the 7th day adventists follow a pretty strict diet, mediterranean (crete) style is fairly generalizable. This is why epidemiological data is so important when it comes to diet because when you perform a RCT there are always questions and doubt even more so with diet (as you see from the quibbling). To complicate matters saturated fats are mostly myristic, lauric, palmitic, and stearic acids and most foods with saturated fats have a mixture of them. These fats have a mix of how they are digested whether through the portal vein or through incorporation into chylomicrons. And each has a very specific effect on inflammatory mediators, we know this from specific isolation of each fat and infusion studies. The problem is that we lose information as we move away from the microscope because most foods have a mix of them. There are some exceptions, like coconut oil has a lot of lauric acid where most saturated fatty acid foods don’t. So you see the confusion when we try to generalize the effect of saturated fatty acids. While RCTs are still helpful they can be confusing to interpret,which is why in any discussion on an RCT the authors mention trends and don’t just focus on the P value, which is important but isn’t an “end all be all” sort of thing. Let me explain that a little.

                We normally use a P value of 0.05, it can be any value (P of 0.1 can be used or 0.01, in the selection we call this an “alpha”, no need to worry about the difference) basically this means there is a 5% chance that the study is wrong. So even if you get a p value of 0.05 there is still a 1 in 20 chance that the study is wrong. What if you did a study and your p value was 0.051. Some would draw a line in the sand and say you didn’t prove anything others would say that it didn’t meet the 0.05 level but come on with a p of 0.051 there is a 5.1% chance that the study is wrong versus a 5% is it really that big a difference. It can be, but because diet trials are so difficult to actually randomize the “trend” really matters. Your “proof in the pudding” is exactly right. What we know with certainty is …..
                1) longevity seems to follow persons/people who have diets high in plants low in meats (as the “blue zones” points out)
                2) evidence that replacing saturated fatty acids with PUFA’s is pretty good (especially if they are omega-3′s)
                3) don’t smoke (you won’t find an RCT on smoking but that doesn’t mean cigarettes are good)
                4) Diets high in meats tend to have lower life expectancy. Even ZM seems to agree with this (he doesn’t agree that it is from SAFA).
                5) We will never have a well designed RCT that puts the nail in the coffin for a macro dietary nutrient like “saturated fatty acids”, it would just be too difficult to perform.

              • Z.M. says

                B.Dobson: “Almost impossible to do a good randomized controlled trial. You seem to accept some but reject others when they all seem to have fault.”

                No one ever said that there are perfect trials. However, there are degrees of quality based on objective principles. Different trials differ in what they can claim based on quality and confounders.

                The trials finding benefits were rife with confounders to anyone who has read them, since there was no attempt to isolate the pufa safa change. Most of the older trials attempted to isolate this change and so were far better (not perfect) controlled. If you are familiar with the concept of a scientific experiment you would know what I’m talking about.

                Remember that the claim is that replacing safa with pufa is beneficial, and if a trial replaces safa with pufa AND decreases trans fat, decreases processed foods, increases fruits and vegetables etc., then the ability of the trial to evaluate the pufa safa change is considerably diminished. This is basic science here, not an agenda.

                B.Dobson: “You two should stop with the small stuff.”

                I tried to end the discussion earlier, but hopefully it can truly end now because there is no resolution in sight!

        • Z.M. says

          Casey: “You are hopeless, going back to your clear lack of knowledge about trials and about these trials specifically.”

          OK Casey, enough. I’m not going to reply anymore, because you would keep carrying on and on to no end. I’ve also endured your snide remarks that you have inserted throughout your replies. If you think your arguments are so strong then let it rest, please.

  48. DianneP says

    I understand you people like to think in terms of stats and all…. but then that is science.
    What I do not read here is the main problem with fats….
    Canola oil seems to be the rage for being less saturated fat but we know the proportion of omega fats is damaging.
    We know that commercial fats are damaging due to tooooo much omega 6 overall.
    We also know that olive oils are mostly fake from Italy so cannot be trusted.
    I buy one brand of coconut oil and a different brand of olive oil, both known to be totally organic.
    Other than that, nuts, avocados, chia seeds, are basically unprocessed sources of fats with the added benefits of protein.
    We need to eat fat in our diets…. for nutrients, taste and I believe it is essential for the cells. It is really a mess out there but it can be sorted by the lay person.
    I hate the processed world of fats as this is the main issue.

    • Casey says

      Dianne, while I believe there is likely some truth to your emotional, rather than scientific, belief in organic and such there is no evidence to support what you say. It is based on what you believe not what you know. Again, I would like to believe and even use my purchasing power to get the purest least processed oils and such that I can there is still no evidence to support the arguments that it makes any difference.

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