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.