Saturated Fat is Back for People with Diabetes

by David Mendosa Patient Advocate

A fundamental pillar of misguided medical dogma fell last week. A massive study has just exposed the belief that saturated fat, the type of fat in dairy products and meat, causes heart disease. It doesn't.

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But for almost 60 years this fear of saturated fat, unsupported by any good science, has stopped the safest and most effective way we have to manage our diabetes. For the first 13 years after my diabetes diagnosis in 1994 it stopped me from eating low-carb -- which requires high-fat for energy -- making tight blood sugar control and weight management impossible without drugs.

This fear is probably also the basis for the twin epidemics of diabetes and obesity that plagues the modern world. Until now the medical establishment has pushed us to eat "whole grains" and other high glycemic carbohydrates that make preventing and managing our diabetes so tough and contributes so much to our collective gain in weight.

The University of Cambridge in England led an international research collaboration that analyzed data from 72 cohort studies and randomized trials with more than 600,000 participants from 18 countries. The scientists found that total saturated fat was not connected to the risk of heart disease, which is the single leading cause of death and disability for people with diabetes and all humans around the world.

This new research has impeccable credentials. The British Heart Foundation funded it. One of the world's leading medical journals, Annals of Medicine, published the results of the research March 18. The abstract of the study, "Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis," is online, and people at the University of Cambridge kindly sent me the full-text. The Annals is a journal of the American College of Physicians, which with 137,000 members is the largest medical-specialty organization in the United States.
The lead researchers include scientists and professors from Harvard University and the University of Oxford as well as from the University of Cambridge and its Medical Research Council.

People are listening to the new message. In recent days widespread media reporting has featured the findings of this new study. That's great, because some were on message, but ingrained bias led many headline writers to obfuscate the true story. During the first days after the study became public Google News linked thousands of reviews in the press. Time totally missed the boat with "Uh Oh, Unsaturated Fats May Not be as 'Good' As We Thought." Health Magazine announced "Bad News About Good Fats."

Fortunately, most of the press not only captured the significance of the study but also captured it pithily: "Saturated fat does not cause heart disease: High carb diet does." And this one: "[Don't Fear the Fat]." Or this NPR broadcast, "Saturated Fat Is Back!" And my favorite: "Was all that we knew about the link between fat and heart disease wrong?

I am convinced that it was indeed wrong. The new findings are the capstone of a growing body of research that challenges the accepted wisdom that saturated fat is inherently bad for you. The first shoe dropped four years ago with the research published in The American Journal of Clinical Nutrition that Dr. Ronald Krauss led, "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease." That review of prospective observational studies raised serious questions about whether consuming saturated fat leads to heart disease.

We started to go off the tracks with the launching in 1956 of the "Seven Countries Study" led by Ancel Keys, who started the demonization of saturated fat.This study was, however, fatally flawed. It cherry-picked data that fitted the author's preconceptions, ignoring data from more than a dozen other countries that didn't support what he was trying to prove. Nevertheless, in 1956 the American Heart Association told us that eating lots of butter, eggs, and beef would lead to our getting heart disease. The steamroller intensified when the United States Senate Select Committee on Nutrition and Human Needs, generally known as the McGovern committee, bought into the argument. The rest was our sad, misguided history. Until now.

But not all fats are good fats, as the authors of the new study are quick to point out. Nowadays, just about everyone knows that those artificially created trans fats made from partially hydrogenated vegetable oils are about the worst "food" we can put in our mouths.

The researchers of this study also found insufficient evidence in support of long-standing guidelines that we should consume lots of polyunsaturated fats to reduce our risk of heart disease. But that's another key area where we went off the tracks that deserves and will get separate coverage here. For now the message is to relax and appreciate the benefits of eating those healthy saturated fats so we can cut way back on the carbs.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.