Is Saturated Fat Good for You?

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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.

 

Tackling Concussions Head-On: How Nutrition Can Improve Outcomes

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football

I sat on the floor hunched over and crying. My elbows were raised – close to my eyes as my arms hugged my head, hands clenched at the base of my neck. My brain felt like a percussion instrument shaking inside my skull. As the pounding grew more intense the pain became unbearable. I had a concussion, my second in two years, which earned me a night in the ER.

Concussions are common in sports and recreation. Though considered a mild type of traumatic brain injury because they are usually not life-threatening, all concussions should be taken seriously. A single blow to the head can result in short-term loss of brain functioning or long-term changes in thinking, language, emotions and sensations including taste, touch and smell (1). Repeated concussions can be very dangerous and may lead to permanent changes in brain functioning or in extreme cases, death (2). Though widely recognized in football players, concussions happen in all sports – even in everyday activities – and they are occurring at younger ages. Athletes who have had one concussion have a greater risk (2 – 5.8 times higher) of experiencing another concussion (3). Multiple blows to the head could lead to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease associated with poor memory, changes in personality, behavior, speech and gait (4). Posthumous examination of some former NFL players in addition to a few college football players who committed suicide revealed CTE. In March 2016, the NFL acknowledged the link between traumatic brain injury and CTE. The movie ‘Concussion,’ set for release in late December, 2015 highlights concussions in former NFL players though the league has gone to great lengths to make today’s game safer.

Decreasing the Damaging Effects from Concussions

Anyone who experiences a blow to their head or body (a forceful blow to the body can cause the brain to shake inside the skull) should be immediately examined by a physician with experience in the evaluation and management of concussions. Though the person may say they feel fine and can continue with regular activities, symptoms of concussion do not always appear immediately and may instead be delayed for several hours. Continuing to play or perform mental tasks like studying can increase severity or symptoms and cause complications including the possibility of developing permanent brain damage.

Symptoms of Concussion may include:

  • Confusion
  • Headache
  • Vision changes
  • Memory loss
  • Difficulty with coordination, clumsiness or stumbling
  • Dizziness
  • Irritability
  • Personality changes
  • Slurred speech
  • Delayed response to questions
  • Nausea or vomiting
  • Sensitivity to light and noise
  • Problems sleeping
  • Seizures
  • Loss of consciousness

In addition to the symptoms that occur soon after a concussion, some people experience Post-Concussion Syndrome (PCS) days or weeks later. PCS can cause many of the same symptoms experienced after a concussion as well as trouble concentrating, apathy, depression and anxiety. Symptoms may last a few weeks. If you suspect PCS, have the patient evaluated by a psychiatrist (5).

Nutrition Management

In addition to rest, following a graduated return-to-play and school protocol, and other steps you should take to treat concussions, emerging research suggests nutrition may play an important role. Certain nutrients seem to help reduce some of the damaging effects from concussions:

Protein: 1 – 1.5 grams of protein per kg body weight per day is recommended along with sufficient calories to reduce the inflammatory response (6).

EPA and DHA Omega-3 Fatty Acids: EPA and DHA, omega-3 fatty acids found in fish and algae, increase fluidity of cell membranes, reduce inflammation and enhance cerebral blood flow (which is reduced for up to a month or longer in athletes that recover slowly) (7). Cell membranes are like gateways allowing substances to enter cells or blocking their entry. When cell membranes are more fluid (and therefore less rigid), they perform better, opening the gate for nutrients to come in. DHA, in particular, makes up 97% of the omega-3 fatty acids in the brain and is essential for normal brain functioning (8). Several animal studies show EPA and DHA supplementation before or after a traumatic brain injury helps limit structural damage and decline in brain functioning (9, 10, 11, 12, 13, 14, 15).

There is no clear consensus regarding optimal intake of EPA and DHA prior to or after a concussion. Given that many Americans do not eat enough fish and an estimated 75% of American diets are too low in EPA and DHA, it makes sense to start by meeting the general guidelines for recommended intake of EPA and DHA by:

  • Consuming fatty fish varieties that contain high levels of omega-3s, including salmon, tuna, mackerel and herring at least twice per week;
  • Take an omega-3 supplement providing EPA+DHA daily (be sure to look for high-quality fish oil, algal oil or krill oil supplements in your local grocery or health store);
  • Eat and drink DHA omega-3-fortified foods and beverages, including milk, 100% juice, and yogurt.

Research has yet to identify exactly how much EPA + DHA may be helpful after a concussion. However, according to the Food & Drug Administration (FDA), doses of EPA + DHA up to 3 grams per day are considered safe.

Zinc is necessary for optimal brain functioning while a deficiency of this mineral may compound oxidative damage from concussions. Though zinc supplementation may be an effective treatment modality, additional research needs to determine if zinc supplementation is safe after concussions. The Upper Limit for zinc is 40 mg per day.

Animal and human studies suggest creatine helps prevent secondary brain injury after traumatic brain injury. However, animal studies show long-term creatine intake may decrease its beneficial effects on the brain after injury. Future research needs to better elucidate the relationship between creatine pre-TBI and creatine post-TBI and outcomes.

Other potential approaches to addressing concussions through nutrition include ketogenic diets which are very high-fat, minimal-carbohydrate diets that are effectively used to decrease both the incidence and severity of seizures in children with epilepsy. Ketogenic diets provide an alternate energy source for brain functioning – ketones derived from the breakdown of fat. This may be important since available glucose, the primary energy source for brain functioning, may be decreased after a concussion.

Current research supports the integration of a dietitian into the team of health professionals treating concussions. Though nutrition interventions are considered preliminary at this time, consideration should be given to nutrition strategies that may reduce long-term effects while causing no further harm.

Disclosure: I am a GOED/Omega-3 Science Advisory Council Member supporting the research behind omega-3 EPA and DHA for a healthy brain, heart and eyes.

References

1 What are the Potential Effects of TBI? Injury Prevention & Control: Traumatic Brain Injury. CDC. http://www.cdc.gov/TraumaticBrainInjury/outcomes.html

Concussion (Traumatic Brain Injury). Pubmed Health.

3  Harmon KG, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15-26. http://www.amssm.org/Content/pdf%20files/2012_ConcussionPositionStmt.pdf

4  McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte T, Gavett BE, Budson AE, Santini VE, Lee H, Kubilus CA, Stern RA. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. J Neuropathol Exp Neurol 2009; 68(7): 709–735.

Post-Concussion Syndrome. PubMed Health 

6 Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. The National Academies Press. 2011. http://www.nap.edu/catalog/13121/nutrition-and-traumatic-brain-injury-improving-acute-and-subacute-health

7  Meier TB, Bellgowan PS, Singh R, Kuplicki R, Polanski DW, Mayer AR. Recovery of cerebral blood flow following sports-related concussion. JAMA Neurol 2015;72(5):530-8.

8 Salem N Jr, Litman B, Kim HY, Gawrisch K. Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids 2001; 36(9):945-59.

9 Mills JD, Hadley K, Bailes J. Dietary supplementation with the omega-3 fatty acid docosahexaenoic acid in traumatic brain injury? Neurosurgery 2011;68:474–81

10 Wu A, Ying Z, Gomez-Pinilla F. Omega-3 fatty acid supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma 2007;24:1587–95

11 Wu A, Ying Z, Gomez-Pinilla F. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma 2004;21:1457–67

12 Wang T, Van K, Gavitt B, Grayson J, Lu T, Lyeth B, Pichakron K. Effect of fish oil supplementation in a rat model of multiple mild traumatic brain injuries. Restor Neurol Neurosci 2013;31:647–59

13 Mills JD, Bailes J, Sedney C, Hutchins H, Sears B. Omega-3 fatty acid supplementation and reduction of traumatic axonal injury in a rodent head injury model. J Neurosurg 2011;114:77–84

14 Wu A, Ying Z, Gomez-Pinilla F. The salutary effects of DHA dietary supplementation on cognition, neuroplasticity, and membrane homeostasis after brain trauma. J Neurotrauma 2011;28:2113–22

15  Wu A, Ying Z, Gomez-Pinilla F. Exercise facilitates the action of dietary DHA on functional recovery after brain trauma. Neuroscience 2013;248:655–63