Big Fat Lies

The role of nutrition in disease prevention can at times be simpler than it is made out to be. However, when you start focusing on several different factors of how conventional dietary advice has led us astray, it can become a bit more complex. I’ve done my best to keep this article as simple as possible. My hope is that the average reader can come away with a better understanding of the lies we’ve been fed, and at the same time find just a “few” references available in the event you wish to open up a discussion on health and wellness with your health professional.

Today, 1 in 3 people are pre-diabetic or diabetic and 66% of the U.S. population is either overweight or obese. The standard dietary recommendations from the government, medical professionals, nutritional experts, and non-profit organizations like the American Heart Association and American Diabetes Association follows a low-fat, high carb approach. That advice was propagated by the government in 1980. I’d say we’ve got some catching up to do.

Since such recommendations made Americans fear the intake of whole, unprocessed foods such as butter, beef, whole eggs (yes, the yolk too), and coconut oil, the development and marketing of processed, fake “health” foods has exploded and so has our weight.

 

 

The presumptions about food in the 1970s and 1980s were based on two flawed ideas. First, that eating fat makes us fat, and second, that fat in the diet – specifically saturated fat and cholesterol – was associated with an increased risk of heart disease.

Setting the Record Straight

Myth #1: Fat makes you fat

Fact: Excess of any macronutrient (fat, carb, protein) over prolonged periods can lead to weight gain. However, not all macros are created equal. While it is true that carbs and protein have less than half the calories of fat, looking at food from a pure mathematical aspect does not fully explain how the body treats each macro differently.

For example, in this study comparing a fat/protein breakfast (whole eggs) to one of mainly carbs (bagels), researchers found that those eating the egg breakfast compared to the bagel based breakfast reported lower levels of hunger and on average consumed 400 calories less per day.[1]

Another study looked at how a low-fat diet compared to a low-carb diet could possibly lead to more difficulty maintaining weight after weight loss. In this study they found that those on a low-fat diet saw greater reductions in resting metabolic rate than those on a very low-carb diet.[2]

So, if we wanted to design an ideal meal or diet that would lead to a) increased hunger, b) the consumption of more calories, and c) a bigger decrease in metabolic rate, what would that meal or diet look like? There are a few distinct ways this “advice” could have unintended consequences.

Numerous other studies on a higher fat/low-carb diet have shown weight loss as well.[3][4][5][6][7][8][9] In fact, most of the time this type of diet outperforms lower fat diets up to the six month mark, though by year’s end they tend to be equal.

What about skim versus whole milk? Well, it should be clear by now that fat does not make us fat. Fat keeps us fuller longer, and helps us absorb fat soluble vitamins. Take this recent study comparing weight in 2-4 yr olds.[10] What they found was that those who drank whole milk had the lowest Body Mass Index (BMI, which is weight/height), those that drank 2% milk had the next lowest BMI, and those that drank 1% milk had a higher BMI than the other two groups.

While the study could lead us to believe that reducing fat in milk causes kids to weigh more, it does not definitively provide that proof. This is an observational study only, but what this study can show us is that higher fat in milk does NOT cause increased weight.

To use this graph from earlier, if fat did indeed making us fat, why is it that obesity rates were lower prior to Americans being instructed to reduce fat?

 

 

Myth #2: Fat, specifically saturated fat causes heart disease.

Fact: Saturated fat has not been associated with cardiovascular disease (CVD).[11] Let me repeat that again. Saturated fat has not been shown to be associated with CVD.

I could write a book on this topic alone, but it has been become clear over recent years that the original saturated fat and heart disease studies had serious design flaws.[12][13] And, those studies were observational, which could never have proved a direct link between the two anyway.

One type of saturated fat that is showing some benefit is the kind found in coconuts. Coconut oil has long been made a villain, but evidence shows that some societies consumed copious amounts of coconuts as part of their native diet without detrimental health problems.[14] More recent research is showing them to be even beneficial for heart[15] and dental health[16]. And while it’s way too early to tout coconut oil as a treatment for Alzheimer’s, it does have some unique properties (medium chain triglycerides) that warrant further investigation.[17]

In a systemic review of dietary factors and heart disease, the authors commented:

“The general consensus from the evidence currently available is that a reduced consumption of saturated and trans–fatty acids and a higher intake of fruits and vegetables, polyunsaturated fatty acids including omega-3 fatty acids, and whole grains are likely beneficial.

This is reflected in the revised Dietary Guidelines for Americans 2005 from the US Departments of Health and Human Services and Agriculture.24

However, little direct evidence from randomized controlled trials (RCTs) supports these recommendations. In some cases, RCTs have not been conducted, and RCTs that have been conducted have generally not been adequately powered or have evaluated surrogate end points rather than clinical outcomes.

Despite this lack of information, evidence-based recommendations derived from cohort studies have been advocated. This is cause for concern because dietary advice to limit the intake of a certain nutrient (ie, dietary fat) may result in increased consumption of another (ie, carbohydrates), which can have adverse effects on coronary heart disease risk factors…We found strong evidence that trans–fatty acids are associated with CHD risk, but weak evidence implicating saturated and polyunsaturated fatty acids and total fat intake.”[18]

Myth #3: Higher fat diets worsen our lipid (cholesterol) profile.

Fact: It sounds crazy, but the idea that cholesterol causes heart disease is widely accepted to be false.[19][20] What seems to be among the underlying causes is chronic inflammation.[21] In fact, your lipid numbers are actually helped by a higher fat/low-carb diet[22][23][24][25][26][27] and at the very least are just as beneficial to a low-fat diet.[28][29] The role of oxidized cholesterol is also leading some to question about the simplicity of labeling all LDL as “bad” cholesterol.[30][31][32]

Myth #4: Eating cholesterol raises blood cholesterol.

Fact: Again, one must first assume that cholesterol causes heart disease, which it does not.[33][34] But, let’s assume for the moment that it did. For the majority of people, if they eat more cholesterol, their body produces less, and if they eat less, their body produces more.

However, about 25% of people are hyper-responders and may see a bump in their total cholesterol[35][36], but this is because of an increase in both HDL and LDL levels, which is considered a “wash” by even those that still fear higher blood levels of cholesterol. Emerging evidence points to the importance of the size and if oxidized LDL particle[37] and triglyceride levels being for heart health[38], both of which are improved by a lower-carb diet.

Myth #5: To lower your risk of diabetes, decrease fat and saturated fat intake.

Fact: Excess processed carbohydrates in the diet along with sedentary lifestyles are likely the main drivers in the diabetes epidemic today.[39] A recent meta-analysis has shown that low-carb diets, and Mediterranean Diets (though usually lower in saturated fat) kicked low-fat diets’ butts when it came to improving health status’ of diabetics.[40]

Other studies show that low-carb diets work well for blood sugar control as well.[41],[42],[43] One review mentions a study comparing intake of saturated fat and monounsatured fat being equal, yet no significant difference in blood sugar control following a meal.[44]

Myth #6: To lower your risk of heart disease, replace butter with “buttery spreads” that contain “heart-healthy” vegetable oils.

Fact: Numerous people in the health field have been saying for years that vegetable oils, because they are easily oxidized and throw off the balanced ratio of omega 3s to omega 6s in the diet are anything but “heart-healthy”, and likely cause much more harm than good.

Just recently “recovered data” from a 1970s study was reported on in which people reduced butter intake for safflower oil (one of the common vegetable oils). Keep in mind this is what the American Heart Association recommends for improving heart health. The study found that those who changed their diet and dropped butter intake for vegetable oil died sooner and suffered more heart problems than those who did not.[45]

This is such an important finding that I’m actually going to quote the study’s authors

Conclusion: Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega-6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid (safflower oil) in place of saturated fats (butter) increased the rates of death from all causes, coronary heart disease, and cardiovascular disease. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega-6 linoleic acid, or polyunsaturated fats in general, for saturated fats.”

So, what about those worldwide dietary recommendations that need changing? While it’s no big surprise to me, considering the amount of money at stake the American Heart Association released a statement that basically stated their recommendations are not going to change.[46]

Are You Different?

I will end this article on a personal note. Ultimately, we can talk studies all day long, or we can actually try them out and see what works for us, which some people are doing in what they call an “n of 1” (or n=1) experiment. I’ve done this myself. If you care to read about my experience, you can find it here http://www.fitnesscoachmark.com/nutrition/i-should-be-dead/

Summary: TL;DR = Too Long Did Not Read

  1. Fat does not make us fat.
  2. Fat, saturated fat and cholesterol do not cause heart disease
  3. Low-carb/high-fat diets outperform low-fat diets in the short-term for weight loss and outperform them as well when it comes to improving your cholesterol numbers and measures of blood sugar control in relation to diabetes.
  4. Advice to ditch butter for vegetable oil in the hopes it would protect our health have been shown to be completely wrong and have caused more deaths than butter ever has.

 

Sources:

  1. http://www.ncbi.nlm.nih.gov/pubmed/20226994
  2. href=”http://jama.jamanetwork.com/article.aspx?articleid=1199154
  3. http://www.ncbi.nlm.nih.gov/pubmed/23155696
  4. http://www.ncbi.nlm.nih.gov/pubmed/23035144
  5. http://www.ncbi.nlm.nih.gov/pubmed/12679447
  6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892194/
  7. http://ajcn.nutrition.org/content/90/1/23.long
  8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538279/
  9. http://www.nejm.org/doi/full/10.1056/NEJMoa022637
  10. http://adc.bmj.com/content/early/2013/02/13/archdischild-2012-302941.short?g=w_adc_ahead_tab
  11. http://ajcn.nutrition.org/content/91/3/535
  12. http://www.altmedrev.com/publications/12/3/228.pdf
  13. http://www.ncbi.nlm.nih.gov/pubmed/19751443
  14. http://www.ncbi.nlm.nih.gov/pubmed/7270479
  15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538279/
  16. http://www.nydailynews.com/life-style/health/coconut-oil-battle-tooth-decay-article-1.1151478
  17. http://www.cbn.com/tv/1472017228001
  18. http://archinte.jamanetwork.com/article.aspx?articleid=1108492
  19. http://blogs.cbn.com/healthyliving/archive/2012/10/23/cholesterol-not-the-cause-of-heart-disease.aspx
  20. ttp://www.ncbi.nlm.nih.gov/pubmed/21951982
  21. http://www.time.com/time/covers/0,16641,20040223,00.html
  22. http://www.ncbi.nlm.nih.gov/pubmed/21992535
  23. http://www.ncbi.nlm.nih.gov/pubmed/18950537
  24. http://www.nejm.org/doi/full/10.1056/NEJMoa0708681#t=abstract
  25. http://www.nejm.org/doi/full/10.1056/NEJMoa022207
  26. http://link.springer.com/article/10.1007%2Fs00125-004-1603-4
  27. http://link.springer.com/article/10.1007%2Fs11745-008-3274-2
  28. http://www.ncbi.nlm.nih.gov/pubmed/12679447
  29. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892194/
  30. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130805/
  31. http://www.ncbi.nlm.nih.gov/pubmed/15047623
  32. http://www.ncbi.nlm.nih.gov/pubmed/11031210
  33. http://dietheartpublishing.com/Cholesterol/10/09
  34. http://www.sciencedaily.com/releases/2013/02/130227151254.htm
  35. http://www.ncbi.nlm.nih.gov/pubmed/21776466
  36. http://www.ncbi.nlm.nih.gov/pubmed/19751443
  37. http://www.ncbi.nlm.nih.gov/pubmed/21776466
  38. http://circ.ahajournals.org/content/96/8/2520.abstract
  39. http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0057873
  40. http://ajcn.nutrition.org/content/early/2013/01/30/ajcn.112.042457.abstract
  41. http://onlinelibrary.wiley.com/doi/10.1111/j.1463-1326.2009.01151.x/abstract
  42. ttp://www.ncbi.nlm.nih.gov/pubmed/15148064
  43. http://www.ncbi.nlm.nih.gov/pubmed/15801687
  44. http://care.diabetesjournals.org/content/35/2/434.long
  45. http://www.bmj.com/content/346/bmj.e8707
  46. http://newsroom.heart.org/news/no-change-in-aha-recommendations-on-saturated-or-poly-unsaturated-fat

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