60 years on the war against saturated fats is taking a new turn as more and more scientists around the globe are realising that saturated fats are not what's hurting our health. The latest cover of Time Magazine encouraging us to "Eat Butter" is a complete contrast from the cover several decades earlier when Ancel Keys led the war vilifying saturated fats and encouraging us to hold the bacon, eggs and butter.
I grew up on a diet of margarine, white refined bread and low fat dairy. I dutifully cut all the fat off my meat, cursed at my mum for liberally pouring olive oil into salads, and felt ever so guilty if even a morsel of chicken skin or fat from a lamb chop passed my lips. Why? Because conventional wisdom told us that saturated fat and cholesterol caused heart disease so ergo we should eat less high fat red meat, eggs and dairy and replace them with vegetable oils, margarine and more carbohydrates especially in the form of grains and cereals. Sugar replaced fat in packaged goods and refined grains replaced animal protein as a daily staple. Why would be even doubt what the government, the Australian Dietetics Association, the Australian Heart Foundation and the Australian Medical Establishment tells us? In them we trust. And one would be forgiven for thinking, rightly so.
But what happened 60 years on in this "vast nutritional experiment" (as it has been called) has been nothing short of a dismal failure. Obesity, Type 2 diabetes and other chronic illnesses and degenerative diseases have all skyrocketed and reached epidemic levels in our recent past. With nearly 1 million Americans a year dropping dead from heart disease and the western world growing sicker and fatter each year, the most curious amoing us can't help but stop and ponder whether we somehow, just maybe, got it wrong.
Here's a potted summary (from the Time magazine article) of how we detoured off path:
- historical records suggest that for most of our history on this planet humans were voracious omnivores, feasting on plentiful wild game.
- a guy called Dr Ancel Keys back in the early 1950s put forward the idea that high levels of cholesterol would clog arteries leading to heart disease. His solution was to reduce saturated fat intake. His landmark Seven Countries Study found that people who ate a diet low in saturated fats had lower levels of heart disease. Keys landed a front cover on Time magazine in 1961 in which he admonished Americans to reduce fat consumption.
- the vegetable oil industry jumped in step and, with Ancel Keys as their poster boy, promoted replacing butter with margarine and vegetable oils.
- the American Heart Foundation followed suit and codified dietary guidelines advising Americans for the very first time in history to cut down on saturated fats.
- sadly for humanity, it transpired (a little too late) that Keys was a fraud and his research was dodgy from the start. He cherry-picked his data leaving out countries that didn't fit his hypothesis. But the anti-fat message went mainstream (largely thanks to the clever marketing of big business and their sugar-laden fat-free advertising campaigns) and by the 1980s it was so embedded in modern medicine and nutrition that it became nearly impossible to challenge the consensus.
- the research that challenges the idea that fat makes people fat and is a dire risk factor for heart disease is mounting. New research suggests that it's the consumption of carbohydrates, sugar and sweeteners that is chiefly responsible for the epidemic of obesity and Type 2 diabetes. Refined carbohydrates - like those in "wheat" bread, hidden sugar, low-fat crackers and pasta - cause changes in blood chemistry that encourage the body to store the calories as fat and intensify hunger, making it much more difficult to lose weight. A 2010 meta-analysis- basically a study of other studies- concluded that there was no significant evidence that saturated fat is associated with an increased risk of cardiovascular disease. Those results were echoed by another meta-analysis published in March in the Annals of Internal Medicine that drew on nearly 80 studies involving more than half a million subjects.
- There is also a massive public misunderstanding of cholesterol and its role in the body. There are 2 types of LDL particles that carry cholesterol around the body- small, dense ones and large, fluffy ones. The large ones are mostly harmless - and its the levels of those particles that fat intake raises. Carb intake (and I would also add excess omega 6 intake and stress) seem to increase the small, dense particles that now appear to be linked to heart disease. When people get their cholesterol checked, I query whether their GPs are really checking the right markers. This is why having a GP with an excellent understanding of cholesterol is really important and to that end the only GPs I recommend and trust here in Sydney are the integrative medical practitioners at the U-Clinic in Surry Hills, being Dr Kate Norris (who I have blogged about before here) and Dr Min Yeo. If your GPs is not across this, you could be walking out of your GPs office with a lecture on needing to unnecessarily lower your cholesterol or, worse yet, a script for statins.
The article discusses the host of issues we face in overturning our vilification of fat:
- First, one of the issues we face is that the demonisation of fats is so deeply embedded in western culture that even the mere words themselves "saturated fat" and "cholesterol" have become ingrained as dirty words. I try to use these words positively around my children (so a positive association is all they know) and to educate them and my clients on what the specific roles of saturated fat and cholesterol are in the human body and why they are essential to our growth and function and to perform our best. The best place to start changing perception is always education and leading by example.
- Secondly it is going to take much time and education to dislodge the notion that eating fat will make you fat. It doesn't take much of an imaginative leap to think that this is true because fat is the very thing that jiggles around our waist and thighs. But this mantra needs to be overturned through an understanding of physiology and the role of fats in the body. In the same way that eating broccoli doesn't make you green, eating fat from natural sources doesn't make you fat. We are what we metabolise, not what we eat. Saturated fats from natural sources are used by the body for a host of important functions rather than just making a beeline straight for our waist. An excess of sugar and carbs get stored as fat, not an excess of fat per say that makes you fat. Look at the bodies of traditional populations (past and present eg Masaai warriors) who ate liberal amounts of saturated fats from natural sources- their bodies are lean and strong. Look at modern day proponents of traditional wholefoods - are they overweigh? And trial it yourself- what happens to your body mass index when you replace sugar and gluten with natural fats and animal protein? And lastly look at scientific studies like the 2008 study in the New England Journal of Medicine that looked at more than 300 subjects and found that those on a low fat diet lost less weight than those on high fat diets.
- A third notion that needs to be dislodged is the calories in versus calories out. That is too simplistic a view. All calories are not created equal. Fats are calorically dense, yes, but they are also very satiating which means that you don't need to rape the fridge and pantry door every 5 minutes to feel full.
I salute the author of article for raising these issues even though the explanations presented might not have been as full or scientific as the issues deserve.
The Time Magazine article is a refreshing step in the right direction. It does not however adequately discuss the importance of source and processing of fats ie that not all fat is created equal. It does not make a distinction between saturated fats from natural sources (eg coconut oil and dairy, egg yolks, and meat from pastured animals) on the one hand and processed/industrialised fats on the other (eg vegetable oils, and unnatural saturated fats in the form of trans-fats found in margarine). Nor is there an explanation of the differences between saturated, monounsaturated and polyunsaturated fats and in particular the importance of the balance between omega 3 and omega 6 polyunsaturated fats. However one step at a time is a good step in the right direction. Let's first plant the seed that it is sugar and refined grains, not saturated fats, that are the nutritional culprits to ill health. And the rest will all unfold in due course, one would hope.
It remains to be seen whether more and more articles like this will penetrate the walls of our government agencies and result in any formal change in dietary guidelines. What would be required is tremendous public pressure of a type that I am not sure that I will witness in my lifetime although I remain hopeful that at least this next generation of children will be exposed to an alternative point of view - a ground-swell of action that simply can't be ignored. And I often wonder if the government fears what legal repercussions lie in store in turning dietary guidelines on their head. In our litigation-loving society, it's not a far stretch to foresee a plethora of law suits being taken by millions of Australians whose diet mostly consists of the Heart Foundation 'tick of approval' packaged foods laden with sugar and refined grains that largely contributed to their obesity and Type 2 diabetes. However, in a breadth of fresh air, last year Sweden took the momentous step in becoming the first nation to reject low-fat diet dogma in favour or low-carb high-fat nutrition. Sweden's switch in dietary advice followed the publication of a two-year study by the independent Swedish Council on Health Technology Assessment. The committee reviewed 16,000 studies published through May 31, 2013. The committee found that "Butter, olive oil, heavy cream, and bacon are not harmful foods. Quite the opposite. Fat is the best thing for those who want to lose weight. And there are no connections between a high fat intake and cardiovascular disease." When more and more progressive countries hopefully follow in Sweden's footsteps, maybe America and Australia will sit up and take note. But as Brian Shilhavy (Health Impact News Editor) so eloquently put it "the USDA nutritional guidelines favor the heavily subsidized crops of wheat, soy, and corn. The political forces are just too strong in the U.S. right now to allow any dietary advice that would cut into corporate profits and their production of cheap food to dominate world food supplies." Indeed.
Last year Time Magazine published an article on the dangers of sugar which I blogged about here. Now all we need is for Time Magazine to publish an article on the dangers of gluten and industrialised oils and will we have public health largely back on track if the recommendations are implemented by the masses.
The war over fat is far from over. Consumer habits are deeply formed formed and entire industries are based on demonising fat. But here's what I think we (especially the parents among us) can do:
- Question everything and encourage your children to question everything: Simply because a government or some regularity body or a teacher tells us something or legalises something (eg tobacco) doesn't necessarily mean that they are right or that the product is safe. Do you own research and make up your own mind. And get your kids to do the same when they are old enough. Don't hand over something as precious as your health to a third body. Take responsibility for it.
- Question the validity of "studies" that are freely touted as gospel truth and toask whether the study was robust, properly conducted and grounded in real science. Popular health magazines recycle mainstream dogma and flawed studies which become sticky and hard to debunk.
- Consider whether what we are eating and drinking (and how we move, sleep, breathe, connect and play) is broadly consistent with how our Palaeolithic ancestors or pre-industrialised populations lived, because we know (from anthropological evidence and the work of nutritional pioneers like Dr A Weston A Price) that traditional societies lived (in fact thrived) in a state of perfect robust health, free of all chronic illness and degenerative disease.
- Encourage your kids to listen to their own bodies and ask how they feel after eating certain foods. I personally know how I felt and looked on a grain-based low-fat vegetarian diet versus a nutrient-dense traditional wholefoods omnivores diet.
When these things come together- when modern science backs up the wisdom of our ancestors and it accords with ones own personal experience- what results is powerful shift in realisation and consequential action that can pull humanity out of our physiological demise and back to reclaiming and harnessing the beauty and potential of our species.