New Findings on Dietary Fats

FatsJacquie Eubanks RN BSN

The theory that the consumption of saturated fats is linked to obesity and high cardiovascular disease (CVD) risk has been the cornerstone of dietary guidelines for decades. As the message that saturated fats are simply “bad” for one’s health continues to be promoted by mainstream health organizations including the American Heart Association, more recent research suggests that this hypothesis was based on observational studies and has never been scientifically proven. Meta-analyses of numerous controlled and randomized controlled trials involving thousands of participants have found no statistically significant effects of dietary saturated fat reduction in regard to heart attacks, strokes or all-cause deaths.

The relationship between macronutrients (proteins, carbohydrates and fats) and cardiovascular disease (CVD) is confusing and controversial. As the low carb vs. low fat diet wars continue, there are many who would like to set the record straight. The results of a large multinational epidemiological cohort study recently published in The Lancet were welcomed by those who believe the current advice was based on flawed science, and denied by those who argue against the benefits of fat consumption. The Prospective Urban Rural Epidemiology (PURE) Study involved over 200 investigators, who for seven years followed the dietary intake of 135,335 individuals aged 35-70 from 18 different countries.

So, why all the fuss? This study assessed the consumption of carbs and total fat; including saturated, polyunsaturated, and monounsaturated fats; to find associations with CVD and total mortality. Higher carbohydrate intake was associated with an increased risk of total mortality but not with the risk of CVD or CVD mortality. The intake of total fat and each type of fat was associated with a lower risk of total mortality, totally contradicting the dietary advice of the last four decades. Higher saturated fat intake was associated with a lower risk of stroke; and total fat, including saturated and unsaturated fats, was not significantly associated with risk of CVD mortality.

These findings indicate that:

  • High carbohydrate intake was linked to worse total mortality, and had the most adverse impact on CVD risk factors
  • High fat intake was linked to lower risk, and was not associated with cardiovascular disease (CVD) or CVD mortality
  • Monounsaturated fats appeared to be most beneficial, while saturated fats were not harmful
  • Reducing saturated fat intake and replacing it with refined carbohydrates was linked to the most adverse effects on blood lipids and increased CVD risks
  • Three to four servings of combined plant foods, including fruits, vegetables and legumes, was associated with lower total mortality and non-cardiovascular mortality

While the study is ongoing, the findings to date do not support the current recommendations to restrict total fat intake to less than 30% of total daily caloric intake, and saturated fat to less than 10% of total energy. The conclusions indicated that individuals with a high carbohydrate intake above 60% of total energy consumption, would likely benefit from a reduction of carbohydrate intake and an increased fat and protein intake. In light of their findings, the researchers concluded that global dietary guideline recommendations restricting fats should be reconsidered.

 In recent years, multiple studies involving hundreds of thousands of people have reached the same conclusion. An editorial published in the British Journal of Sports Medicine concurs. The article published by a team of cardiologists from the United Kingdom, the U.S. and Switzerland cited reviews that show no association between intake of saturated fat and a greater risk for heart disease. The collaborative team stated, “It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and the reduction of dietary saturated fat. Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself, and driving a market of ‘proven to lower cholesterol’ and ‘low fat’ foods and medications, has been misguided.” They suggested these misconceptions may stem from “selective reporting of data.”

Even so, this study is unlikely to end the war on fat, as leading health organizations continue to tout a low-fat diet, and with the change of mind set required, it will take time before we see any new recommendations. In the meantime, individuals are free to draw their own conclusions, as they make their dietary choices. Those seeking optimal health through their diet might do well to remember that fats are not the enemy. It’s overall dietary patterns, not individual nutrients, that hold the key to good health. A better practice is to greatly reduce refined carbs and include whole foods, as well as healthful high fat foods, such as olive oil, nuts and seeds, avocado, and grass-fed meats, for a significant reduction of high total cholesterol and improvement in their high density lipoprotein (HDL) level.

With each new study, it appears that a complete lifestyle approach, encompassing a healthful diet, regular physical activity and stress reduction, will not only improve quality of life, but can reduce cardiovascular and all-cause mortality. These finding do not indicate approval to go overboard on fatty fried foods or commercially baked goods, but they do mean that you can enjoy eggs for breakfast, buttered whole grain toast and a bit of cream in your coffee without worry.

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Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.
5 Studies on Saturated Fat – Time to Retire the Myth?
Saturated Fat: Not so Bad or Just Bad Science?
Artery-clogging saturated fat myth debunked.
The Low-Fat vs. Low-Carb Debate Has a New Answer.
Saturated Fat and Health: Recent Advances in Research.
Artery-clogging saturated fat myth debunked.



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