Is There a Final Word on Saturated Fat and Heart Health?by Amy Hendel, P.A. Health Writer
Editor’s Note: This article is a part of an Op-Ed series, “Second Opinion,” where patient experts share their take on current research, news, and trends in health and medicine. The views expressed in this article do not reflect the opinions or views of HealthCentral.com.
When even the experts see the dueling headlines of “saturated fat good for you,” “saturated fat bad for you,” and feel challenged to offer meaningful, science-based information on saturated fat recommendations, what’s a consumer to do? The debate on saturated fats seems never-ending. There’s been a push to encourage consumption of saturated fats as being good-for-you. A recently released White Paper seems to offer the necessary evaluation of facts and explanation of research data that, in my opinion, clearly supports the position that saturated fat consumption is a strong risk factor of heart disease.
The White Paper commissioned by the True Health Initiative, a growing group of more than 250 world-wide experts committed to offering science-based nutrition recommendations, was written as an evidence-based response to criticism of The Seven Countries Study (SCS). This study was the first major study to investigate diet, lifestyle and risk factors for heart disease across seven contrasting countries and cultures over a significant time span. Lead researcher Ancel Keys, a Minnesota physiologist, helmed a collection of world-wide researchers to study (jointly) questions about heart and vascular disease among several countries with varied eating traditions and lifestyles.
The hypothesis of the SCS was that rate of heart disease would vary among populations and individuals because of lifestyle differentials, especially fat composition of the diet and serum cholesterol composition. The goal of the study was to study in fine detail, associations of diet, risk factors, and disease rates using standard measurements. The measurements were to be taken by trained individuals with blindfold coding and blindfold analysis.
The study had phases. First phase (1958-1983) looked at baseline measurements, and then conducted surveys after five and 10 years of 16 cohorts of middle-aged men in the seven countries. Second phase (1984-1999) extended the cardiovascular surveys, looking at additional aspects of health in the elderly from nine cohorts. Some of the research continued beyond those dates.
During the study period, there was a separate FINE study and then using data from the FINE (Finland, Italy, Netherlands, Elderly) study, the HALE (Healthy Aging: A Longitudinal Study in Europe) study was done. Also included in the SCS was data from the Zutphen Study (1960-2000), which provided important data on trans fats association with heart disease and mortality from heart disease linked to trans-fat consumption. This background information on SCS is offered to show just how robust and complex the study was, gathering and analyzing information — especially mortality rates — gleaned from more than 25, and in some cases 50, years of research.
The findings were comprehensive. Risk factors like serum cholesterol and blood pressure level were clearly linked to heart disease, and blood pressure specifically was associated to stroke risk. Smoking and alcohol habits were linked to Cardiovascular Disease (CVD) risk. The data was also used to establish predictors of cognitive decline, depression and optimism. One finding in particular was in regards to saturated-fat consumption. Saturated fat was strongly correlated with long-term coronary heart disease (CHD) mortality. Sources of fat were butter in Finland, hard margarine in the Netherlands and lard in Slavonia (Croatia).
The debate with regards to the saturated-fat findings has persisted despite what was learned from this and other well-recognized research projects. There are many experts who claim that the SCS science is flawed and “not pure” or that it was not interpreted correctly, and these individuals have pushed the message (recently) that saturated fat is safe, wholesome, necessary, and even beneficial, in larger portion sizes, more frequently.
With carbohydrates being identified as culprits in heart disease, diabetes, obesity, and other serious lifestyle-related diseases, the landscape was ripe for saturated fat’s comeback. Most nutrition experts have known for decades that Americans were consuming too much of the wrong types of (carbohydrates) grain-based foods, but few consumers and patients were tuned in. Telling Americans to lower carb intake is one thing — telling them that saturated fat is “safe and healthy and can be safely eaten in larger portions, with more frequency” is quite another.
This new White Paper, An Evidence-based Response to Revisionist History “with emphasis on primary source material, historical records, and review/critique by Seven Countries Study investigators” aims to answer the naysayers who claim to interpret the findings of the SCS differently or to find serious flaws in the SCS data sets. One naysayer in particular, New York Times Magazine writer Gary Taubes, has propagated the theory that we got fatter and sicker “when we cut fat.”
Taubes’s conclusion and efforts to draw support for the reintroduction of fats like butter has been tireless. He has had support from some members of the medical community. Many of those involved in this White Paper repudiate his findings and his position.
In fact, according to David Katz, M.D., master of public health founder and president, The True Health Initiative, Immediate Past President, The American College of Lifestyle Medicine, Director, Yale University Prevention Research Center, we never cut (saturated) fat, when we ate “more carbs.” We simply “ate more carbs,” according to a U.S. Department of Agriculture report on food trends from 1970-2014. You can observe the “flow of the American diet over 40 years” in a Flowing Data chart compiled by Nathan YauWe certainly started to eat loads of refined grains a few decades ago. But we never stopped or significantly reduced eating unhealthy fat.
To extrapolate that saturated fat is good for you is way off the science, if you read the SCS, read the responses of several noted experts in the White Paper, and look at the actual eating trends of Americans over the last four decades. Telling people that it’s safe, even healthy, to eat more saturated fat puts the average American at greater health risk for cardiovascular diseases.
Dean Ornish, Clinical Professor of Medicine at the University of California, San Francisco, has devoted much of his professional life to identifying lifestyle risk factors for heart disease. He has devoted 35 years to clinical research that had confirmed the viability of using diet and comprehensive lifestyle changes to reverse even severe coronary heart disease. Those lifestyle changes are typically intensive and must be maintained long term, but his published studies verify the viability of certain dietary changes, most notably, reducing saturated fat to extremely low levels to reduce or reverse cardiac disease and risk factors.
So before you reach for that tub of butter, maybe you should instead consider adopting an eating program that will more than likely reduce your risk of heart disease and even reverse certain risk factors already present.
A dietician or nutritionist can help you to create a personalized plan but it will generally include: fruits and vegetables, whole grains, fat-free dairy, healthy fats, and meat alternatives like oily fish, soy foods, nuts, seeds, beans, and legumes. “Butter” the whole grain toast with a bit of heart-healthy avocado spread or hummus instead!