‘It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so…..’
I heard this quote by Mark Twain for the first time at a lecture by an eminent doctor a couple of years ago and I feel that it has particular relevance to the recent report by the National Obesity Forum that eating saturated fat could help cut obesity (heart disease) and type 2 diabetes!
Predictably this has caused a huge reaction from the majority of conventional modern medicine, because it flies directly in the face of the core dietary advice that we have been subjected to in the West since the 1950s; basically saying that saturated fat consumption causes weight gain, type 2 diabetes, heart disease and many more chronic conditions. This is positioned as an indisputable fact. So what is going on?
Well you do have to ask yourself the question as to why, even with a reduction in fat intake (due to dietary advice) over the past 60 years, rates of diabetes and obesity continue to escalate rapidly in the Western world? Why is it that the total cost of diabetes alone to the NHS was nearly £24 billion last year (that’s approximately 20% of the total NHS budget) with 1 in 4 adults in the UK presenting with either diabetes, prediabetes and/or obesity? The advice is clearly not working!
The entire dietary advice that we have been subjected to over the past 50 years is based on the premise that fat makes you fat and that fat intake (particularly saturated fat intake) is connected to raised cholesterol levels and that raised cholesterol is correlated with cardio vascular disease. It has therefore been assumed (purely on a statistical basis) that saturated fat intake must directly cause heart disease.
The truth of the matter is that dietary intake of saturated fats does not directly correlate with heart disease in humans. It is absolutely true that raised levels of saturated fats in the blood are connected to an increased risk of heart disease and diabetes. So what is the main driver of raised levels of saturated fat in the blood? The answer is refined carbohydrates in humans. Excessive amounts of sugar in the blood (from the likes of cakes, pastries, biscuits, sweets etc.) literally hammers your liver and gets converted to saturated fatty acids and cholesterol (not too mention excess weight). It should be also noted that a number of the studies used to assess the impact that saturated fat intake has on levels of saturated fats in the blood have been done on rodents and their results have been assumed to be relevant to humans. We are not rodents; our physiology is similar but different and hence leads to a false understanding of cause and effect.
So in summary excessive intake of refined carbohydrates (not fat) in humans is the single largest contributor to elevated levels of saturated fats in the blood, raised cholesterol and heart disease. Diabetes, by the way, is essentially a carbohydrate intolerance and there is substantial scientific evidence to support the beneficial impact that restricting carbohydrates and high glycaemic load foods has on diabetes.
If the current advice to avoid dietary fat were correct then the Eskimos and Masai (the ones that are not contaminated by the Western World) with up to 90% of their calories coming from fat would be overwhelmed with diabetes and cardiovascular disease. This is not the case.
I really do feel that there has to be some sense of proportionality applied here. It is not about consuming butter in your coffee and eating 10 rashers of bacon for breakfast every day. It is about consuming a range of healthy fats (saturated/polyunsaturated/monounsaturated) and not being fat phobic. Low fat diets are potentially dangerous. Saturated fat makes up to 75-80% of the structural fats in the body and are the primary storage form of energy. Fats are required for proper bone health, protecting the liver from the adverse effects of alcohol and medications, supporting the immune system and enabling the efficient absorption of phytonutrients along with vitamins A,D E and K. All rather important stuff.
A healthy diet should focus on quality of the macronutrients rather than quantity or ratio. We are a hugely adaptable species and there are many examples of different tribes all over the world that thrive at both ends of the macronutrient spectrum (from high fat to high carbohydrate) with very low levels of chronic disease. They key point here is that they are eating natural sources of these macronutrients rather than man made/modified versions.
Yes, there are situations that I see in clinic (via genetic testing) where a client has the genetic potential to present with massively elevated levels of cholesterol. In those situations you do need to consider total saturated fat and carbohydrate intake, as these clients have to work very hard to optimally manage their cholesterol levels. These clients are however an exception to the norm, yet remind us that one size does not fit all in terms of dietary advice.
Maybe this report hails the start of a new paradigm, where fat is hopefully not as feared as it has been and can be celebrated for its health benefits as part of a balanced diet consisting of high quality nutrients?
Finally as we started on a quote I thought we should end on one. ‘All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.’ (Arthur Schopenhauer). I have a feeling we have just started the second stage? Time will tell……