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The Real Skinny on Dietary Fat
Is butter the new broccoli? For years we’ve been told to cut back on animal fat to improve cardiovascular health. Now, headlines in the Globe and Mail and dozens of Paleo diet books are telling us that fat is back; saturated animal fat may not be the problem we once thought it was. But what is the real skinny on fat?
The meat lobby has worked hard to spin the data and to lobby policy makers to include meat in dietary recommendations. But scientists who understand the complexities of nutritional research are holding fast to their assertion that fat is not back. Frank Hu, professor of nutrition and epidemiology (disease causation patterns) at Harvard School of Public Health, says, “Evidence from studies on thousands of people shows that if you replace saturated (animal) fat with unsaturated fat, you reduce your risk of heart disease. If you replace saturated fat with refined carbs you don’t reduce your risk.”
Prior to the 1980s people were eating large portions of red meat, bacon and dairy products. The information about the inflammatory, pro-disease nature of saturated animal fat came out and generally people replaced the fat with a very high carb diet. Remember all the muffin shops selling 1,200 calorie muffins and the flood of pasta cookbooks? All those refined carbohydrates contributed to a surge in diabetes, obesity and cardiovascular disease. Too often I hear people concluding that because reducing dietary animal fat didn’t reduce heart disease rates, then fat must not be bad. The truth is, replacing fat with refined carbs is like replacing cigarettes with alcohol: both are disease causing. The solution is to cut back on animal fat and replace it with whole foods, like lean protein (chicken breast, egg whites, pork tenderloin) and eat more fish, beans, raw nuts, olive oil, quinoa, brown rice and of course vegetables and fruit.
But that kind of common sense advice doesn’t sell books and make headlines. Contradictory and controversial information makes headlines. The British Medical Journal published a report by a reputable nutrition advisory panel that recommended the general public should reduce their intake of dietary animal fat. That didn’t make headlines. But an article they published, written by a journalist (not a scientist) named Nina Teicholz which was critical of the prior article, was all over the news. Her article was full of errors and misleading statements, but it has been quoted frequently and held up as information from the esteemed British Medical Journal. She points out that there are large studies that fail to show a correlation between reducing saturated animal fat and cardiovascular death rates. However, a study would have to include a massive number of people to prove a statistically significant connection when you are dealing with these particular parameters. She also points out that there is a large study showing that women told to reduce animal fat didn’t reduce their rates of heart disease, however, in that study, the women weren’t told what to replace it with. Left to themselves, people will eat more refined carbohydrates, which is a risk for heart disease, so again, you won’t see a statistically significant difference. The bottom line is, we need to ignore claims that large trials contradict advice on saturated fat.
Fat proponents cite studies showing that dairy products don’t raise cholesterol. But the only studies that don’t show elevated cholesterol were funded by the dairy industry and included low fat dairy products. Analysis of studies over seventy years that asked people to eat full fat dairy showed a clear elevation in harmful cholesterol levels. Any evidence to the contrary is weak and poorly designed. But it does make headlines and sell books.
In all the debates on whether animal fat causes heart disease, I am always amazed that we are forgetting that animal fat and particularly processed meats have long been linked to increased rates of cancer. In October 2015, the International Agency for Research on Cancer announced that based on the analysis of large amounts of research over many years, processed meats (like bacon, sausage, cold cuts and hot dogs) are “carcinogenic to humans” and that red meats (beef, pork, lamb, and veal) are “probably carcinogenic to humans.”
So does this mean we all need to become vegan? If you are motivated to prepared and eat a lot of nutritious, whole food then go for it. But too commonly the diet of vegans slips into a low protein, high refined carb, fast food version of a vegan diet. Remember, white bread and potato chips are vegan, but not healthy. I coach my patients on a nutrition plan that combines the principles of eating reasonable portions of whole, unprocessed foods, including lean meats and low fat dairy. This lifestyle plan is low in refined carbs, animal fat and salt. It has been proven to help people lose weight and reduce blood pressure, heart disease, and cancer—plus it is do-able for most people.
Mitochondrial Function Key to Health
Have you ever wondered why the body ages or why you seem to have less energy as you age? It turns out the answer lies deep within the cells in a tiny organelle called the mitochondria. They are the energy producers of the body. They turn our food into the fundamental fuel that drives cellular activity. It is in the mitochondria that carbohydrates, protein, and fat are metabolized, producing cellular energy called ATP. The ATP provide the energy to allow cells to do what they do; it keeps the brain working, fires muscles, repairs tissues, and more.
The more energy a certain tissue requires, the more mitochondria those cells contain. The brain and heart have the highest concentration of mitochondria because they require large amounts of oxygen and energy. The heart muscle is packed with mitochondria. Any dysfunction on the level of the mitochondria has a significant impact on the functioning of these organs especially.
As we age, our mitochondria produce about 40% less ATP and therefore our organs feel the effects of decreased energy production. Mitochondria get damaged over time. The rate of their decline can be influenced by a number of lifestyle factors.
Malfunctioning at the level of the mitochondria has now been shown to be at the heart of a host of degenerative diseases, including diabetes, hypertension, and heart disease; neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, ALS, as well as cancer. Mitochondria dysfunction has also been shown to be related to chronic fatigue syndrome and has implications for affecting athletic performance. Interventions to stabilize mitochondrial function and enhance ATP production will be the new medicine of the future.
The formation of ATP is dependent upon proper intake of vitamins, minerals, omega-3 fatty acids and plant based nutrients. Deficiencies of these nutrients can alter mitochondrial function. Antioxidants like Vitamins C, E and A protect the mitochondria. Other nutrients like resveratrol from grape skins, green tea EGCG and curcumin from tumeric also have strong protective effects.
Exercise protects the mitochondria as well. A well-trained athlete has more than twice the muscle mitochondria than a sedentary person. Exercise stimulates the production of more mitochondria in the cells thus providing an anti-aging effect, especially where we need it most: the brain and heart.
However, those protective mechanisms can be overwhelmed by additional sources of bodily stress, leaving the mitochondria susceptible to damage. A diet high in processed food and high in fat as well as excess alcohol can all damage the mitochondria. Exposure to chemicals, heavy metals, and some pharmaceuticals, like statin drugs for cholesterol, can damage mitochondria.
The heart has to produce 13 to 35 pounds of ATP per day to sustain its approximately 86,000 daily beats. There has been extensive research to find ways to enhance mitochondrial function to maintain the ATP critical to heart function. In addition to exercise and high plant-based diets, natural medicines have been shown to help. CoEnzyme Q10 is a nutrient that fuels the pathway that makes ATP. In 2013, the European Society of Cardiology stated that it is the first “drug” to significantly improve heart failure in over a decade. This statement was based on research showing that there were very significant reductions in mortality in people with advanced heart failure who took CoEnzyme Q10. Magnesium and l-carnitine have also been shown to reduce death after heart attacks and more. In a recent Mayo Clinic review, acute heart patients who took L-Carnitine had a 27% reduction in all-cause mortality, a 65% reduction in arrhythmias, and a 40% reduction in angina symptoms.
Naturopathic physicians seek to understand the underlying cause of disease and use treatments that target those mechanisms. In the case of neurological disease, cancer, heart disease and more, interventions that repair mitochondrial function can help give the body the fuel it needs to promote healthy tissue function. There is so much more to health than managing symptoms with drugs. Take charge of your health with a great lifestyle and natural medicines.
Eight Important Lab Tests You Should Know About
Many of us go to the doctor and just get the basic blood work they recommend. We may or may not hear back from the doctor regarding the results. I recommend that patients take a more active role in their health by learning about blood tests and getting copies of their results. (Locally, Lifelabs offers patients online access to most blood work.) It is helpful to understand which tests to request from your conventional or naturopathic physician and optimal levels you should be aiming for.
Thyroid: For patients dealing with fatigue or depression, I often recommend a full thyroid panel. The thyroid governs metabolism, affecting energy and weight loss. Typically just a TSH test is run, but sometimes imbalances in the thyroid can be picked up by testing free T4, free T3 and thyroid antibodies. If the thyroid hormones levels are borderline, I recommend supporting the thyroid non-pharmaceutically.
Ferritin: Another important test for fatigue and depression is ferritin. This test measures iron stores. Lack of iron can cause anemia, which can cause fatigue. It can also lower dopamine levels in the brain, which affects mood, motivation and food cravings. Too much ferritin can be a sign of excess iron storage which can damage the cardiovascular system and many organs.
Insulin: For patients with weight issues, dementia and some hormonal imbalances, checking fasting insulin is an excellent tool to understanding how the body is dealing with blood sugar. Adult onset diabetes is characterized by insulin resistance at the cellular level. Therefore, it takes a lot of insulin to help carry sugars from the blood to the cells. Even before elevated blood sugar is detected, this high insulin can be a sign of insulin resistance. High insulin levels promote fat storage and are hard on the circulation. Programs that reverse insulin resistance can accelerate the process of weight loss, protect the cardiovascular system and more.
Homocysteine: Patients who have a personal or family history of cardiovascular disease or dementia / Alzheimer’s are wise to have their homocysteine levels checked. This amino acid, if elevated, is a risk for increased strokes and Alzheimer’s. The “normal” range is stated as being under 11 umol/L, but studies show that the risk of Alzheimer’s is increased in people whose homocysteine is over 7 umol/L.
Vitamin D3: The rate of vitamin D3 deficiency in Canada is staggering. Gerry Schwalfenberg, an assistant clinical professor in the department of family medicine at the University of Alberta, said testing showing that “the fact that 60 to 70 per cent [of Canadians] have inadequate levels [is] not good,” given that vitamin D insufficiency is being linked to so many chronic diseases. Vitamin D is an important preventer of autoimmune disease, viral illness, cancer, heart disease, diabetes, osteoporosis, MS and more. Having your levels checked is therefore wise. The optimal level of vitamin D is over 125 nanomoles/litre.
C Reactive Protein (CRP): Inflammation is an important risk factor for cardiovascular events, like strokes and heart attacks, and it creates an environment that supports cancer growth. It is a symptom of autoimmune disease, obesity, diabetes and other important health conditions. The C Reactive Protein in our blood is a reflection of general inflammation levels. While the normal range is under 5.0, the optimal range is under .8 for men and under 1.5 for women. Breast cancer survivors are wise to monitor CRP since elevations are associated with higher reoccurrence rates.
Vitamin B12: The levels of this important nutrient can diminish with age as absorption becomes more difficult. Vitamin B12 can be depleted by many medications, such as metformin (diabetes), birth control pills, and antibiotics. I am most concerned about acid blocking medications that many of my patients use for long term management of acid reflux. I much prefer to treat the cause of this problem than to manage it with a medication that impairs the digestion and absorption of a number of important nutrients. Acid blockers also can set up a more alkaline pH that promotes the growth of a weakened, dysfunctional set of intestinal bacteria.
Small Intestinal Bacterial Overgrowth Testing (SIBO): SIBO is a condition in which the wrong bacteria are growing in the small intestine, creating abnormal fermentation of carbohydrates into methane and hydrogen. SIBO patients suffer from gas, bloating, digestive concerns and many other health conditions. When indicated, I test patients through a university laboratory in PortlandOregon.
Be proactive with your health care by getting the blood work you need to understand your health and take steps to prevent illness.
Dr. Deidre Macdonald is a naturopathic physician who has practiced medicine in downtown Courtenay for 17 years. For more information, contact The Macdonald Centre for Natural Medicine at 250 897-0235 or via www.getwellhere.com
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Seeing Dr. Macdonald has made an enormous difference in my life. She is a very astute and compassionate doctor. She coached me through a process to deal with the health issues that had been plaguing me. Now I have so much more energy than I did before seeing her. I don’t have the chronic digestive issues I had, and I sleep better.
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448 10th Street Courtenay, B.C.