Saturated Fats Cause Heart Disease and the Earth Is Flat

If you think flat Earthism is gone, you’re wrong. Some people still believe the earth is flat. The Flat Earth Society even has it own website. The society’s roots may be traced back to the 1800’s.

However, the members don’t use scientific evidence to support their view. According to an interview with the society’s president in The Guardian three years ago, they believe the earth is flat because it appears flat. The sun and moon are spherical, but much smaller than mainstream science says, and they rotate around a plane of the Earth because they appear to do so.

Most public health authorities still recommend that total fat consumption does not exceed 30 percent of total calories and that saturated fats be no greater than 10 percent.

The British, National Institute of Clinical Excellence (NICE) stated in a document in 2010 that in order to better prevent coronary heart disease (CHD) at a population level, the reduction of dietary saturated fat is crucial. They estimated that halving the average intake of saturated fat (from 14 to 7 percent) might prevent 30.000 deaths annually in the UK.

The public health recommendations are very surprising, considering the large amount of data indicating that reducing total fat consumption or the amount of saturated fats in our diet will not reduce mortality or affect the risk of dying from CHD.

The largest controlled intervention trial on diet and heart disease to date, the Women’s Health Initiative randomly assigned more than 48 thousand women, 50 – 79 years old, to a low-fat intervention or a comparison group. Saturated fat intake was lower in the intervention group as was dietary polyunsaturated fat. However, dietary carbohydrates were higher in the intervention group.

After six years of follow-up there were no differences between the groups in the incidence of coronary heart disease and stroke. So, replacing fat with carbohydrates does not seem beneficial.

The much cited Siri Tarino meta-analysis, published 2010 in The American Journal of Clinical Nutrition included 16 prospective observational cohort studies. There was not a significant association between the intake of saturated fats and coronary artery disease.

Ok, I know what you are thinking: “Now the Doc is going to claim the public authorities suffer from flat Earthism. Their recommendations are not based on current scientific evidence but rather reflect stubbornness and a tendency to stick with outdated, previously held views“. But believe me, these were not my words.

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The Influence of the Seven Countries Study

Few weeks ago one of my readers drew my attention to a very interesting paper published in Food and Nutrition Sciences last spring, entitled Food for Thought: Have We Been Giving the Wrong Dietary Advice? The paper is written by Zoë Harcombe, Julian S. Baker and Bruce Davies from the University of the West of Scotland, Hamilton, and University of Glamorgan, Pontypridd, UK. The paper may actually bridge some of the gap between the public recommendations and what I believe is currently available scientific evidence.

The authors went through 20 volumes of Ancel Key’s Seven Countries Study. It is well known the American and European public recommendations on diet and nutrition developed in the 1980’s were largely based on evidence from this study.

The main conclusions from the Seven Countries Study were:

  • The incidence rate of CHD tends to be directly related to the levels of blood cholesterol
  • The average level of blood cholesterol is directly related to the average proportion of calories provided by saturated fats in the diet
  • The CHD incidence rates are as closely related to the dietary saturated fatty acids as to the blood cholesterol levels

This is the foundation for the Diet Heart Hypothesis which is still alive and well according to public health recommendations.

The Macronutrient Confusion

Harcombe and coworkers highlight few classification errors in the Seven Countries Study which are quite scary in light of the huge influence of this study on dietary recommendations for the last forty years.

Firstly, they point out that “the dietary references that were mentioned used unquantifiable descriptions such as “loaded with saturated fatty acids” and “cholesterol from butter cream meats and eggs””.

Secondly, “the study classified cake and ice cream as saturated fats, as opposed to refined carbohydrates. Meat and eggs are described as saturated fat when their fat content is primarily unsaturated. Butter and cream are one third unsaturated fat, which was not noted in their analysis. So, here we have a profoundly influential research project introducing imprecise evaluations of macronutrients which have continued to present day”. 

The authors conclude that “The Seven Countries Study was not a scientifically robust study. The dietary references are vague, sporadic or absent.

There were no comments on causation and no attempt was made to consider association until 25 years post study completion and 10-15 years after UK and USA dietary advice had already been changed based on the recommendations of Key´s work. The study clearly demonstrated that the science surrounding macronutrients and nutrition was not as accurate as it is today. Yet contemporary knowledge is not being applied when considering nutritional advice for the population.”

Finally I want to bring forward some important issues highlighted by the authors which may clear up some of the macronutrient confusion:

  • Biscuits, savoury snacks and processed food should not be defined as saturated fats because they are substantially carbohydrates
  • Red meat is not a saturated fat but a combination of various fatty acids
  • Sirloin steak is approximately 71% water, 21% protein, 3% unsaturated fat and 2% saturated fat
  • Natural food such as meat, fish, eggs and nuts contain saturated, monounsaturated and polyunsaturated fats, only the proportions vary
  • Few people appreciate that it is impossible to eat saturated or polyunsaturated fat alone
  • Dairy products are the only food group with more saturated than unsaturated fat
  • Many of the foods demonized by past research groups, even lard, contain more unsaturated than saturated fat.

 The Bottom Line

There appears to be a large gap between public recommendations on the relative consumption of different macronutrients and currently available scientific evidence.

Although this somewhat strange inertia may be compared to flat Earthism, it’s causes are likely complicated and multifactorial.

However, it appears that a part of the problem may be traced to macronutrient confusion and wrong definitions. In fact, it’s quite scary to learn that the Seven Countries Study classified processed foods, primarily carbohydrates, as saturated fats.

Of course, this may have lead to wrong conclusions, some of  which may have affected public health recommendations on diet and nutrition for the last three or four decades.

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Haraldur Magnússon
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Most excellent article

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Haraldur. Appreciate your interest.

Paul Hodson
Guest
Paul Hodson

Thanks for the article. I have recently read “How to Prevent and Reverse Heart Disease” by Dr Caudwell Esselstyn (https://www.amazon.com/Prevent-Reverse-Heart-Disease-Nutrition-Based/dp/1583333002). As a result, I have moved to a fully vegan diet to try to lose weight and reduce my risk of CHD. This book is amazingly persuasive in its arguments and results (he took 24 patients who had sever CHD and halted or reversed their heart disease by cutting out all oils and animal products from their diet. After reading this post, I am very confused. Are you arguing that we should be eating the very things I have given… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the post Paul. I don´t have anything against vegan diets and I think they can be effective when it comes to reduce cardiovascular risk, in particular if you are aiming to lower your blood cholesterol, although I believe cholesterol is not the only thing that matters. So, I´m not saying you should be eating the things you have given up. Everybody has to make their own choices. Many people feel well on a vegan diet while others don´t. What I am saying is that there is a lot of misunderstanding when it comes to saturated fats and the… Read more »

Mie
Guest
Mie

Axel, you do realize that excessive intake of red meat is linked to increased risks of e.g. cancer and stroke? And that for people with diabetes it may be prudent to limit the intake of eggs, as well? I haven’t seen data that would indicate the same things with e.g. nuts or fish.

Besides, I kinda … well, feel uneasy whenever someone mentions the word “natural” in relation to food. Not everything that is “natural” is good for you. And not everything that your grandma wouldn’t recognize as food (to paraphrase Pollan’s, in many aspects, silly & oversimplified book) is unhealthy.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Mie. I´m not promoting red meat. Remember though that correlation does not prove causation. Furthermore red meat may differ very much. For example there may be a huge difference between grass-fed vs grain-fed beef. The fatty acid composition differs quite a lot between these two. Grazing can make a huge difference. So, putting all red meat together as one is just one more example of an oversimplification which may lead to misunderstanding and wrong conclusions.

Mie
Guest
Mie

Axel: “Mie. I´m not promoting red meat.” What do you call this then? “The fear of saturated fats may have kept us from eating natural foods such as meat …” It seems promotion to me. “Remember though that correlation does not prove causation.” Oh, fer Christ’s sake! This is stating the obvious & therefore has very little meaning here. We’ve know a) several mechanisms via which excessive red meat intake may cause the aforementioned problems and b) we’ve got pretty unanimous evidence from large observational studies. To state that “correlation …” doesn’t provide an explanation here. If you want to… Read more »

Someone
Guest
Someone

I back up doc on this one. Read meat is too often packed together with processed meat. So often you see “red & processed meat plaaplaaplaa”. One of the recent meta-analysis in asia area found inverse correlation between red-meat intake and CVD (https://ajcn.nutrition.org/content/early/2013/07/31/ajcn.113.062638.short). Red meat intakes in Asia, are of course much less than for example U.S, but it is also worth to notice that U.S people eat also more than twice the amount of red meat than finnish people(my home country). We should be discussing what is the proper amount to consume. It is not as simple as “the… Read more »

Mie
Guest
Mie

“I back up doc on this one. Read meat is too often packed together with processed meat. So often you see “red & processed meat plaaplaaplaa”.” You have read this one, haven’t you? https://www.pronutritionist.net/onko-liha-epaterveellista/ (For other readers, sorry about the Finnish link but I know “Someone” to be a Finn, so ….) “One of the recent meta-analysis in asia area found inverse correlation between red-meat intake and CVD (https://ajcn.nutrition.org/content/early/2013/07/31/ajcn.113.062638.short).” Interesting. Thanks for pointing that out. I can’t access the full text, so it’s impossible to really say anything about it. Healthy user effect? Perhaps, perhaps not – since the association… Read more »

neilfeldman
Guest

Paul. Respectfully suggest you do some further investigation about Dr. Esselstyn’s regime. You might start here: https://www.fathead-movie.com/index.php/2013/08/13/bill-clintons-vegan-diet/

paul
Guest
paul

Thanks Neil, happy to have a look.

Ted Hutchinson
Guest

The link in the phrase the large amount of data isn’t working for me.
I wonder if you meant to link to this paper.
Reduced or modified dietary fat for preventing cardiovascular disease

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Ted. Exactly, that´s the paper I was referring to. It´s been fixed now. By the way, thanks again for drawing my attention to the Harcombe paper.

Valdimar Jörgensen
Guest
Valdimar Jörgensen

Thanks for your article. It confirms the sometimes not so well known fact, that there is no concrete truth, neither in religion nor science. We have to follow the road that we find most passable or pleasing…

Doc´s Opinion
Guest

So true Valdi !

Mie
Guest
Mie

Axel, a few quick comments before dinner: 1) Old studies such as 7CS are hardly essential in this case, therefore reviewing them is – in my opinion – of little importance. The idea that fatty acids have different effects on cholesterol and therefore can influence CVD risk is WAY beyond 7CS. And I believe that e.g. the problems with processed food and excessive red meat (of which e.g. HSPH often talks about) may be based on e.g. newer epidemiological data. Quite frankly, I find the idea that 7CS is somehow an integral part of current views – more or less… Read more »

Ade Rowswell
Guest

Fantastic article.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Ade. Appreciate your interest. Hope you continue visiting.

Barbara Roberts, MD
Guest
Barbara Roberts, MD

Axel this is a great article. I was astounded to read the Food and Nutrition Sciences article
On the Seven Country Study and learn how various foods were misclassified. It felt almost
as shocking as finding out there’s no Santa Claus! I disagree with the comment that
SCS is no longer relevant. It still drives many dietary recommendations. I think
there is ample evidence of the benefits of a PLANT based diet, which does not preclude
the occasioal intake of meat. Barbara Roberts, MD

Mie
Guest
Mie

What recommendations and where? Just because it may get mentioned, doesn’t mean it’s integral to our understanding of dietary fats and CHD. Historical background, that’s it. After reading the article Axel mentioned, I was astounded how WEAK it was in many ways. Or well, no I wasn’t. I’ve learned a bit about one of the authors. See e.g. https://carbsanity.blogspot.fi/2011/08/zoe-harcombe-credentials.html https://carbsanity.blogspot.fi/2013/01/zoe-harcombe-credentials-ii.html About the paper itself: it is not a systematic review nor a meta-analysis. It has no power to claim anything about current nutritional advice whatsoever. And it makes several dubious claims. E.g. what food scientists classify ice cream and cake… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Mie. I won´t be drawn into a debate with you. I agree with you that the Harcombe paper is not a scientific study, although it is a peer reviewed paper. It highlights some very important issues relating to our understanding of the macronutrient composition of different foods, and how they are defined when it comes to scientific research and public health recommendations. This is what makes the paper interesting to me.

In my opinion, providing internet links to blog posts like the ones above in order to negatively affect the reputation of the authors, will discredit you more than them.

Mie
Guest
Mie

The main point of my post was that the paper makes silly claims (more of these later). The stab at Harcombe was totally secondary and irrelevant in terms of my main points. Yes, I could’ve left it out, you’re right there. However, I’m not a newcomer when it comes to reading texts from her – or other self-proclaimed “diet gurus” – and quite frankly, I’m disappointed with the lack of standard and open-mindedness they display. It’s not just the “SAFA-kills-not-matter-what” school of thought that embraced polemic & polarized statements at the expense of the big picture. And as far as… Read more »

Luke Brennan
Guest
Luke Brennan

Great article!!
I adhere to a ketogenic nutritional protocol and enjoy a vibrant and energetic health.
All my vital stats, blood work and body fat have never been better…achieved effortlessly
‘Saturated fats’ have, for the past 40odd years been considered equal, which is far from the truth.
Keep the papers coming

charles grashow
Guest
charles grashow

Doc

What is your opinion on LDL-P? Do you think the number of particles or the particle size is more important?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Charles. I´v actually written a couple of articles on LDL-P. Here are the links if you´re interested:
https://www.docsopinion.com/health-and-nutrition/lipids/ldl-p/
https://www.docsopinion.com/2012/11/21/the-difference-between-ldl-c-and-ldl-p/

charles grashow
Guest
charles grashow

Question – which is more imore important with regard to LDL-P – particle amount or particle size?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

I believe particle number (LDL-P) is more important than particle size.

Patients with familial hypercholesterolemia (FH) usually have large LDL-particles, but their risk of heart disease is very high, and so is their LDL-particle number.

It is likely that the association between small LDL and heart disease often reflects an increased number of LDL particles in patients with small particles. Therefore, particle size in itself may be less important than particle number..

Charles Grashow
Guest
Charles Grashow

So – if someone had an LDL-P >2700 and small LDL-P >400 one SHOULD be concerned??

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Charles. An LDL-P value >2000 may be associated with increased risk of cardiovascular disease. Remember though that it is always difficult to assess risk by only looking at individual lab values. You need to look at the whole picture, including family history, smoking, blood pressure, BMI, other lab values such as Non-HDL cholesterol, LDL-cholesterol, blood glucose or rather glycated hemoglobin. In some cases hs-CRP can help as well.

JustMEinT MusingsClare
Guest

Again another great article and I thank you for writing it… making it available to the general public.
Personally I am sick and tired of hearing dieticians pushing the GRAINS and minimising the healthy fats…. except for olive oil (ICK does not suit my taste buds). Dietician’s are trained NOT to want to advise or help patients who go LCHF as I have done. Even when presented with proof that it lowers many risk factors. There are non so blind as them who will not see.

Will
Guest

Hi Axel, You wrote, “The study clearly demonstrated that the science surrounding macronutrients and nutrition was not as accurate as it is today.” But were scientists back then truly oblivious to the fact that foods in nature always contained a variety of fatty acids (both saturated and unsaturated)? I have to say I’m skeptical. For instance, this table shows the fatty acid breakdown of butter (including unsaturates like linoleic acid and linolenic acid) based on a reference from as far back as 1943 – https://antoine.frostburg.edu/chem/senese/101/consumer/faq/butter-composition.shtml By classifying certain foods as “saturated fat”, I think Keys et al were trying to… Read more »

Z.M.
Guest
Z.M.

will: “You also mentioned the Women’s Health Initiative and the Siri-Tarino meta-analysis. The major confounder in both of these case is refined carbohydrates. Since refined carbohydrates are also bad for the heart, replacing saturated fat with refined carbohydrates could be masking any potential benefit you’d expect to see by reducing SFA.” I could never get this replacement argument. I’m sure if a clinical trial is done that replaced whole grains with vegetables or n-3 fats, things would not look too good for whole grains. This does not mean whole grain is “bad”. Same goes for saturated fat. The so call… Read more »

Mie
Guest
Mie

“The so call benefits of whole grains are probably overblown based on observational data, not randomized trials” In the first one https://www.foodbase.org.uk//admintools/reportdocuments/547-1-954_N02036_final_report.pdf notice the increased calorie intake & short duration. In addition, the intervention group w/ the highest wholegrain intake also dropped out fruits (it isn’t explicitly mentioned to what extent) from their diet. Not very surprising that the results weren’t as expected. In the latter case, notice the words “not significant”. There’s no viable mechanism to explain why increased fiber intake is/can be a detriment. Or at least I’m not aware of any such mechanism (please, no “anti-nutrient” mumbo… Read more »

Low-fat Richard
Guest
Low-fat Richard

Someone wrote: “One of the recent meta-analysis in asia area found inverse correlation between red-meat intake and CVD (https://ajcn.nutrition.org/content/early/2013/07/31/ajcn.113.062638.short)”. First, the study looked at cause specific mortality, which is not a synonym with a cardiadic event. Meat intake is a proxy for wealth in Asia and wealthy Asians have access to statins, diuretics, revascularization (bypass, stents, etc), blood clot dissolving medications, etc. Poor Asians do not have an access to the aforementioned drugs and procedures. Rural Indians f.ex cannot even afford an aspirin after an acute MI and hence stand a poor chance if/when the second cardiadic event takes a… Read more »

Z.M.
Guest
Z.M.

Richard: “Second; cumulative exposure. Meat intake is still very low overall in Asia compared to the West and nearly all Asians have been raised in very low-meat/flesh diets.”

A low meat intake is not the same as a no meat intake. The former may be far more beneficial than the latter. I know you are here to push your vegan agenda but even if we assume that low meat intake is more beneficial than a high intake, this does not mean that zero intake is better than a low intake.

Z.M.
Guest
Z.M.

Mie: “notice the increased calorie intake & short duration. In addition, the intervention group w/ the highest wholegrain intake also dropped out fruits (it isn’t explicitly mentioned to what extent) from their diet. Not very surprising that the results weren’t as expected. In the latter case, notice the words “not significant”. ” Mie, I never claimed that grains are detrimental. I was referring to the claimed benefits in which case the studies I referenced support my claim. Mie: ” People with dyslipidemia, on the other hand, are more likely to benefit (you do know what SAFA does to LDL receptors,… Read more »

Ehsan
Guest
Ehsan

I really enjoyed. Indeed, my ancestor consumed animal fat (especially tail adipose tissue resulted from fat-tailed sheep) and they never gain weight a lot and were healthy.

Mie
Guest
Mie

ZM “Mie, I never claimed that grains are detrimental. I was referring to the claimed benefits in which case the studies I referenced support my claim.” Fair enough. “Yes, but there is no evidence that saturated fat intake is harmful whether it raises cholesterol or not. However, given what is known about hypercholesterolemia, I agree that some people may need to cut down on saturated fat if their cholesterol skyrockets.” Well, the lack of evidence you mention has a simple reason, which we already dealt with. This doesn’t mean that there isn’t evidence of SAFA’s problems. There is. What it… Read more »

Someone
Guest
Someone

Mie wrote: “And I don’t think heme iron is the only problem. What about AGE compounds? Nitrates? SAFA intake (see e.g. Krauss’ recent work in low carb context)?” I agree that nitrates should be avoided, but again this concerns processed meat. When I pick up sausage from the super market, I make sure it is the one without nitrates. AGE compounds is good topic too. One thing too often forgotten is the way you prepare the food as well. It is not same whether you cook your food in low temperatures vs high temperatures. About the amounts of meat intake,… Read more »

Z.M.
Guest
Z.M.

Mie: “Well, the lack of evidence you mention has a simple reason, which we already dealt with. This doesn’t mean that there isn’t evidence of SAFA’s problems. There is” I don’t agree. I haven’t not seen any convincing evidence that saturated fat is harmful given the lack of evidence from both observational and clinical research. I put far more weight to long term evidence on hard endpoints but even short term studies are inconsistent and seem to depend on context. Mie: “And I don’t think heme iron is the only problem. What about AGE compounds? Nitrates? SAFA intake (see e.g.… Read more »

Mie
Guest
Mie

ZM “I put far more weight to long term evidence on hard endpoints but even short term studies are inconsistent and seem to depend on context.” Well, since most of them have not achieved the reductions aimed and/or have used refined oils/carbs as replacement etc. etc. it’s no wonder that context matters. “I think it is reasonable to say though that many of the trials could have been a lot more successful if appropriate interventions were used.” Perhaps. Perhaps not. But then the same applies to the SAFA trials, too, right? 🙂 “Remember also that these trials were for the… Read more »

Z.M.
Guest
Z.M.

Mie: “Well, since most of them have not achieved the reductions aimed and/or have used refined oils/carbs as replacement etc. etc. it’s no wonder that context matters.” I see it more as targeting the wrong thing. Targeting saturated fat never works while increasing fruit, vegetable and n-3 fatty acids works almost every time. Of course, many of these trials were multi-interventional so many plausible interpretations are possible but this is my interpretation of the evidence I’ve seen. Mie: “Perhaps. Perhaps not. But then the same applies to the SAFA trials, too, right?” but saturated fat is innocent until proven guilty… Read more »

Mie
Guest
Mie

ZM “Targeting saturated fat never works while increasing fruit, vegetable and n-3 fatty acids works almost every time.” Well, the effects are better (even though still somewhat limited). So yes, I’d say that focusing on what you can and should consume instead of what to cut out might be better. “Maybe we should be asking questions such as in what context is saturated fat harmful? In what context is saturated fat harmless or even beneficial? These are much more open minded questions than the dogmatic views that is normally seen. I’m sure you’d agree :)” As open-minded as I am,… Read more »

Z.M.
Guest
Z.M.

Mie: “As open-minded as I am, I have to say that there’s no research to indicate that SAFA is beneficial, no matter the context, and that there’s no known mechanism to explain why SAFA could be beneficial in any given context.” Mie, there is data on possible benefits. Note the key word here “possible”. No hard data, but at the same time there is no hard data that saturated fat is harmful. Consider for example, a meal of vegetables with butter (which would improve the absorption of nutrients in vegetables and also comes with its own fat-soluble vitamins), in a… Read more »

Will
Guest

Z.M.,

In the meal of vegetables with butter, I wouldn’t count the improved absorption of nutrients as an advantage of saturated fat per se. You could just as easily improve nutrient absorption via olive oil or any other dietary fat.

I compared grass-fed butter to some alternatives (like olive oil and canola oil) on NutritionData. Butter has more vitamin A per 100g, but olive oil and canola oil have more vitamin E and K. This isn’t a clear victory for butter, either IMO.

Z.M.
Guest
Z.M.

Will: “I compared grass-fed butter to some alternatives (like olive oil and canola oil) on NutritionData. Butter has more vitamin A per 100g, but olive oil and canola oil have more vitamin E and K. This isn’t a clear victory for butter, either IMO.”

Will, you can do this for any foods and declare “victory” for one food over another.

Will: ” You could just as easily improve nutrient absorption via olive oil or any other dietary fat.”

Yep, and I never said otherwise. I don’t know what your point is.

Someone
Guest
Someone

It is also worth noticing that even though olive oil and canola oil comes with decent amount of E-vitamin(antioxidant), we also need more antioxidants if we are consuming those oils since those oils get oxidized more easily than SAFA. Im not trying to say which one is the best, just saying that it’s not that simple comparison.

Richard
Guest
Richard

Agree. Wholeheartedly. ummm…Unfortumately, I cannot really join the party. Paleo? LOL! Eric Rimm from the Department of Nutrition, Harvard said to Reuters in regards to a major health report produced by the National Academy of Science, which he was an author of that: We can’t tell people to stop eating all meat and all dairy produces. Well, we could tell people to become vegetarians… If we were truly basing this on science we would, but it is a bit extreme. Interesting findings from Asia, these studies utilized advanced methodology: Chinese lacto-vegetarian diet exerts favorable effects on metabolic parameters, intima-media thickness,… Read more »

Mie
Guest
Mie

Richard: “ummm…Unfortumately, I cannot really join the party. Paleo? LOL!” Don’t worry, we all know the limitations of your approach (vegan dogmatism). “BTW, I am just browsing through an interesting paper from Axel’s homecountry, Iceland.” Seems like a pretty well-designed cohort study, based on a quick read-through. However, a) Look at the CI for adolescence & high milk intake (table 4). It’s all over the place. b) After a sensitivity analysis no statistical significance: “The odds ratio for advanced disease among men with a high milk intake in adolescence was 2.14 (95% CI: 0.62, 7.39).” c) No accurate knowledge of… Read more »

Richard
Guest
Richard

Mie wrote: “Don’t worry, we all know the limitations of your approach (vegan dogmatism)”. But I just stated that animal foods such as egg whites and very low-fat yogurts can be part of a healthy diet, albeit their consumption should be kept very low as well. Mie, you give up too easily. Its too easy for you to state that I am dogmatic and then just disregard everything I say. At top of everything, you even try to make the fellow reader to just blindly accept that my message is not worth taking into consideration by accusing me of dogmatism.… Read more »

Larry Istrail
Guest

Great summary. I have done much research on this topic, summarized here:

Clinical trials: https://www.awlr.org/saturated-fat-and-heart-disease-clinical-trials.html

Prospective Studies: https://www.awlr.org/observational-studies-on-heart-disease.html

Mie
Guest
Mie

There are problems in that blog text, in the case of Ramsden et al and Hooper et al. 1) Ramsden et al did find out that diets richer in PUFA are beneficial. Ramsden et al state that “For non-fatal myocardial infarction (MI)+CHD death, the pooled risk reduction for mixed n-3/n-6 PUFA diets was 22 %” 2) Hooper et al state that : “This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a… Read more »

Patrick Larson
Guest

If anyone has read Good Calories, Bad Calories by Gary Taubes, this has all been covered, and then some. It’s been my main reason other than http://www.marksdailyapple.com for changing my way of thinking about food. We are demonizing the wrong food (meat) when we should be demonizing sugar and it’s related carbs (grains, to a great extent).

Mie
Guest
Mie

I recommend reading Taubes, too. His work is good for improving your skills in critical reading because it’s full of cherry-picking, out-dated research and plain silliness.

As far as “demonizing” goes, that is the key problem right there: shaddy interpretations and extrapolations grounded in dogmatic thinking. That’s Taubes, Lustig, Campbell etc. etc. who pay no attention to dose & context or the big picture. There’s no need to “demonize” anything, not meat nor sugar nor grains.

Richard
Guest
Richard

Mie,

American Institute of Cancer Research (AICR) has an important message in regards to Campbell’s work. Overlooking this message may end up in a missed opportunity for healthy longevity.

AICR, the China Study, and Forks Over Knives

“Like the China Study, the ongoing results of the AICR/WCRF CUP strongly support a whole-food, plant-based diet for lower risk of cancer and many other diseases”,

https://www.aicr.org/about/advocacy/the-china-study.html

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Richard and Mie. I have nothing against you two using the discussion forum. However, it wouldn´t be right to let it dominate the forum on every blog post I write, unless it deals with that specific topic. If the two of you are going to engage in an off topic discussion, feel free to do that in relation to some of the older posts, where you have been exchanging words before. And by the way Richard. I can´t accept lengthy posts with a lot of copy/pasting, nor comments that include text that you have used many times before when commenting… Read more »

Mie
Guest
Mie

You’re absolutely right Axel. I’ll refrain from commenting posts that aren’t related to the topic of your post.

Mie
Guest
Mie

Z.M. “Mie, there is data on possible benefits. Note the key word here “possible”. No hard data, but at the same time there is no hard data that saturated fat is harmful. Consider for example, a meal of vegetables with butter (which would improve the absorption of nutrients in vegetables and also comes with its own fat-soluble vitamins), in a low iron context. Wouldn’t you consider this meal better with butter than without?” Hmm? That’s a bit far-fetched example, in my opinion. No one’s arguing for a diet lacking in essential fatty acids. And along similar lines, eating e.g. rancid… Read more »

Z.M.
Guest
Z.M.

Mie: “Hmm? That’s a bit far-fetched example, in my opinion.” I don’t think so. You said you didn’t think there was any context in which saturated fat was beneficial. I gave you an example of a commonly eaten meal of butter with vegetables, so I don’t understand how that is far-fetched. In fact, I think it’s far-fetched to be comparing rancid meat to fresh meat. Mie: ” Or butter compared to fatty fish, avocado, e v olive oil etc.?” The replacement/comparison argument is usually made by people who want to demonize certain foods. Comparing butter to other foods does absolutely… Read more »

Mie
Guest
Mie

Z.M. “I gave you an example of a commonly eaten meal of butter with vegetables, so I don’t understand how that is far-fetched. In fact, I think it’s far-fetched to be comparing rancid meat to fresh meat.” Notice what I stated? “No one’s arguing for a diet lacking in essential fatty acids.” And no diet in this context (Western world) is going to be lacking in fats so as to hinder the absorption of fat-soluble vitamins. In addition, your argument has a tendency to render the concept “healthy” meaningless, in general sense. E.g. added sugar: clearly not a good idea.… Read more »

Z.M.
Guest
Z.M.

Mie: “E.g. added sugar: clearly not a good idea. However, if you’re starving, then yes, it could be considered healthy. Sensible?” Mie, you are one who claimed that saturated fat has no benefits so maybe you should explain what you mean by “having no benefits” or else this argument is going nowhere fast. Mie: “Well, since you already agreed that e.g. in the context of people with dyslipidemias, replacing SAFA is a good idea, I don’t quite follow you now. ” Well, obviously I’m not talking about people with dyslipidemias. Mie: “When there’s clearly an improvement in replacing something for… Read more »

Low-fat Richard
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Low-fat Richard

ZM, The amount and type of dietary fat to a large extent determines the number of circulating LDL particles and blood levels of total cholesterol. Moreover, SFA with 12–16 carbon atoms are the most potent LDL- or total-cholesterol-raising fatty acids (Pedersen et al 2011). In the 7CS, the amount of SFA in the diet explained 89% of variability in serum cholesterol levels across the 16 different cohorts, exactly as would be expected based on the findings from metabolic ward. We know that the strength of the (independent) association between blood cholesterol and CHD and strokes is diluted in most studies… Read more »

Z.M.
Guest
Z.M.

Richard, we’ve been through this many times before so I’m not going to respond except to point out your double standard of citing observational research when it suits your ideas but any that contradicts it are flawed.

Richard
Guest
Richard

Axel, point understood. But I haven’t addressed my points in a neat way that summarizes it all. Hence, I try again. I hope you reconsider adding this. When Siri-Tarino et al. considered 7 of the 11 studies included in their original meta-analysis paper that addressed the association between saturated fat and fatal coronary heart disease they found an 18% excess risk that almost reached statistical significance (0.99-1.42).When Stamler considered all 11 studies he found a 32% excess risk despite over-adjustments for serum lipids and a number of other problems addressed in his editorial that would expected to have significantly weakened… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Ok Richard I´ll finally accept this comment. Firstly, I don´t think we should confuse the diet heart hypothesis with the lipid hypothesis. Much of your argumentation above surrounds the role of LDL-cholesterol in atherosclerotic heart disease. A correlation between LDL-cholesterol and the risk of heart disease does not prove that saturated fats are bad. So we shouldn´t really be discussing the lipid hypothesis. I know there is some data indicating that high consumption of saturated fats raise LDL – cholesterol. However, if you read my article you can see that I referred to the Hooper meta-analysis which didn´t show any… Read more »

Richard
Guest
Richard

Thanks Axel, you are the legitimate cardiologist here, and I respect that. Everyone can make their own conclusions about SFA and dietary cholesterol based on the four lines of evidence I presented (1-4). The evidence from RCTs is not supportive to the idea that smoking cessation is beneficial to prevent lung cancer, neither is it supportive that physical inactivity is harmful. Outside the pharmacological context, we shouldn’t make too much of RCTs. That’s what I think. BTW, I am just reading an article about the Bedouins living on wheat-based diets by a diet-heart legend, J.J Groen. An average Bedouin once… Read more »

Mie
Guest
Mie

Someone: “It is also worth noticing that even though olive oil and canola oil comes with decent amount of E-vitamin(antioxidant), we also need more antioxidants if we are consuming those oils since those oils get oxidized more easily than SAFA. Im not trying to say which one is the best, just saying that it’s not that simple comparison.” But in the context of current intake nothing suggests that oxidation is a major issue, nor in the context of increased intake for that matter in the case of olive oil (Med.diet trials). Remember Ramsden et al: intake of n-6 fatty acids… Read more »

Someone
Guest
Someone

Yeah, it’s possible that it’s not a problem. Chris MasterJohn brought up interesting points about E-vitamin and vegetable oils in this article: https://www.westonaprice.org/blogs/cmasterjohn/2012/05/17/ajcn-publishes-a-new-pufa-study-that-should-make-us-long-for-the-old-days/ (I think someone has pasted this link earlier too if I recall correctly). He points out that E-vitamin levels in plasma are usually first raising while using PUFA-oils but then trend starts to get worse by the time. Unfortunately studies made are not long enough that we could make any conclusions of the matter. Studies following the effects of increased PUFA usage for over then years would be interesting. Too bad that most of the studies are… Read more »

Mie
Guest
Mie

I’m well aware of Masterjohn’s position. And I’m not convinced. Naturally, there will never be a decade-long trial on dietary fats. What we do know, however, is that in the case of “normal” intake, there are benefits for PUFA-rich diets – and even in the case of excessive intakes, the data on possible problems is pretty much non-existent (see Reijo’s comments). As for the vitamin E claim, his claims are based on one rat study and a couple of older studies SUGGESTING that there MIGHT be something there. However, as he himself points out, later trial evidence disputes the claim.… Read more »

someone
Guest
someone

Yeah. I did not claim anything,i just said that he raised interesting questions. Also i was not trying to give any answers. Some people have desperate need to know All the answers and that may drive them to make rapid conclusions. You love disagreeing with others even one is not take any side in the argument.

Mie
Guest
Mie

“I did not claim anything,i just said that he raised interesting questions.” And I didn’t claim that YOU claimed anything, now did I? Instead, I discussed the reasons why I find Masterjohn’s position weak. “You love disagreeing with others even one is not take any side in the argument” Pardon me, but I thought that we’re here to DISCUSS issues we consider interesting. Sometimes I agree on something, sometimes I don’t. Should I refrain from commenting if I don’t? And anyway, since you yourself just stated that you didn’t make any claims – implying that you don’t agree with Masterjohn… Read more »

Low-fat Richard
Guest
Low-fat Richard

Someone wrote: “Richard, we’ve been through this many times before so I’m not going to respond except to point out your double standard of citing observational research when it suits your ideas but any that contradicts it are flawed”. The way public health measures are shaped is nicely described in the book “merchants of doubt” which ducuments the journey of climate change and tobacco denialism. When we have a substance that is known to promote disease in laboratory and metabolic ward (Tobacco & SFA), we are more senstive to correlations in observational studies even though they may not be always… Read more »

Z.M.
Guest
Z.M.

Richard your entire post just confirms how pitiful the evidence is against saturated fat. The fact that you would even bring up the faulty analogy with tobacco confirms that you have already admitted that the evidence against saturated fat cannot stand on its own.

ScarlettDuchess (@ScarlettDuchess)
Guest

The LCHF (low carb high fat) diet is very popular particularly in Scandinavian countries. I’ve read many comments about the effects of the LCHF diet such as losing weight without exercise, improving blood sugar, reversing type 2 diabetes, optimal blood pressure and lipid panel, more energy, better sleep, no longer suffering hunger pains, IBS, fibromyalgia, joint pain, ADHD, fungus, bleeding gums, depression…

I eat plenty of cholesterol and saturated fat in my diet and have for decades. My cholesterol, HDL, LDL, and triglycerides are excellent. Fungus? Never suffered with it. IBS? IB..what? LOL

Mie
Guest
Mie

Z.M. “Mie, you are one who claimed that saturated fat has no benefits so maybe you should explain what you mean by “having no benefits” or else this argument is going nowhere fast.” No benefits in reducing CHD mortality in general population or in high risk population or in CHD patiens. I though this was obvious? “Why can’t I enjoy the benefits or possible benefits of all types of fats?” Of course you can enjoy different types of fats, if you choose to do so. I, however, fail to see why you’d have to try & justify your own way… Read more »

Z.M.
Guest
Z.M.

Mie: “but since your position obviously isn’t very solid”

Love the arrogance.

I had originally written a response to your points but then thought it was pointless because it is clear we are never going to agree and you misunderstand many of my points which makes this discussion tedious. So I’ll end it here.

Mie
Guest
Mie

Your choice, of course. However, we did agree on quite a few things and the conversation remained civil. At least I considered this civil. Maybe not that much in real life, but for me it was a nice change to partake in an Internet discussion where I didn’t get called names or accused of being on the payroll of Big Pharma / Egg Council / you-name-it. 🙂

Z.M.
Guest
Z.M.

and I’m sure we will clash again sometime in the future 🙂

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