Oh saturated fatty goodness. The fountain
of guilt for many a delectable meal, the source of your ever expanding waist
line and those lurking deposits in your arterial walls that are just begging to
cause your heart to spontaneously combust. These thoughts seem to be so
ingrained, so obvious to a vast
majority of people in today’s society that when it comes to health and
wellbeing and a move towards improving the diet, most will automatically
attempt to reduce their intake of saturated fatty acids (SFA). This has allowed
for hundreds of products to erupt onto our supermarket shelves that boast
labels like ‘99% fat free’ or ‘baked not fried’ and be sold by the millions,
clever marketing techniques reinforcing the fear of death in us for anything
even remotely fat related. Never mind what this essential component (yes that’s
right – essential) in our food is being replaced with, ie: a chemical
shitstorm, or the fact that the evidence suggesting we avoid SFA originated in
the 1950’s and has since been thoroughly debunked by scientists and dietitians alike, saturated fat is considered by many to be the root of all evil in
current Western dietary habits.
Thankfully, a growing number of thinkers
have begun to question where these beliefs have stemmed from and why saturated
fat has been positioned as such a great evil. After all, it is a substance
which makes up about 50% of every cell in the human body and the form our
stored excess energy takes. As a result, a new hypothesis is currently gaining
steam in what may still be considered ‘fringe’ areas of dietary science, but
has nevertheless garnered hundreds of thousands of supporter’s worldwide. Heard
of the Paleo diet? Atkins? Naturally developed a fear of carbohydrates after
6pm without really understanding why? These are all slightly modified elements
of a high fat low carbohydrate diet (HFLC) for which the benefits are slowly
making more and more people sit up and take note. New ideas being put forward state that our diet should be made up of high fat, moderate protein and low carbohydrate intake.
Naturally, most people currently operating
under mainstream nutritional thinking will react with fear or scepticism to the
concept of a high fat diet. But as with many other nutritional myths that need
to be thoroughly debunked before we can move towards curing our obesity,
diabetes and heart disease epidemics, the education around saturated fat needs
a serious face-lift.
The vendetta against SFA started in 1950’s
with a scientist named Ancel Keys. Keys conducted various studies which centred
on linking environmental and behavioural factors to heart disease, with a big
focus on dietary input. There’s a common misconception when it comes to Keys
and a paper titled ‘The Seven Country Study’, which was one of his most
prominent studies linking heart disease to SFA intake. The story goes that he
collected data on the total fat intake and
mortality from atherosclerosis (blocked arteries leading to heart attack) rates in 22 countries which when graphed looked like this:
A graph which shows very little association between fat intake and heart disease, and certainly no conclusion that saturated fat causes heart disease. So instead, Ancel Keys chose to cherry-pick the data
that would best support his hypothesis, and thus boiled it down to six
countries which when graphed looked like this:
And presented only this simplified version
in his study, which would go on to form the backbone of our current nutritional
thinking.
However, although
it is true that he cherry picked data, he didn’t commence the famous ‘7 Country
Study’ until 1958 while this original six country graph was born in his paper titled
“Atherosclerosis: A Problem in newer public health” in 1953 [1]. He was even
met with opposition when he gave a talk to the World Health Organization (WHO)
two years later in 1955, where it was argued that the link he found between SFA
intake and heart disease was too weak. The opposition included the American
Heart Association (AHA) who said in 1957 that more controlled studies needed to
be carried out before a link between saturated fat, cholesterol and heart
disease could be influential in changing people’s diets. In 1958 Keys commenced
his famous ‘7 Country Study’ [2, 3], which correlated with his new chairmanship
on the AHA Council of Community Service and Education’s study committee [4]. Under
Ancel Keys and another board member Jeremiah Stamler’s influence, in 1961 the
AHA officially started to endorse a low fat high carbohydrate diet [5]. Keys’
was featured on the cover of Time Magazine in January 1961 for his contribution
to this research and secured himself as the father of dietary science. He
initiated two prominent hypotheses: The ‘diet-heart’ hypothesis and the
‘lipid-heart’ hypothesis.
It’s important to understand the difference
between these two hypotheses. The diet-heart hypothesis is the idea that intake
of dietary cholesterol and saturated fat will raise serum cholesterol (blood
cholesterol) levels in humans. The lipid-heart hypothesis holds that high
concentrations of serum cholesterol cause heart disease.
As a result of the AHA releasing
information correlating to ‘scientific evidence and studies’ and mounting
‘evidence’ that foods containing saturated fat and cholesterol lead to heart
disease, the US Department of Agriculture (USDA) and Health and Human Services
(HHS) released their first Dietary
Guidelines for Americans in 1980. These guidelines stated that fat should
make up no more than 30% of total daily intake while intake of complex
carbohydrates should encompass 6-11 servings a day [6]. In 1984, Time magazine
released an issue dedicated to health and nutrition with a cover titled
‘Cholesterol. And now the bad news…’ with the main article proclaiming that the
diet heart hypothesis had been definitively proven and the AHA were right all
along.
Every five years
since 1980 the USDA and HHA have released a revised copy of the dietary
guidelines which have continued to vilify saturated fat or foods high in
cholesterol in the diet. In 1992 the USDA introduce a food pyramid to simplify
their concepts of what a balanced diet should look like. Today you will find
this same food pyramid on many ‘healthy’ food products and integrated into our
school curriculum. It is also reflected in the RDI guidelines you will on the
back of many of the cereal boxes lining supermarket shelves. In all reality,
the food guidelines originating in 1980 in the US are no different from those
that we apply to ourselves in NZ today [7]. And thus our well-ingrained ‘facts’ on saturated fat and cholesterol are systematically implanted from birth. NZ happens to be the second fattest
and preventable disease ridden country in the world behind the US.
Unfortunately, the
evidence to back these beliefs up has never been conclusive enough to justify
our current behavior towards food. And the proof is in the pudding: dietary
trials and guidelines were initially developed to curb the ever increasing
pandemic of diabetes, obesity and the number one killer since the 1900’s –
heart disease. Today, heart disease is still the number one cause of death
worldwide [8]. Obesity rates have doubled for adults since the 1980’s and even
more disturbingly, in some countries tripled for children [9]. WHO estimates
the number of individuals with diabetes worldwide to be 347 million, 90% of
which is type two diabetes (a preventable disease due mainly to poor diet and
inactivity) [10]. Clearly, despite decades of time and millions of dollars
being spent in an attempt to curb our unnecessary death rate from preventable
diseases, the guidelines and education we are currently pushing are not working.
So what’s the
solution here? Firstly, it’s important to begin to get the facts right.
Saturated fat is
an essential component to our bodies make up; around 50% of our cell membrane
structure is made from SFA. The term ‘saturated’ indicates on a biochemistry
level that all carbon atoms are occupied by a hydrogen atom, making it very
stable and unlikely to oxidise and contribute to inflammation. Saturated fat is
essential for the breakdown of fat soluble vitamins E and K, and saturated
animal fat holds high levels of essential vitamins K2, A and D. It is an
excellent source of energy for the body; we even store excess carbohydrates as
saturated fat to be readily accessible when needed. (In fact, when we burn body
fat through dieting or exercise your body is consuming saturated fat as it
would do if you had eaten it – the processes are exactly the same.) Thinking
about this evolutionary wise – why would our bodies have naturally developed
over millions of years a tendency to store a substance that causes heart
disease? This is exactly why it of course, doesn’t.
The evidence condemning
saturated fat comes down to serum cholesterol and its association with heart
disease (the lipid-heart hypothesis). At a glance, high serum cholesterol has
been linked to heart disease through elevated levels of LDL lipoproteins in the
blood. Cholesterol is fat soluble and therefore unable to travel around in the
blood stream easily, instead it is packaged with triglycerides and
phospholipids and transported via HDL and LDL lipoproteins. LDL has
traditionally been viewed as the ‘bad’ carrier – its job is to carry cholesterol
away from the liver to the various areas of the body it is needed for. HDL goes
the opposite direction and picks it up to be transported to the liver, where it
is excreted as bile. Traditional cholesterol tests measuring your risk of heart
disease will separate total HDL cholesterol (HDL-C), LDL cholesterol (LDL-C)
and triglycerides, basing risk factor on the total amount of LDL-C.
However, recent research
has discovered that it is not actually the overall level of cholesterol in the
blood that poses a threat to the heart, but the number of lipoprotein particles
themselves. More specifically, it is a combination of low HDL particles, high
triglycerides and high levels of a particular type of LDL lipoprotein [11]. LDL
can be recognized in two ways – light, larger and low-density, or small and high-density
particles. The larger LDL pose no threat at all while these smaller particles
are more likely to go through a process of oxidisation and cause inflammation,
which research has shown is more likely to cause atherosclerosis or heart
disease than anything else [12].
Cholesterol is
just another substance, like saturated fat, which has been battling against a
bad rap for decades now. Looking back at the diet-heart hypothesis stating that
foods high in saturated fat or cholesterol raise serum cholesterol levels, at
least one half of this statement has since been accepted as false by the
nutritional community at large. Cholesterol is produced in the liver where at
least 75% of our daily needs can be easily made; the other 25% comes from
dietary cholesterol. The liver has the ability to self-regulate production of
cholesterol in relation to the amount we consume; when we eat too much the
liver produces less and vice versa. Something even Ancel Keys can agree on:
“There’s no connection whatsoever between cholesterol
in food and cholesterol in blood. And we’ve known that all along. Cholesterol
in the diet doesn’t matter at all unless you happen to be a chicken or a
rabbit.” – Ancel Keys, Ph.D., Professor Emeritus at the University of
Minnesota, 1997
Saturated fat is associated with serum
cholesterol levels a little more closely, but a more in depth examination shows
that saturated fat only raises levels of the larger, airy LDL particles at the
same time as increasing HDL, and even decreasing triglycerides [13]. High
levels of triglyceride levels are often a marker for other diseases in the body
like insulin resistance or inflammation and will quite often be associated with
low HDL levels. High levels of triglycerides are a direct result of excess
consumption of carbohydrates [14].
Finally, we can let hard science prove that
there is no causal association between saturated fat and heart disease that has
yet been proven. A meta-analysis followed up nearly 350 thousand subjects over
23 years, looking at dietary saturated fat and effects on the heart health.
They found no association between SFA and risk of heart disease [15]. A Japanese
study followed 58 thousand Japanese men and woman over a 14 year period to test
whether SFA intake is associated with heart disease in a group whose average
SFA intake is low. An inverse relationship with SFA and mortality from stroke
was observed (as SFA intake went down strokes increased) as well as no increase
in heart diseases with an increase in SFA [16]. In a study testing the
relationship between cholesterol and heart disease/all-cause mortality in
persons over 70 years, no relationship was found [17]. Finally, dietary cholesterol
contains an essential nutrient which many of us lack – choline. It can be found
in cholesterol rich foods like eggs and meat and a deficiency of choline in the
diet is thought to have a negative impact on heart disease [18].
Disturbingly, the information and studies I
have cited in this article has been known for decades now. The statistics
around preventable, lifestyle driven diseases make it obvious that our current
health initiatives and strategies are not only not working, but are
contributing significantly to the rise of our obesity and heart disease
pandemics. Eventually, discussions and education around nutrition and the
‘benefits’ of a diet high in carbohydrates and low in fat will need to become
more prominent in schools, families and the media. There are some pretty big
obstacles in the way though – not least the trillion dollar ‘health’ industry
that owes its revenue to outdated and incorrect information it has helped
ingrain into our consciousness. And you can bet that companies will fight tooth
and nail to keep it that way. But what can you do on a personal level? Get
educated. Make use of the wonderful tool called the internet. Make informed
choices about what you are putting into your mouth and fueling your life with.
Start creating a difference in your own vitality and help to spread a positive
message on nutrition.
And lastly - start enjoying eggs for breakfast again. Egg yolks and all!
EbD
And then of course, reality set in. Not in
a ‘oh my god, life is actually quite awful and you have been kidding yourself’
kind of way. But just a recognition that
despite how good your intentions are, it can
be tough. Sometimes you do need
to sleep in a little longer and it’s not every day that you consciously want to exercise for an hour and ignore
the bags of potato chips that are perpetually floating around the office. 
When I started writing this post and
searching for motivational quotes, I instantly found that they helped me regain
some clarity. One of my favorites is from T.S. Elliot: “Only those that risk
going too far can possibly find out how far one can go.” I’d like to think of
myself as someone that will always push the boundaries in life, but how can I
possible do that when I’m sitting at home feeling sorry for myself? When I need
a bit of exercise motivation, ashamedly Tumblr will quite often offer me some
body inspiration. It’s pretty hard to crave a plate full of pasta when you’re
looking at photos of Miranda Kerr in a bikini. More importantly though, the
most effective means of re-finding my enthusiasm is by reading the goals I have
set for myself. I’ll write some more, write about my progress, what I still
need to achieve and remind myself where I would eventually like to end up. This
process allows me to see the smaller steps in front of me – sometimes I need to
focus on my short terms goals rather than the seemingly impossible big
picture. 
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