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.

7 Strategies for Successful Weight Loss

  • #1 – Eyes on the Prize: Write down why you want to be at a healthy weight. Do you want to have less joint pain so you can play with your grandchildren? Is it so you will feel better about yourself and have less negative self-talk? Is it to have more energy? You will need compelling reasons why you want to lose weight in order to get through the summer barbecues, Halloween candy, Christmas parties and sometimes just the supermarket checkout!
  • #2 – Conscious Eating: Before you eat anything, take 3 deep breaths. Check in with your self and your body. Listen for what is motivating your desire to eat. Is it hunger or an emotion? If it is an emotion, a craving, or a body sensation other than hunger, keep breathing and find another outlet for your feelings. If it is hunger, then consciously choose nourishing food.
  • #3 – Know your triggers for overeating: Chances are by now you know where the rough spots are. Does boredom send you to the fridge, or do pot-luck dinners result in some serious grazing? Make a plan for dealing with your known trigger situations. Since most diets fall apart when we are under stress, have a list on your fridge of 10 ways to reduce emotional stress without eating. Some good examples are: going for a walk, writing in a journal, reading a spiritual book, talking to a supportive friend, deep breathing, yoga… make your own list.
  • #4 – Menu Plan: Many diet books recommend writing down what you have eaten. This strategy can be a helpful part of conscious eating. However, writing down what you are going to eat is also very important. Knowing there is a plan in place means less impulsive eating. Planning means shopping and cooking are more efficient and you will be more likely to stay on track.
  • #5 – Eat to 80% full: Many people who have dieted extensively have a “scarcity consciousness” when it comes to food and they feel they have to eat everything now because there may not be food later. Trust that it is okay to eat just enough to feel comfortably satisfied without feeling stuffed. If you do get hungry, don’t panic. If you find yourself saying, “I’m starving”, reframe that survival mode thinking with “I’m hungry, and when the time is right, there will be plenty of healthy food to eat”.
  • #6 – Eat 3 meals a day plus planned snacks: Skipping meals makes conscious eating very difficult. It is hard enough to make good food choices without dealing with the brain fog of low blood sugar. Eat three balanced meals a day, and plan on healthy snacks for mid morning and afternoon. Doing so will keep your blood sugar and energy stable to avoid the temptation to eat sugar for “quick energy”. Nuts like raw almonds make a very good mid afternoon snack.
  • #7 – Eliminate late night eating: In many cultures, the evening meal is quite small, thus not loading up the body with calories it can’t burn in the quiet of the evening. I advocate eating a modest meal in the early evening, brushing your teeth, and forgoing eating for the rest of the evening. This strategy eliminates some of the most disastrous eating patterns – eating in front of the TV and grazing all evening on quick, junk food.

Remember, our food becomes who you are. Let your food serve your health first and your taste buds second. Taking charge of your eating habits is an essential step to taking charge of your health.

Coconut Oil for Weight Loss? Facts vs Hype

coconutCoconut oil is being touted as the new superfood. Dr. Oz says its “the miracle fat that fights fat.” Here’s the real skinny on coconut oil and weight loss. This oil is about 50% medium chain tryglyerides, which go straight to the liver where they are burned as fuel and raise the metabolism slightly. One to two tablespoons a day would cause you to burn about 60 more calories. But wait a minute. Two tablespoons of coconut oil contains about 200 calories. Do the math. Don’t consume extra calories in coconut oil thinking it will help you lose weight. Even in studies that compared people asked to eat two tablespoons of coconut oil vs the same amount of another oil didn’t show any difference in weight or waist line. The most successful method for lasting weight loss I’ve come across is to address emotional eating. Learning mental and emotional mastery through goal setting, mindfulness and relaxation techniques helps people lose weight and grow into a calmer, happier person at the same time. I love sharing these important tools with my patients and seeing make the real changes necessary to achieve their long term goal of great health.

The Diet Wars – Vegan vs Low Carb

You have no doubt noticed that there are two trends in nutrition these days that are at odds with one another.  If you walk down the book aisle at Costco, you’ll see ten books on low carbohydrate diets – Low GI, Paleo, Atkins etc.  These diets recommend one eat lots of meat and fat, and little flour and sugar.  You’ll also see ten books on the Vegan diet – lots of veggies and grains, and no meat or dairy.  Each convincingly states its case that it is the superior diet for preventing disease yet they are vastly different diets.  So what is the truth?

This conflict was played out at a recent naturopathic medical conference.  The focus of the conference was cardiology and we had two keynote speakers who were well known cardiologists.  They both started their talks the same way by saying,  “After years of practicing interventional cardiology, I got tired of performing an angioplasty on a patient one year, then seeing them back a few years later for bypass surgery. I realized that I wasn’t part of the real solution which is to prevent and reverse this disease. I went on a mission to find lasting solutions for cardiovascular disease.”

The first speaker was Dr. Mimi Guarneri, Director of Scripps Centre for Integrative Medicine. She said, “I realized the culprit was animal fat.”  She became a proponent of the new Ornish program and recommends a Vegan diet.  The second speaker was Dr. William Davis, who wrote the book Wheat Belly.  His conclusion was that the reason for the rise in cardiovascular disease is the sugar, pasta, muffins and bread that North Americans have eaten more of since the low fat craze in the 80’s.  He says that high carb diets are causing obesity, insulin resistance, and inflammation, which all cause cardiovascular disease and more.  He recommends that we stop eating bread, sugar, and other carbs and eat all the meat we want.  In fact, when I asked him if is possible to be a healthy vegan, he basically said “no”.

I went on a quest to find the answer to this dilemma and to negotiate some peace in the diet wars. But first we have to understand the players.  The vegan diet and the low carb diets each have their strengths and weaknesses.  And is there a third path that might take the best of both worlds and leave the rest?

A vegan diet is certainly intended to be high in nutrient dense whole foods like vegetables, fruits, grains, nuts, seeds and beans.  Science tells us that low animal fat diets are associated with lower rates of cardiovascular disease and reducing red meat reduces colon cancer risk.  The high fiber content of a good vegan diet is great for blood sugar and cancer.  In addition, there is no doubt that a vegan diet is kinder to animals and the environment.   I respect people who chose a vegan diet because they care about animals and our planet.  I do think you can be healthy on a vegan diet with dedication and education.

However the real world challenge of a vegan diet is that often I see people filling up on refined carbs like bread, pasta, and sweets and not eating enough protein.  Those are the folks who gain weight on a vegan diet and impair their blood sugar. Potatoe chips, fries, pop and candy are all technically vegan.  Also, there are many nutrients that are challenging to get on a vegan diet, including fish oils, which lower heart disease.  Calcium, vitamin D, vitamin B12, iron, zinc and iodine can become deficient on a vegan diet.

The low carb diets, such as the Paleolithic diet and Atkins are very low on carbs and focus on vegetables, meat and fats.  A survey showed that 55% of U.S. adults said they were avoiding or eating less sugars and carbohydrates.  That’s good news for blood sugar and diabetes prevention for sure.  The low carb diets work as well or better than traditional diabetic diets.   Research comparing different diets for weight loss have shown that the low carb diets do have a slight advantage in helping people lose weight.  People on a low carb diet feel more satisfied with less calories.  There may also be a metabolic advantage that promotes fat burning.  That’s great, because being overweight and having diabetes both increase the risk of cancer.  But what about heart disease?

The research shows that a low carb diet is no better than the standard American diet (S.A.D.) in terms of preventing cardiovascular disease.  The high levels of animal fat in this diet are pro-inflammatory and we know that damages arteries.   These diets tend to be low in fiber, which can cause constipation.  If fruit is eliminated, a valuable source of phytonutrients is lost.  Also, some carbohydrates are needed to make serotonin. Studies show that if people are prone to depression, restricting carbs can make it worse.

So which diet wins the diet war?  Any extreme diet has nutritional issues and can be hard to maintain in the real world.  Why don’t we combine the best of the vegan diet (high plant based foods, low animal fat, low red meat) and the best of the low carb diets (low in refined sugar and flour).  The DASH diet does just that.  The Dietary Approach to Stop Hypertension diet is based on extensive research and is a healthy balanced diet that is high in vegetables, fruits, nuts, seeds, low saturated fat meat like turkey and chicken breasts, fish and low fat dairy.  It is low in sugar and refined flour.  Grains are ideally whole, as in brown rice and quinoa.  Salt is limited, which basically means cooking at home since restaurant food is loaded with salt. A beautiful, whole food diet, rich in flavour and nutrition can be attained with this way of eating.  It is a way of life that can be sustained and therefore will produce the results we all want – long lasting vibrant health.