Tuesday, November 12, 2019

Retrospective #269: “Eat Good Fat”

In bold black letters, the “Thank You” note said, “Eat Good Fat.” It was included with my 32oz jar of Ancients Organics ghee. When I sometimes snack before supper, I put a dab of ghee on a radish half. It helps to get my supper k/g (ketogenic) ratio above 1.5, a desired ratio which I easily achieve at breakfast and lunch. Although expensive, I prefer the Ancient Organics brand for its “delicious sweet and nutty flavor” and its “incredible caramelized aroma.” It’s also “cooked in small batches over open flames” and made from “milk of grass fed and pastured cows.” It’s really good fat!
But this is not a column about ghee. It’s about the roiling dispute in the world of nutrition concerning dietary fats in general and saturated fats in particular. Saturated fats are enjoying a Renaissance everywhere except in government and “public health” circles, principally the USDA and AMA, ACC, AHA and ADA. The reason, IMHO, is that these groups have been bought and paid for by their commercial interest supporters. But this column is not another rant about that either. It is about two major scientific papers in influential medical journals that deserve more attention.
The first study was a large, mostly-British meta-analysis of 49 observational studies and 27 randomized controlled trials (643k participants), published March 2014 in the Annals of Internal Medicine. It was funded by the British Heart Foundation. The title: “Association of Dietary, Circulating, and Supplement Fatty Acids with Coronary Risk: A Systematic Review and Meta-analysis.” The CONCLUSION: “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of saturated fats.”
The second study appeared in the British Medical Journal (BMJ) in 2013: “Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: Evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.” “Secondary prevention” is to prevent a heart attack in those who already have heart disease. “Primary prevention” is for those who do not have Coronary Heart Disease (CHD).) This Australian study concluded:
Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid in place of saturated fats INCREASED THE RATES OF DEATH FROM ALL CAUSES, CORONARY HEART DISEASE, AND CARDIOVASCULAR DISEASE. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.”  I wish I could just SHOUT THIS FROM THE ROOFTOPS!
Nevertheless, the 2015 Dietary Guidelines for Americans doubled down on their advice to substitute polyunsaturated fats, from processed vegetable oils, for saturated fats. The committee was led by Alice H. Lichtenstein, D. Sc., Vice-chair of the 2015 Dietary Guidelines Advisory Committee, and Robert H. Eckel, M.D., co-chair and lead author of the “2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk, A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.” Together, they are a formidable force.
The 2010 Dietary Guidelines stated, “Saturated fatty acids contribute an average of 11 percent of calories to the diet, which is higher than recommended. Consuming less than 10 percent of calories from saturated fatty acids and replacing them with monounsaturated and/or polyunsaturated fatty acids is associated with low blood cholesterol levels, and therefore a lower risk of cardiovascular disease. Lowering the percentage of calories from dietary saturated fatty acids even more, to 7 percent of calories, can further reduce the risk of cardiovascular disease.” 
Such is the current state of affairs in U. S. dietary matters. Does it sound eerily like the world of domestic politics? And we have to vote every day with the food choices we make. So, choose wisely and remember the roiling dispute is trending away from Polyunsaturated fatty acids (PUFAs) and toward of Saturated fatty acids (SFAs).
Are you afraid to go against the Dietary Guidelines or the practice guidelines your doctor must follow? Do you avoid whole eggs, full-fat dairy, or red meat? Ask yourself why? You doctor is trapped, but you’re not…

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