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.
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{ 47 comments… read them below or add one }
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?
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.
rice not a natural source of food?! huh??
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.
I believe he means “white rice” the bleached /processed rice. Rice is not naturally white.
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
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!!
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.
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.
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.
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.
Looking forward to it!
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.
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
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.
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
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
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.
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
It was halted and reversed. Read the full text.
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.
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.
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.
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.
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
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.
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.
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.
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?
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
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
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? ……
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.
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?
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.
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
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
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.
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:
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/
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.
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.
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.
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.
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.
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!!
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/
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).