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.

 

Is Coffee Good for You?

CoffeeDrinking coffee will leave you dehydrated and geeked out on caffeine. For several decades we’ve been warned about America’s favorite beverage. Yet these dire warnings were largely based on assumptions rather than actual science. A growing body of evidence suggests your morning Cup O’ Joe may be good for you! Here’s a look at the latest research.

What’s in a Coffee Bean?

Coffee beans are actually seeds from coffee cherries. They are picked, dried, and roasted turning them from green to those familiar aromatic brown beans we know and love. It’s ironic that a beverage made from seeds has gotten such a bad rap. Green coffee beans are naturally rich in antioxidants including chlorogenic acids, compounds that are readily absorbed in the human body, have antibacterial and anti-inflammatory actions and are associated with many health benefits including a reduction in cardiovascular disease, type II diabetes and Alzheimer’s disease. Antioxidants protect plants from disease and pests. Some antioxidants also protect human cells from harm. Roasted coffee beans are loaded with antioxidants (contrary to popular belief, they are not destroyed during roasting) and scientists are slowly uncovering the metabolic fate of each type antioxidant as well as the potential health benefits associated with regular coffee intake.

Potential Health Benefits

A National Institutes of Health study published in 2012 found older adults who drank caffeinated or decaffeinated coffee were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections. Those who drank over 3 cups per day had a 10% lower risk of death compared to those who did not drink coffee. Though this study only showed an association between coffee consumption and a decreased risk of death, it provided some reassurance to people who couldn’t seem to give up their favorite beverage. Studies published over the past three years lend strength to the relationship between regular coffee intake and a decreased risk of certain diseases.

Heart Health
A study published in the British Medical Journal’s publication Heart, examined diet and artery health in over 25,000 Korean men and women. Those who drank 3 to 5 cups of coffee per day were 19% less likely to have the first signs of atherosclerosis,  plaque buildup on artery walls, compared to those who were not coffee drinkers. Lower intakes were not associated with a reduction in plaque buildup. Drawbacks to this study: diet was examined at one point in time and study subjects were asked to recall their coffee intake over the previous year (people generally don’t recall their food / drink intake with great accuracy). Also, keep in mind this study showed an association between coffee intake and artery health, it doesn’t prove that coffee reduces plaque buildup on artery walls or that it can prevent cardiovascular disease. More research is needed to understand how coffee intake could potentially support heart health.

Cancer
A recently published study found individuals previously treated for stage III colon cancer who were regular coffee drinkers, consuming at least 4 cups of caffeinated coffee per day, had a 42% lower risk of recurrence of colon cancer and 33% lower risk of dying from the disease. This study found an association between coffee intake and decreased risk of colon cancer recurrence.

Research on coffee intake and risk of various cancers is mixed with some showing it is protective and others suggesting it may increase risk. Keep in mind there are many potential factors that impact cancer risk and risk of cancer recurrence with a sedentary lifestyle, high body fat and alcohol intake strongly associated with increased risk of certain types of cancer. Fruit and vegetable intake is associated with a decreased risk of some types of cancers. As for your Cup O’ Joe, time and more research, will tell us how America’s favorite beverage fits in the picture.

Should You Increase Your Coffee Intake?

All of these studies on regular coffee consumption include higher intakes. No benefits are noted for lower intakes – one to two cups per day. Keep in mind that some people should avoid or be cautious with caffeine intake including kids, teens, people with anxiety disorders, glaucoma, heartburn or cardiovascular disease. Also, pregnant women should avoid higher intakes of caffeine – more than 3 cups of coffee per day (regular sizes cups). Now about the caffeine – regular intake of moderate amounts of caffeine will not dehydrate you.

If you drink coffee in moderation, enjoy it! Don’t increase your intake based on these studies or start drinking if you aren’t a regular coffee consumer. Future research will tell us more about the many naturally occurring compounds in coffee, their actions in the body and the potential link between coffee and disease risk.

References
Heart 10.1136/heartjnl-2014-306663
New Eng J Med 2012;366:1891-1904.
J Nutr 2008;138(12):2309-15.
Mol Nutr Food Res 2005;49:274–84.
J Agric Food Chem. 2006;54:8738–43.
Am J Epidemiol 2002;156:445–53.
Biol Pharm Bull 2006;29:2236–4
Pest Manag Sci 2003 Apr;59(4):459-64.
J Clin Oncol 2015 Aug 17. [Epub ahead of print]

 

 

Which Fat is Best for Heart Health?

Butter

If you are more confused than ever about dietary fats, you’re not alone. Can a high fat diet help you lose body fat? Which fat is best for heart health – butter, coconut oil or vegetable oil?

What is Cholesterol & Why is it Essential?
Cholesterol is an essential component of all cell membranes and a precursor to hormones, vitamin D and bile acids (needed for the digestion of fat). It is so important that your body regulates cholesterol balance to ensure your cells receive a continuous supply of cholesterol.

How does High LDL Contribute to Cardiovascular Disease?

Though cholesterol is critical for life, low density lipoprotein cholesterol, LDL cholesterol, is considered a risk factor for heart disease because excess LDL can lead to an increase in plaque buildup in your arteries. Think of this process like a garden hose with gunk stuck in it. The gunk interferes with water flowing through the hose. If too much debris gets in there, no water will flow through.  Likewise, plaque in your arteries will decrease the amount of blood that moves through your arteries at one time and a complete blockage could lead to a heart attack or stroke.  Now, this is a simplistic view, especially considering LDL isn’t just one particle but instead, several that contain different amounts of cholesterol. Some research suggests that smaller, more dense LDL particles are more artery clogging. However, in addition to particle size, total number of LDL particles and oxidation of LDL contribute to the disease process.

As LDL particles travel through the bloodstream, excess LDL particles can stick to artery walls (particularly walls that are damaged due to smoking, high blood pressure and other insults). Trapped LDL becomes oxidized and sets off an inflammatory cascade resulting in the development of plaque (gunk) stuck to arteries – atherosclerosis.

Coronary Artery Disease

How Can I Lower my LDL Cholesterol?

Cholesterol in food has little effect on your blood cholesterol.

Years ago we were told to stay away from shrimp, eggs and other high cholesterol foods. Yet this advice wasn’t based on sound science – cholesterol in food has little effect on your blood cholesterol levels. So there is no need to take these nutrient-rich foods out of your diet. Shrimp is loaded with protein, and is a good source of iron plus it contains just 80 calories per serving. Eggs are also packed with nutrition – the whites are an excellent source of protein and the yellow color you see in the yolk is from antioxidants – plant compounds that protect plants from disease and protect your body from the damaging effects of free radicals, compounds that are essential but can cause damage as well.

Coconut Oil, Butter and Other Solid Fats are Not the Best Options

Man-made trans fats (partially hydrogenated oils) are the worst kind of fat you can eat. However, they should, finally, be making their way out of our food supply over the next few years. High levels of *saturated fat, the kind that is solid at room temperature like butter, increases HDL (the “good” cholesterol but not a target of therapy – doctors don’t focus on HDL levels because increasing HDL does not lower heart disease risk) and LDL cholesterol in the blood. In controlled diet experiments where saturated fat is replaced with polyunsaturated fat rich vegetable oils, risk of heart disease is reduced. Replacing saturated fat with monounsaturated fat, the kind found in olive oil, also lowers LDL but not to the extent that polyunsaturated fat does.

Coconut oil is popular and calorie for calorie it might be better for weight management than other fats. However, coconut oil raises our total, good and bad cholesterol levels. And therefore, it is not the best option for heart health.

Excess Carbohydrate Intake can Increase LDL

Overconsumption of carbohydrate-rich foods can also increase VLDL cholesterol (very low density lipoprotein). Foods with added sugars, in particular, are potent stimulators of VLDL production when the energy (calories) aren’t needed right away for energy or increasing glycogen stores (stored carbohydrate in your liver and muscle).

Best Fats for Your Heart

Nuts, seeds, avocados, olives and liquid oils are your bets for heart health. Oils with more polyunsaturated fat have a greater impact on LDL cholesterol than those rich in monounsaturated fat. Make sure you are choosing the right oil for the right cooking application. Many oils can’t stand high heat and they break down, damaging the structure (and function) of the oil.

Fatty Acids in Oils

Conclusion

Many factors contribute to high blood cholesterol levels, including genetics, overweight/obesity, inactivity, smoking, diabetes and age, making cholesterol management a multifactorial issue. Saturated fat increases LDL cholesterol but, as I’ll say over and over, we are all different and, people vary in their response to dietary saturated fat due to intrinsic differences in fat metabolism as well as other factors including obesity, insulin resistance and high triglycerides.

Replace fats that raise cholesterol with liquid oils, nuts, seeds, avocados, and olives. Consider your overall diet as well. Eat a plant-based diet including vegetables (non-starchy veggies as well as beans, lentils and peas), fruits, nuts, seeds and whole grains (oats, barley etc.). Consume fatty fish ( salmon, mackerel, herring, halibut, sardines etc.) at least two times per week. Limit your intake of foods with added sugars and refined starches as well as your alcohol consumption. 

* There are differences in specific saturated fatty acids and their effects on blood cholesterol. Therefore, some foods high in saturated fat do not raise LDL cholesterol. Also, oils have a different array of vitamins (primarily vitamin E) and plant-based compounds that may be beneficial for heart health.

Fatty acids composition of oils taken from the USDA Nutrient Database.