Saturated Fats and Health: Reassessment and Proposal for Food-based Recommendations

The skeptical cardiologist has been pointing out for some time that dietary advice to universally restrict consumption of saturated fats is not scientifically based.

Different foods present different types of saturated fats in different matrices and it is not reasonable to assume the overall effect of these foods can be predicted by measuring only saturated fat content.

In particular, there is not a scintilla of evidence that proves dairy fat which contains significant amounts of saturated fat has any harmful cardiovascular consequences. Thus, attempts to advise Americans to consume low fat or non-fat dairy are horribly misguided.

As I wrote in my letter to the FDA and in a recent critique of the AHA  “the suggestion to restrict or eliminate full-fat dairy from the diet is not a proven strategy for reducing the risk of cardiovascular disease, obesity or diabetes and should be eliminated from current dietary guidelines.”

Yesterday, a “State of the Art Review” (Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Reviewwas published in the Journal of the American College of Cardiology by a group of prominent nutritionists which provides substantial backing for my conclusions.

I encourage a full reading of the article but here is the abstract:

“across the board recommendation to limit dietary saturated fatty acid (SFA) intake has persisted despite mounting evidence to the contrary. Most recent meta-analyses of randomized trials and observational studies found no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality, and instead found protective effects against stroke. Although SFAs increase low-density lipoprotein (LDL)-cholesterol, in most individuals, this is not due to increasing levels of small, dense LDL particles, but rather larger LDL which are much less strongly related to CVD risk. It is also apparent that the health effects of foods cannot be predicted by their content in any nutrient group, without considering the overall macronutrient distribution. Whole-fat dairy, unprocessed meat, eggs and dark chocolate are SFA-rich foods with a complex matrix that are not associated with increased risk of CVD. The totality of available evidence does not support further limiting the intake of such foods.

Hopefully, the Committee discussing the next version of the Dietary Guidelines for Americans are objectively examining the extensive scientific literature that led to these conclusions.

Skeptically Yours,

-ACP

N.B. As I wrote in a previous post on the cardiometabolic health benefits of full fat yogurt

It is important to look at industry influence on research and publications (along with other biases)  but it is hard to find an expert in these areas who hasn’t had some industry ties. Part of these ties develop because researchers who have concluded a particular food is healthy based on their independent review of the literature will be sought after as a speaker at conferences organized by the support groups for that food.

Fortunately, my evaluations remain unsullied by any food industry ties and, like Dr. Astrup,(lead author on the JACC review) I am not an advocate or activist for specific diets and I am not not strongly committed to any specific diet.

6 thoughts on “Saturated Fats and Health: Reassessment and Proposal for Food-based Recommendations”

  1. A personal observation: the return to full fat dairy really increased my satiety which subsequently reduced my cravings for foods that undoubtedly had more sugar. I’m much happier and find myself snacking less. Thanks for the nutrition review.

  2. Congrats! You’re part way there. You will really have arrived when you can categorically assure us all that we will not get fat ourselves by eating these food fats. The idea of fat = fat tempts logic, but reality ain’t so simplistic. And then, it’s ironic that we generally comfort ourselves by chomping down on lots of carbs – which WILL make us fat.

  3. The BIGGER Question is Why does arteries collect plaque? (not veins) That would be the place to start thus address why the endothelial lining is being inflamed/injured. Why does Plaque enter inside and keep developing inside the lining? Plaque is an immune response to injury, it is suppose to be developing a “scab” on the injured lining.

  4. But is the plaque ‘entering’ the lining, or are new endothelial cells being layered over & on top of that plaque. ?
    Paul, your inference is correct. Veins are not subject to the same pressure and other insults, so they are hardly ever known to acquire ‘plaque’ – in the manner of ‘arteries’.

  5. I find the more I read about the nuance of optimizing nutrition, the more confused I become. I try to relate things to chemistry/bio chemistry in the sense that there are no good/bad macros, but just complex molecules that are broken down into energy substrate or protein building blocks. I think where the trouble ensues is the energy abundance component (which can be achieved from overeating any macro group). Besides trans fats which are construed as universally inflammatory, fats are good sources of the building blocks for hormones and polypeptides. I think its very difficult in general to isolate specific food groups and foods impact on health and longevity because its virtually impossible to have a controlled long term diet study (in a lab) for an extended period of time(years) with humans (not mice). The other component to this confusion forces me to revert back to basics which you espouse and that is healthy weight, regular exercise, sleep, drinking in moderation, limiting stress and enjoying relationships are all part of the equation of good health. Then there is the other obvious component of nutrition and with all things in science the more I learn, the less I realize I know.

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