Is Saturated Fat Good for You?

Though largely driven by misinterpretation of the science and cherry-picked population studies, the “Butter is Back” movement comes with very persuasive sound bites followed by arrogant punctuation marks. No wonder so many people hopped on board the bandwagon while looking back, pointing fingers and shouting “health professionals have been misleading us for decades!” Yet the flawed reasoning behind the pro-saturated fat movement comes with a hefty price tag – you could be making food choices that, over time, will increase your risk for cardiovascular disease and type 2 diabetes.

Here’s what I’ll cover in this article:

  • Why is there so much confusion about saturated fat?;
  • The science behind saturated fats, cardiovascular disease (diseases of the heart & blood vessels) and type 2 diabetes;
  • Best food choices for heart health.

Why is there so Much Confusion about Saturated Fat?

There are a few reasons for the confusion about saturated fat (fat that is solid at room temperature such as butter, shortening, coconut oil and the fat on meat) and misinterpretation of the science. First off, some people group all saturated fatty acids (saturated fatty acids make up saturated fat) together as a team. However, there are several types of saturated fatty acids. Some raise LDL cholesterol (the kind that contributes to clogged arteries and is a risk factor for cardiovascular disease) as well as HDL cholesterol (“good” cholesterol, the kind that removes bad cholesterol; SN: drugs that increase HDL do not lower risk of heart disease so there is some considerable debate regarding the role of HDL), others don’t raise LDL cholesterol and some we aren’t quite sure about. Secondly, using population-based studies alone to draw conclusions about saturated fat intake and heart disease is misguided.  These studies are not designed to determine cause and effect (that’s the job of well-designed clinical trials) plus, there are inherent issues with the methods used in many of these studies.  Nutrition research is not easy, especially in humans living their life (those not in a metabolic ward where all factors are controlled and measured including diet and physical activity).

Lastly, some research studies (and the media) take the results way out of context. So, here’s the lowdown based on sound science:

The Science Behind Saturated Fat, Cardiovascular Disease and Type 2 Diabetes

  • There is no dietary requirement for saturated fat. Your body can make all of the saturated fatty acids it needs.
  • Foods high in saturated fat typically increase total, HDL and LDL cholesterol. However, the impact dietary saturated fat has on increasing LDL-cholesterol (the kind that contributes to clogged arteries and an inflammatory cascade in arteries) may depend on the amount of polyunsaturated fat (PUFAs) in your diet (as well as the type of saturated fatty acids consumed).
  • In general, replacing saturated fat with polyunsaturated fat (and monounsaturated fat though there is less evidence for monounsaturated fat) reduces LDL and total cholesterol, both risk factors for cardiovascular disease.
  • saturated fat and cholesterolOverweight, obesity and insulin resistance may reduce the beneficial effects (lowered LDL cholesterol) generally noticed from a reduction in saturated fat intake. *If obese or overweight, losing excess body fat (regardless of the type of diet used to lose the weight) has powerful effects on lowering risk for cardiovascular disease, some cancers, and type II diabetes.
  • Food contains a complex mixture of compounds that may affect cholesterol and cardiovascular disease risk (it is not just the fat). The food “matrix” matters.
  • Many factors impact how a food affects cholesterol and blood lipids (fats) including fats eaten at the same time, overall diet, and carbohydrate intake (and type of carbohydrates consumed – high fiber vs. foods high in added sugar with few other nutrients).
  • There are individual, genetic differences in response to saturated fat intake – your cholesterol might shoot up after eating a diet containing a diet high in the type of saturated fatty acids that raise LDL cholesterol and I might be able to get away with this diet without a problem (blame your genetics or consider it an opportunity to open your taste buds to foods containing less saturated fat; particularly the kind that is artery clogging).
  • Certain saturated fatty acids, or a diet high in saturated fat, may increase risk for type 2 diabetes.

Best Choices for Heart Health

If you are overweight, focus on losing excess body fat. Even small amounts of fat loss will improve health and risk factors for cardiovascular disease. If you have high total and LDL cholesterol, swap foods high in saturated fat for foods high in polyunsaturated fat (liquid oils, nuts, seeds, olives, avocados). Minimize your intake of foods high in added sugars and refined, white flour, carbohydrates. Instead, choose higher fiber carbohydrates as often as possible.

Don’t get sucked into the media headlines written by journalists who could sell ice to an eskimo. Butter isn’t back (for good health anyway). The bulk of your fat intake should still come from foods that are higher in polyunsaturated and monounsaturated fats. However, food is a complex matrix of compounds and therefore, some foods higher in saturated fat may have little to no impact on cholesterol and therefore fit into your diet while contributing to your vitamin and mineral needs and providing plant-based compounds important for good health.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

 

Feast on Fish for Your Heart

Salmon dinner from Foodie Buddha
Salmon Nigiri from Foodie Buddha

By Collier Perno

If you’re among the 60% of Americans with elevated blood pressure I’m sure you’ve heard your doctors say these things: “lower your sodium intake,” “increase your physical activity,” and “decrease your alcohol consumption.” While these are all great recommendations, new research has shows there is an alternative treatment that may be even better at lowering blood pressure: the omega-3 fatty acids eicosapentaenoic acid (EPA) and decosahexaenoic acid (DHA)4.

Omega-3 fatty acids are an essential (the human body can’t make them) polyunsaturated fat. There are three main types of omega-3s, EPA, DHA and alpha linolenic acid (ALA). EPA and DHA are found in cold-water fish, fish oil, and algae and are crucial for brain development, reducing inflammation, protecting structural cell integrity, and they may help decrease muscle soreness in athletes1.

In March of 2014, the American Journal of Hypertension released a comprehensive meta analysis (a statistical method for combining the results of several studies) that examined 70 randomized controlled trials studying the effect EPA and DHA on blood pressure (BP). Participants were adults with normal BP and adults with high blood pressure who were not taking BP lowering medications. Subjects were given EPA and DHA omega-3s in the form of seafood, fortified foods, or dietary supplements. The results of the study showed a decrease in both systolic and diastolic BP in all adults. The most significant effects were found in those with existing high BP. There was an average 4.51 mm Hg decrease in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was reduced by an average 3.05 mm Hg4.

The analysis also compared common lifestyle recommendations and their effects on BP to EPA and DHA omega-3 fatty acids effects on BP. The findings were astonishing. When looking at SBP (the top number – this reflects the pressure in your arteries when your heart beats), consumption of EPA and DHA omega-3 had an average decrease of 4.51 mm Hg, while reduced dietary sodium had an average reduction of 3.6 mm Hg, and decreased alcohol consumption had an average 3.8 mm Hg decrease. The only lifestyle recommendation shown to have a greater decrease in SBP was increased physical activity, which lowered SBP by 4.6 mmHg.

Still not sold on the benefits of consuming omega-3? There’s more! Over the past two decades, some research has linked the consumption of omega-3 fish oils to a reduced risk of cardiovascular disease. Heart disease is the leading cause of death in the U.S. killing about 600,000 Americans each year (that’s 1 in every 4 deaths)2. As previously discussed, omega-3s reduce BP levels (a major risk factor for heart disease) and lower triglyceride levels. A study published in the Journal of American Medical Association concluded consumption of omega-3 fatty acids creates a significant cardioprotective effect in non-hypertensive individuals3.

How do I get my omega-3 fatty acids?

  • The American Heart Association recommends eating fish at least twice a week to increase omega-3 dietary intake
  • Fatty fish such as mackerel, lake trout, sardines, herring, albacore tuna, and salmon are all great sources of omega 3 fatty acids
  • Eating walnuts, flax seeds, soy beans, kidney beans, and tofu are other great ways to increase your omega 3 consumption. These provide Alpha- Linoleic Acid (ALA) form of omega 3s.
  • When looking for omega 3 supplements choose nordic naturals or any supplement that is USP certified. Costco’s Kirkland brand is a great option!
  1. Omega-3 fatty acids | University of Maryland Medical Center. Omega-3 Fat. Acids. Available at: http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids. Accessed November 12, 2014.
  2. CDC – DHDSP – Heart Disease Facts. Am. Heart Dis. Facts. Available at: http://www.cdc.gov/heartdisease/facts.htm. Accessed November 12, 2014.
  3. Key Messages for JAMA/Annals of Internal Medicine Studies. Journal of American Medical Association. Accessed November 12, 2014.
  1. Cid, Martha. Omega-3s Can Significantly Reduce Blood Pressure, Study Finds.     Global Organization for EPA and DHA Omega-3s. Accessed November 12,20

Cheerios: Food or Drug?

The past few days people have been cracking jokes that the FDA found time to slap General Mills for it’s heart health claim on Cheerios. I’ve heard people comment about the fact that consumers should know the difference between a food and a drug and doesn’t the FDA have better things to do? Well, actually it isn’t that simple in our litigious society. Picture this scenario: a man stops taking his statin drugs because he sees the Cheerios claim that it can “lower cholesterol by 4% in 6 weeks.” Man has a heart attack. Family sees dollar signs and sues General Mills claiming that the man was led to believe that he could stop taking his cholesterol lowering medication and eat his Cheerios and lead a happy, low cholesterol life.

I’m all for people being held personally accountable for their health but the FDA has to make clear distinctions between food and drugs so that the above scenario doesn’t happen and so that people who just don’t get it won’t be “led” in the wrong direction by marketing hype. By stating that Cheerios can “lower cholesterol by 4% in 6 weeks” – well, that is a drug claim. Big Pharma companies spend plenty of money on research to be able to prove that their drugs are clinically effective. Food products on the other hand do not go through the same rigorous clinical testing.

Give the rise in drug costs, healthcare mess and opportunity for food companies to make money on functional foods, you can expect the lines between drug and food to get even more blurry in the future. A functional food is one that has an added benefit (plant sterols in your orange juice for instance). And, as you have probably noticed, more and more of these products are dawning store shelves. Currently, functional foods are regulated in the same way all foods are. However, the FDA may impose more regulations on functional foods in the future to save people from their own stupidity (ahem, see example above) and save companies from having to hire more lawyers than R&D folks.

The Best Drink for Heart Health

What do people who have low rates of cardiovascular disease drink? Red wine? Nope. Skim milk? No. Water? No. They reach for tea. Black, white, green or oolong tea. Tea is loaded with antioxidant flavonoids that are beneficial for healthy blood vessels. Tea supports cardiovascular health through other mechanisms as well, including:

– tea provides antioxidants that help keep inflammatory markers under better control
– tea helps dilate blood vessels thereby helping maintain healthy blood pressure

In fact, scientific evidence suggests drinking tea can prevent cell damage that leads to some types of cancer, cardiovascular disease and other chronic diseases. And, it is calorie free so it won’t wreck your diet.

Aim for two -four cups a day and remember to choose black, white, green or oolong tea. You can choose among the flavored versions as well – like green tea with a hint of lemon for instance. Just remember that herbal tea does not contain tea leaves from the Camellia sinensis plant and therefore herbal teas do not carry the same benefits as real tea.

Trans Fat Alternatives

The Center for Science in the Public Interest (CSPI; aka the food & beverage police) are against banning trans fats from foods. In fact, they indicate that banning them “could be more harmful from a public health perspective.” Instead they favor a gradual phasing out of trans fats. How would a gradual phase out be more beneficial than an outright ban? According to CSPI, gradually phasing out trans fats will give restaurants and food companies more time to find suitable alternatives. I’m not totally sure I agree with this since most things need a deadline of some sort or they’ll get pushed to the very back of the “to do” list. And, if most companies operate the way people do – a quicker deadline just means they’ll get it off their plate sooner. Give them more time and they’ll take more time but won’t necessarily produce a better result. Not to mention the companies that care about health will look for better alternatives and the ones who don’t will stick what they have to in their food just to meet trans fat bans.

So what do companies replace trans fats with? There are several alternatives such as unsaturated fats, saturated fats, fully hydrogenated oils (vs. partially hydrogenated oils), blended oils, gums, cellulose and interesterified fats. Are these alternatives better or worse than trans fats? Most are probably better (even saturated fats) though fully hydrogenated oils and interesterified fats have huge question marks by them.

Interesterified fats have been around for many years and are basically a blend of saturated fats and oil. Older studies show that these have no effect on blood lipids. However, health effects may depend on the type of fat inserted and where it is inserted. Think of a long chain of links and inserting different links into this chain. The chain may kink or not bend at all in the places where links are inserted but this depends on the type of links inserted. The same is true for an interesterified fat.

Right now, I’m not a big fan of this type of fat. Some studies have seen increased blood glucose, increased LDL and decreased HDL associated with the consumption of interesterified fats. How will you be able to spot these fats? Look for interesterified fats on the food label or fully hydrogenated oil. In restaurants it is much harder to detect food prepared with interesterified fats. You would have to find out if they use shortening or any hard fat instead of liquid oil. And, many restaurant workers don’t seem to know.

Until research comes out and proves that all interesterfied fats are healthy, I think I’ll opt out of consuming food made with these blended fats.