Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
23 Jul

The Definitive Guide to Saturated Fat

It’s probably the one thing that prevents people from fully buying into the Primal Blueprint. Almost anyone can agree with the basic tenets – eating more vegetables, choosing only clean, organic meats, and getting plenty of sleep and exercise is fairly acceptable to the mainstream notion of good nutrition. The concept of Grok and a lifestyle based on evolutionary biology can be a harder sell, but anyone who’s familiar with (and accepts) the basics of human evolution tends to agree (whether they follow through and adopt the lifestyle is another question), at least intellectually. But saturated fat? People have this weird conditioned response to the very phrase.

“But what about all that saturated fat? Aren’t you worried about clogging up your arteries?”

In fact, “saturated fat” isn’t just that; it’s often “artery-clogging saturated fat.” Hell, a Google search for that exact phrase in quotations produces 4,490 entries (soon to be 4,491, I suppose). Most doctors toe the company line and roundly condemn it, while the media generally follows suit. The public, unsurprisingly, laps it up from birth. The result is a deeply ingrained systemic assumption that saturated fat is evil, bad, dangerous, and sinful, a preconceived notion that precludes any meaningful dialogue from taking place. Everyone “knows” that saturated fat clogs your arteries – that’s treated as a given – and attempting to even question that assumption gets you lumped in the crazy category. After all, if you start from such a “fundamentally incorrect position,” how can the rest of your argument be trusted? Thus, talk of the superior cardiovascular health of the Tokelau (with their 50% dietary saturated fat intake) or the Masai (with their diet of meat, blood, and milk) or the Inuit (with their ancestral diet of high-blubber animals) is all disregarded or ignored. If they even deign to listen to the facts, they’ll acknowledge the existence of healthy populations eating tons of saturated fat while muttering something about “genetic adaptation” or “statistical outliers.” It’s all hogwash, and it’s infuriating, especially when there’s so much literature refuting the saturated fat hypothesis. If you’re interested in more information on these three oft-cited high-saturated fat groups, check out Stephan’s entries on the Tokelau, the Masai, and the Inuit.

It all started, of course, with the infamous Ancel Keys and his Seven Countries Study, which tracked the fat consumption and heart disease levels of various nations. It was named for the seven countries that saw an increase in heart disease cases correspond with increased fat consumption, but it should have been named the Twenty Two Countries Study for all the data he omitted. Data, I should mention, that demolished his hypothesis of fat intake causing heart disease. The original paper noting Keys’ omissions was largely ignored and is tough to track down, but Peter over at Hyperlipid had access to it and shows the original graph with all the nation data included (with the Masai, Inuit, and Tokelau thrown in for fun represented by the red dots).

Try drawing a straight line through those data points… I dare you! As you can see, there is a faint, weak correlation between fat intake and heart disease, but it’s just that: a correlation. It shouldn’t confirm anything except the need to run controlled experiments to directly measure the effects of dietary fat. Unfortunately, that correlation was enough to get Keys the front cover of Time and widespread acclaim as the father of dietary science. His hypothesis gained traction in the scientific community and mainstream CW, a position it has never really relinquished. Subsequent controlled experiments to measure the effects of saturated fat have been either inconclusive, poorly designed, or completely unsupportive of the saturated fat-is-evil hypothesis, but because the starting point assumes it to be true, those inconclusive or unsupportive results become aberrations while the poorly designed studies become canon. Meanwhile, Keys’ peer, British scientist John Yudkin, was finding even more compelling connections between dietary sugar and heart disease, but his ideas gained no traction and garnered no significant follow up experimental studies. Keys got the cover of Time and heaps of public adulation; Yudkin was relegated to publishing now-out-of-print books, writing letters to scientific journals (PDF) that were only ignored, and languishing in relative obscurity. Americans, as you can guess, got the real shaft. I suspect I’m getting a little off track here, so I’ll just point people toward Good Calories, Bad Calories for a full discussion of the Yudkin-Keys issue.

For a quick summary of the Ancel Keys debacle to send to friends and family worried about your saturated fat intake (who might not be interested in reading a blog post), check out this quick clip from Fat Head.

What is Saturated Fat, Exactly?

Saturated fatty acids (SFAs) are referred to as saturated because all available carbon bonds are tied up with a hydrogen atom. That is, there are no openings for rancidity or spoilage, whereas a polyunsaturated fatty acid containing two or more pairs of double bonds without hydrogen atoms occupying the open space is wide open for oxidation. SFAs are shelf-stable, resistant to heat damage, and essential to many bodily functions. Roughly half of our cell membrane structure is composed of saturated fat, and saturated animal fats, like butter or fatty organ meats, contain huge amounts of essential fat-soluble vitamins (K2, A, D, among others). (Sure, you could just take them in capsule or liquid form, but the very fact that these (universally praised) vitamins naturally occur in evil saturated fat indicates that maybe, just maybe it’s not so evil after all. Researchers were particularly dumbfounded at one study (PDF) indicating high-saturated-fat fermented cheeses containing large amounts of Vitamin K2 actually reduced cardiovascular mortality, but they soon came to their senses and recommended opting for supplements rather than real food. Ridiculous.)

Saturated fat is also a fantastic source of energy, at least if you trust your body to make the right decision – otherwise, why else would we store excess carbohydrates as saturated body fat? In fact, when we burn body fat for energy, either through exercise or through dieting, we are quite literally consuming huge amounts of saturated (and monounsaturated) fat. Body fat is energy to be used for later; dietary fat is energy to be used immediately. Whether you’re burning through your stores of adipose tissue or downing flagons of warm ghee, all that fat goes through the same processes in your body to be converted to energy. Burn your ass flab, take a bite of fatty rib-eye – it doesn’t matter. Your body treats that fat the same way. As Richard and Tom have said before, losing weight is like eating pure lard, which has nearly the same fatty acid composition as human adipose tissue. To vilify saturated fat is to assume that, over the span of our evolution, our bodies have somehow developed a predilection for a deleterious energy source that contributes to cardiovascular disease. That’s absolutely preposterous, unless Darwin and company somehow got it all wrong with the whole natural selection thing. Somehow, I’m leaning toward trusting the millions of years old case study known as evolution.

Where Do They Get Off, Anyway?

Since Keys has been thoroughly discredited (not if you ask most people with any real say in the matter) and there are plenty of examples of groups eating a high saturated fat diet and retaining optimum cardiovascular health (“Those are just outliers!”), how does the outcry against saturated fat continue unabated? Well, it all starts with cholesterol, yet another vilified substance that our bodies naturally produce because, well, it’s completely essential to proper bodily function (though if you listen to the experts, our bodies are suicidal entities who can’t be trusted to do the right thing). Elevated cholesterol has long been fingered as a player in cardiovascular disease, and saturated fat has been shown to increase cholesterol levels, so saturated fat is therefore to be avoided. Sounds relatively sound. So high total cholesterol levels are bad, right? Not so fast.

As I detailed in my last big post on cholesterol, total cholesterol doesn’t tell the entire story, and it doesn’t even necessarily indicate risk for cardiovascular disease. Just take a look at the graph plotting global total cholesterol versus cardiovascular disease. There’s absolutely no positive correlation, and there may even be a negative correlation. Far more likely is that there’s no connection at all.

Nowadays, most “experts” will agree that total cholesterol isn’t everything; they instead move the goalposts and focus on LDL, or “bad cholesterol,” which is increased by eating saturated fat. Eating more saturated fat does seem to increase serum LDL (“bad” cholesterol) in certain cases, but it also increases HDL (“good” cholesterol). Okay, so saturated fat increases LDL, which is “bad.” So global levels of saturated fat intake should predict cardiovascular disease, right? It doesn’t seem to pan out that way. Do you see a correlation? I don’t.

Oh, but saturated fat increases triglycerides, they say, which – even I agree – are a good marker for poor heart health. Except that it doesn’t. Carbohydrate intake increases triglycerides, not saturated fat intake. This is either a blatant lie, or it’s willful ignorance. Maybe even both. Either way, the end result is a continuation of the saturated fat vilification. The average person will go to cnn.com, read the headline, and skip ahead to the meat: “…eating lots of saturated fat can all add up to higher triglyceride levels.”

As far as heart disease goes, I still have yet to hear a workable process by which saturated fat contributes to it. It increases LDL, but the LDL it increases is large, fluffy, and almost impossible to oxidize. The layman’s notion of saturated fat literally clogging up the arteries like grease in a drain isn’t taken seriously by researchers anymore (who know it’s really all about inflammation and oxidized LDL), but it’s still the most prevalent explanation for why saturated fat is so bad. We now know that the HDL/triglyceride ratio is far more predictive of cardiovascular events than LDL, but still LDL gets all the attention. The “alternative hypothesis” (which is really the one that makes the most sense) focuses more on oxidized polyunsaturated fats and imbalanced Omega-6/Omega-3 ratios rather than saturated fat intake, which (as is pretty obvious by now) doesn’t matter one way or the other. The observational data doesn’t add up, the actual physiological process can’t be explained, and the body seems to prefer saturated fat. I have to ask… if we know that arteries don’t “clog up” from concentrated fatty acids in the blood like bad plumbing and that SFAs aren’t prone to oxidation, just what is the issue with saturated fat and heart health?

They’ve also tried connecting saturated fat intake with various forms of cancer. Breast, colon, pancreatic – you name the cancer, researchers have probably warned against saturated fat intake as a risk factor for it. But every study that suggests a link between saturated fat and cancer is purely observational. These aren’t controlled studies, folks – these are often studies in which dietary information is gleaned from questionnaires asking people about their dietary habits for the last five years. The subjects are often elderly or middle-aged, people busy with life and all its stresses… and they’re expected to remember their exact dietary habits for the past five years? Give me a break. And even if every one of the subjects were to recall their eating with perfect accuracy, what does a correlation with pick-your-cancer really tell us? It tells us that the Standard American Diet, with its massive amounts of grains, sugar, starches, margarines, vegetable oils, and yes, some red meat and artery-clogging saturated fat, is bad for us. The researchers may try to seize on a single aspect of the diet (usually saturated fat), but that only tells us that saturated fat has a bad reputation. Is it deserved? We certainly can’t draw any conclusions from an observational study confounded by dozens of other variables. And yet still the crazy headlines jump out from all angles: “Saturated Fat Linked To Pancreatic Cancer!”; “Colon Cancer And Red Meat: Is Your Burger Killing You?” I think I did a decent job disassembling the latest red meat (read: saturated fat) scare study, as did Dr. Eades.

What About Cordain’s Stance on Saturated Fat?

Although he’s softened his stance a bit recently, Loren Cordain still maintains that saturated fat never formed a significant portion of the Paleolithic diet. He even suggests that because it increases LDL, saturated fat does play some role in cardiovascular disease. While we’re all in debt for Dr. Cordain’s impressive work cataloguing the possible diet of Grok and highlighting the dangers of grains, legumes, and sugars, I believe it’s becoming increasingly clear that he’s got it wrong with his (albeit tempered as of late) condemnation of saturated fat.

To begin with, man has a taste for fat. It’s delicious, and that’s no mistake. Given the choice between a lean chicken breast and a fatty, crispy thigh, most people instinctively go for the thigh. Social anti-fat conditioning might direct a few of us toward the dry breast, but fatty cuts just taste better. I think even Cordain would agree that Grok would opt for the fatty cuts first; where we differ is in our opinion of Grok’s access to such fatty cuts. Cordain believes the fatty acid composition of ancient game was mostly monounsaturated, while I doubt it was so clear cut. According to the WAPF’s Mary Enig and Sally Fallon, the fatty acid composition of wild game available to native Americans varied, with the most prized sources of fat (kidneys) being primarily saturated. In fact, Vilhjalmur Stefansson, hallowed purveyor of pemmican and admirer of the high-fat Inuit diet, spent considerable time with the northern native Americans and noted that they seemed to “hunt animals selectively.” They would specifically pass on the tender calves and go for the older caribou, the ones with huge slabs of back fat that could be rendered and stored. This caribou fat was about 50% saturated. These are more modern animals, but they’re still wild, and I don’t see how the large animals being consumed by Grok would have inexplicably been low in saturated fat.

Cordain himself allows that most (73%) pre-agrarian hunter-gatherers got more than 50% of their calories from animal foods (with some going as high as 70%), and he figures that wild African ruminant fatty acid composition (a basic model for Grok’s game) was similar to that of pasture-raised cattle. I eat a lot of 100% grass-fed steak, and I will tell you: there is a fair amount of fat on certain cuts, including organs. It’s leaner than grain-fed, but not by much. Plus, when you consider that hunter-gatherers (Grok and modern alike) use the entire animal, especially the fatty organs, it becomes clear that saturated fat was consumed in relatively large amounts by many groups of paleo-era humans. Maybe not all of them, but it certainly wasn’t unheard of.

The justification for the anti-saturated fat campaign that has raged on for half a century is largely baseless. Even if saturated fat does increase (large, fluffy) LDL, it increases protective HDL right along with it, and cardiovascular mortality has never been explicitly demonstrated to increase with saturated fat intake. Several studies have been attempted and – though their results were inconclusive – supporters repeatedly cite them as evidence for the connection. The Finnish Mental Hospital study, which the saturated fat critics tend to hang their hats on, has been discredited for its poor control. Most analysis of the Lyon Diet Heart study focuses on the low levels of saturated fat, while the real benefits came from an improved Omega-6/Omega-3 ratio. If you’re interested in more breakdowns of the saturated fat studies, just visit Whole Health Source (or Hyperlipid, or Free the Animal, or any of the many Primal friendly blogs on the interwebs). One of the most important things we can do is band together to undermine the dangerous, counterproductive CW. We may have truth and science on our side, but – as the past hundred years of nutrition research have shown – it isn’t always enough.

I’d love to hear you thoughts, so hit me up with a comment. As a side note, due to the length of this post I almost made it a two-parter. What do you think? Are you okay with the length or would you have preferred receiving this article divided up into more manageable sizes?

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You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. The whole ‘saturated fat is bad’ thing was based on the China Study…which was not accurate.

    Jeff wrote on November 10th, 2010
  2. Where did Grok get his animal protein and saturated fats. Even cheetas fail 9 times out of ten attacks. Early hominids with pointed sticks and rocks could not be successful hunters. Domesticating hunting dogs and the invention of the bow and arrow are very recent as was the horse. Seems likely that Grok scavenged long bones and skulls for the marrow and brains – much sat. fat and a good bit of protein.
    What think ye?
    Regards to all – Oupa Gofar

    oupa gofar wrote on November 30th, 2010
  3. I remain somewhat doubtful of the idea of saturated fats being a good thing. I recall asking a chemist about fats once and he explained the molecular structures of each fat; double bonds, single bonds, kinks, etc. His explanation lay in the fact that the molecular structure of the fat was what caused the fat to clog arteries.

    For instance both trans fats and saturated fats are essentially straight, allowing them to lay flat within the arteries. Monounsaturated fat, polyunsaturated fat and oleic acid, however, are far from straight, this causes difficulty in allowing them to line the arteries.

    I do see the logic in eating saturated fat, pemmican is essentially pulverized meat with animal fat and it was a staple of the aboriginal diet. You can look at a history text and see how the european explorers described the aboriginal peoples of North America, with envy and admiration for their physical prowess.

    Perhaps the chemist was wrong, I would simply rather not take my chances.

    Ilishia wrote on December 5th, 2010
    • Well the “clogging” is done by cholesterol (so the theory goes), not fat itself. While the blood contains triglycerides, it is a more complex process than just being transferred from the food you eat directly to your blood.

      Dave wrote on December 6th, 2010
      • I agree that fat you directly eat does not..kinda, but I do not agree that cholesterol clogs up your arteries. Cholesterol are not the bad guys, they are around your heart and your brain the most because they are there to constantly repair cells and they help keep your memory in check.

        The theory I heard: It’s the “small” dense LDL(protein, not cholesterol) that cause problems. Both LDL and HDL “carry” cholesterol. LDL is for repairing cells ect and the HDL recycles LDL when it becomes damaged. Usually LDL are long, but when LDL get damaged, they start breaking away and becoming smaller and denser. They get small enough to enter though the arterial wall but not though the endothelial wall (inner most wall that meets with the blood). This is were the “small” LDL become stuck and therefor fully oxidizes and becomes “foam” cells since there is no flow of blood for them to move. When the LDL oxidizes, it becomes sticky, making things attach to them like blood cells and other proteins ect. Eventually this debri pile becomes inflamed and large enough to bust through the endothelial wall, causing a clot and thus a heart attack. Of course this is simplified and there are many other heart issues as well like valve failure ect.

        They say what causes the higher rate of oxidization is the use of polyunsaturated fats since they oxidize pretty rapidly compared to saturated fats(which your heart favors). If you are eating hydrogenated or partially-hydrogenated oils, you are eating HIGHLY oxidized Polyunsaturated fats which I’m sure will damage the LDL almost just as soon as they are created.

        spazchicken wrote on December 7th, 2010
        • I thought that cholesterol causing a problem might be when combined with a diet including sugar and grains. The sugar causes inflammation and damages the blood vessels so then the cholesterol is used to patch up the damage. So without the damage occurring, the LDL could go about its business and fat would just be used for fuel.

          Jen Too wrote on January 22nd, 2011
  4. Someone may have mentioned this point, but I think it’s worth mentioning again:

    When something blatantly untrue becomes common knowledge, follow the money trail.

    Somebody stood to gain by reducing the consumption of saturated fats in the North American diet. How about oilseed growers? Fish producers? Or the chicken lobby?

    These things don’t happen by accident. When otherwise intelligent persons (such as M.D.s) spout this kind of nonsense, somebody is driving the promotion of said nonsense, and profiting obscenely from it – though frequently not the M.D.s, the media or other proponents of the bad science.

    Just food for thought.

    Becky wrote on January 15th, 2011
    • Maybe the money trail leads to the sugar industry (heck it was a main cause of the Civil War, more than slavery) and pharmaceutical companies and the health care industry… Plus, even the AHA might not really want the problem to be solved by preventative medicince and everybody eating a truly healthy diet because then what place would there be for them?

      Jen Too wrote on January 22nd, 2011
      • Exactly. The pharmaceutical industry could not sell all their drugs to treat symptoms if the illnesses were to go away.

        And the low fat thing is win-win for the sugar industry. When companies make low-fat snacks, they have to replace the fat with something to make their product taste good. So often that is sugar.

        Regarding the AHA, I am sorry to say I agree with you. Them and the ADA, unfortunately. Cure such problems with diet, and neither have a reason to exist.

        Cornelius wrote on January 22nd, 2011
  5. I double-checked the numbers on caribou fat composition from Dr. Cordain’s “Origins and evolution of the Western diet: health implications for the 21st century”.

    They don’t add up. The claims from the section “Fatty domestic meats” are trivially false, even according to his own data!

    http://www.gnolls.org/715/when-the-conclusions-dont-match-the-data-even-loren-cordain-whiffs-it-sometimes-because-saturated-fat-is-most-definitely-paleo/

    J. Stanton wrote on January 19th, 2011
    • Saturated fats, when eaten on a low carb diet have no effect on arterial health or blood sugar and in fact, the lower the carb intake and the higher the saturated fat intake, the less saturated fat, blood sugar, and insulin in the bloodstream.

      amada service wrote on January 31st, 2011
  6. @amada: Yup. It makes me sad when I see people ordering muffins and sugary lattes with fat-free milk (or worse, soy milk) for lunch, thinking they are eating “healthy” by not eating meat and by eating low-fat. One such person once made a comment to me about how he didn’t particularly like low fat, but he was doing it for his health. Since he had started the conversation, I replied “Fat is good for you,” hoping he would ask for clarification, but he only looked at me for a startled instant as though I were criminally insane, and then quickly lowered his eyes and slowly edged away, apparently hoping he would not provoke me into foaming at the mouth and brandishing a weapon. :)

    However, the fact is, get rid of the sugar and other carbs, eat plenty of saturated fat, and not only is it a more “heart-healthy” way of eating, you will actually lose body fat, quickly and easily. In fact, if you have trouble losing body fat initially on a low carb diet, the solution is to eat MORE fat, not less.

    What so many people “know” to be true these days is actually bass-ackwards, and so many health problems that plague people would be be virtually nonexistent if they only knew the truth. But then, I guess the truth does not sell drugs and medical treatments, or get people to pay way too much for medical insurance.

    Cornelius wrote on February 3rd, 2011
  7. Hi there Mark,

    I just read this article (first time on this site); I appreciate your scientific approach. I have a question for you, and I would be greatly obliged for your opinion:

    Specifically, (for just under 2 months now) I have been enjoying a very low-carb, high protein, high fat, high raw vegetable diet. Feels great. But (and this concerns my direct question) I have intentionally been having one high glycemic/high protein meal within 45 minutes after my intense exerise (typically, a bowl of lightly sweetened whole grain cereal and 40 grams of whey). So what do you think of this (fairly common, I think) notion that eating sugar and protein together shortly after exercise is “good” (and that the insulin spike it ostensibly causes, is likewise “good”)? I have been hearing this for as long as I have been exercising from just about every source, and I think there has even been some research showing that it increases strength gains from resistance exercise. But, I would hate to end up doing more harm than good to my body with this custom through the inflammatory effects of the carbs. As a gratuitous aside, I crave carbs soon after hard exercise, though I have no cravings for them at other times (that is, after having eschewed them for a few weeks). What’s your learned opinion?

    Thanks,
    Eric

    Eric wrote on February 17th, 2011
  8. Eric, you might want to read this entry for Mark’s thoughts about post workout eating:

    http://www.marksdailyapple.com/post-workout-fasting/

    As for the cravings, you might want to try putting some Branched Chain Amino Acids (BCAA) into your water bottle for your workout. That should curb the cravings.

    Dave wrote on February 17th, 2011
  9. Since this article was written, more and more people around the paleosphere are getting on board with “safe” starches, specifically white rice and potatoes. If you want to eat carbs and are trying to change your body composition, eat ’em, but ditch the whole grain shite and stick to gluten-free, lectin-free, fructose free carbs like white rice or potatoes.

    Eric R wrote on February 17th, 2011
  10. I find many parts of your entry, and many of the comments, troubling. I’m not sure what your scientific background is, but I know there is a great deal of misunderstanding regarding interpretation of various study designs that can lead to confusion. Your attack of all observational studies is shortsighted. Well-designed and carefully analyzed observational studies are critical to the biomedical literature. As some have mentioned above, it is unethical or impractical to run a randomized clinical trial in most cases of lifestyle/dietary change. And a well-executed observational study (especially prospective cohort studies) can closely mimic an RCT, yielding useful and important results. Confounders are adjusted for in either design or analysis stage and, in many cases, the effect can be considered causal. Please, do not disregard an entire segment of scientific inquiry.

    I’m also concerned about the conspiracy theories about mainstream media and science. Why would someone benefit from advising against saturated fat consumption? The notion that scientists are deliberately propagating mis-information is both ridiculous and offensive.

    You also seem to be disregarding all of nutritional epidemiology. Are you familiar with the various methods of nutritional assessment? Long-term diet can be measured validly. Are there drawbacks? Of course. But food frequency questionnaires offer us a method of getting real data (individual-level data) about diet and disease. Sure you can make recommendations about diet off the cuff or based on aggregated data from historical populations, but I’d much prefer to make my dietary decisions based on individual-level data, acquired from a well-designed and analyzed study.

    Regarding ecological studies, they can be a useful first step in research, but they must be interpreted cautiously. Since you don’t have individual-level data, you cannot be sure that the people who are driving up prevalence of exposure in a population (say eating the most sat. fat) are the ones in the population who are driving up the prevalence of outcome (say CVD). It’s also not possible to adjust for confounding in these types of studies.

    Obviously there are better/worse doctors and scientists out there, and some may be misinformed. But I think overall, you are much better off putting confidence in them over someone with simply an interest in diet-disease relationships who can say whatever they want with no evidence.

    M wrote on February 26th, 2011
    • I don’t know about these “studies” but I know that my own health is proof for myself that many things he states is true. I cured myself of so many diseases and a couple that were “Incurable” simply by natural methods of healing and a change of diet. I got sick when I followed the mainstream’s recommendations. I personally don’t need “scientific” evidence when personal evidence is much more important(IMO).

      Colleen wrote on February 26th, 2011
  11. Colleen,

    I appreciate your comments, but:
    1. In terms of curing yourself of various health issues, how do you know you would not have improved based on another diet? Or through other lifestyle changes? The problem with a study with an n of 1 is that you can never know (except in rare circumstances) what would have happened under an alternate exposure.
    2. What are you calling “mainstream” diet advice? The current advice is NOT to avoid all fat, but to choose healthy fats (e.g., nuts, olive oil). And of course to choose natural/organic/unprocessed/whole foods. If you mean mainstream in terms of the USDA recommendations, then I somewhat agree with you. Since their primary mission is promotion of US agriculture rather than promotion of health, I’m somewhat skeptical of advice they give. While they make some good points, much of their guidelines are misleading and potentially harmful. For example, their hesitation to label any food as “bad” (to avoid upsetting food producers) and their reluctance to propose elimination of all processed foods and grains. But advice from nutrition researchers whose goal is to learn about diet-disease relationships and to enhance public health….that I think is worth paying attention to. I am all for natural healing and I agree that current medicine places way too much emphasis on prescriptions and procedures that may be unnecessary. But, please don’t take that and interpret it to mean that ALL doctors and scientists are out to over-treat you and get your money. For the vast majority, your health is their goal.

    With epidemiological evidence, results represent an average effect. So yes, there will be people to whom the results don’t apply. But in terms of public health recommendations, these studies are what allow us to create guidelines for a large group of people that will help the majority of those people. Of course, you can feel free to experiment and find for yourself what diet works best for you. It is worth pointing out, though, that diet-related impacts on chronic disease often do not become apparent until many years of cumulative exposure. So while you may feel great short-term, you may be increasing your risk of various chronic illnesses or experiencing sub-clinical symptoms that may eventually manifest.

    M wrote on February 26th, 2011
  12. @M:

    I have all the evidence I need. Every other way of eating I’ve EVER tried has made me sicker by every known measure. On this one, all my symptoms (of LONG TERM ILLNESSES – CAUSED BY EATING THE ‘CONVENTIONAL’ WAY) disappeared concurrently with my starting to eat this way. That’s not coincidental.

    You should read Gary Taubes’ “Good Calories, Bad Calories” if you’re so hot for good research. He takes everything you thought you knew and debunks it with scientific evidence. Once you’ve read that, if you still doubt the veracity of Mark’s (and my, and the dozens and hundreds of others who’ve found success eating this way) claims, more power to you – but I doubt your doubt will survive the evidence.

    Griff wrote on February 26th, 2011
  13. Hello, M:
    Thank you for your measured comment. i appreciate your position, but unfortunately, I disagree with several points you make, which are at the heart of your argument.

    Firstly, peer-reviewed scientific journals have published information that has subsequently been shown to be wrong.

    Secondly, even extremely well-designed studies can produce data which can be misinterpreted. For example, our cardiologist commenter, above, pointed out that dietary fats have been blamed for CVD, but inflammation is the real cause.

    Thirdly, North American peer-reviewed journals often *do* have an agenda and those in the background who stand to gain by certain outcomes receiving favorable positions in the journals, and other outcomes being omitted.

    Fourthly, regulatory agencies, academic communities, and journals have been strongly influenced by those who stand to profit enormously from beneficial decisions.

    I think you are sincere in your beliefs, but your comments would tend to indicate that you have some degree of naivete regarding the assumed scientific purity of published research studies.

    In my lifetime (50 years) I have seen many contradictory theories promoted and have received much contradictory advice. It may have been the best those U.S. doctors knew – or were willing to know – but results change as knowledge expands.

    I have been reading medical and other journals from around the world for the last decade, and my eyes have been opened to the vast wealth of information that has been published. North American journals do not necessarily represent the epitome of modern scientific research, and in fact, often simply parrot the sales pitches of those companies that stand to benefit from the free publicity and the perceived credibility of these “scientific” studies.

    Becky wrote on February 26th, 2011
  14. Griff, I think we probably agree with one another more than it may seem. I’m not saying anything either way regarding Mark’s claims. I’m simply pointing out that it is extremely important to consider the source of your information. A friend/colleague, etc. may sound like a great source of information, but they don’t have all the facts. Diet’s impact on health is extremely complicated…timing and composition of meals play a role, as does individual biochemistry, metabolism, and physiology. Not to mention physical activity. I’m guessing many people who make a substantial change to their eating habits also improve their commitment to being physically active (or feel more energetic and naturally become more active). In any case, an understanding of WHY certain foods may be helpful vs. harmful is kind of important.

    If you’ve found success with your current way of eating, great. Really, I think everyone should experiment a little and see what works for him/her. I know I do. But again, in terms of broad recommendations, it is crucial to do large, population-based studies to get a sense of diet-disease relationships. And broad recommendations are extremely important. Yes, you’d be well off with the very simplistic advice of “eat real food,” but population based studies provide us with a wealth of critical information.

    Again, I’m not sure exactly what you are considering “conventional” or “mainstream” dietary advice. Have you looked at something like this? http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/ It’s a little different from the old “eat low fat even if it’s processed crap” mantra that most people may be familiar with.

    That book you mention looks interesting. Although per the synopsis on Amazon, it seems to agree entirely with what I’m saying. That the real scientists know that much of the old dietary advice was based on a complete lack of evidence. It seems there is a severe lack of communication between public health researchers and mainstream media. This problem is compounded by the fact that the media tends to misrepresent and oversimplify everything and that government offices such as the USDA may not be able to offer the best advice due to conflicts of interest.

    I do hope that in general you are not against research and science. I guess I take it for granted that people appreciate how important it is. Given the nature of science, there are studies that eventually are disputed, but collectively they’ve allowed us to dramatically increase our knowledge of health and to extend the average lifespan.

    M wrote on February 27th, 2011
    • M,

      If you have time, I would be interested to hear your thoughts after you inspect this site fairly thoroughly:

      http://www.westonaprice.org/know-your-fats/526-skinny-on-fats.html#chol

      Cornelius wrote on March 3rd, 2011
      • Thanks, I will check that link out when I get a chance. I know I’ve looked at it in the past, but I’d like to look at it again. I’ve also been meaning to read “Know Your Fats” by Mary Enig. Have you seen that?

        But again, just to clarify, I haven’t meant to say anything specifically about diet either way. I’m only commenting on sources of dietary information, how a good dose of healthy skepticism is important, and that harmful dietary consequences can be insidious, not showing up for years.

        That being said, I do think that most experts (people who dedicate their lives to studying this) will agree that while fat in general is very healthy (and often better than carbs), saturated fat is only marginally better than trans fat and something to be avoided, given the evidence we have currently.

        M wrote on March 7th, 2011
  15. I think you go too far by actively aiming for saturated fat intake.

    See: http://www.mprize.org/blogs/archives/2010/01/hi_dr_feinman_a.html for a good discussion.

    Excerpt:

    What I think we’re seeing is exactly the divergence within these populations that you know: that carb is really rather bad for overweight, insulin-sensitive people, such that replacing it even with SFA is relatively harmless — whereas for lean, insulin-sensitive people, SFA (and dietary cholesterol, its fellow-traveller in omnivorous diets) is likely more *relatively* harmful, because carb is less able to derange the metabolism. We have to remember that any time we look at these studies and see only modest or borderline-significant effects: 66% of the US population is overweight, and half of that majority is obeese; Europe is somewhat better-off, at 49.8% and 13.3% in men and 36.0 & 13.5% in women per MONICA. So the deleterious effects of any nutrient with a differential effect on low-BMI, insulin-sensitive people will tend to be blunted by the much larger number of people for whom such effects are blunted by their “larger” problem.

    It also means that the deleterious effects of a rise in SFA intake are at least temporarily outweighed if it is is part of a dietary shift into a lower-carb diet when it is successfully used for weight loss (as opposed to just being a person’s self-selected default diet, which of course is what’s going on in teh studies in Jakobsen and in the Swedish, Greek, and US Nurses low-carb/high-protein studies). But it’s reasonably clear that if you’re insulin-sensitive — which, interestingly, is what one is likely to become after losing weight on a successful low-carb weight-loss diet! — the effects of SFA become more *relatively* harmful as teh deleterious effects of carb recede.

    Moreover, I think we have a fair amount of evidence for a specific (albeit widely exaggerated) benefit of omega-3 fatty acid intake, which unfortunately the Jakobsen meta-analysis couldn’t evaluate. I think it’s reasonable to expect that a discrimination here would have further emphasized the benefits of these fats.

    MikeL wrote on February 28th, 2011
    • M, if you will get Gary Taubes’ book “Good Calories, Bad Calories,” you will see all the peer-reviewed research you will ever need to put the lie to your current beliefs about saturated fat. Taubes spent seven years searching for evidence supporting the lipid and cholesterol hypotheses, and published his book to show that there isn’t any. There are ZERO studies showing any correlation between saturated fat and heart disease. Most doctors are not aware of this fact because they are indoctrinated by the common wisdom just like everyone else in this country.

      Go read the research. That’s where it is. Taubes did you the favor of compiling it all in one easy-to-find place.

      Griff wrote on March 7th, 2011
      • “you will see all the peer-reviewed research you will ever need to put the lie to your current beliefs about saturated fat.”

        With all respect, that book was written 4 years ago, and scientific research continues. It seems prudent to follow the research as it stands, but keep an open mind and continue to follow new studies and discoveries.

        lrc wrote on May 4th, 2011
  16. Saturated fat is indeed not the bad guy it’s been portrayed to be.

    France is a fine example, from 1961-2000 their saturated fatty acid and total fatty acid intake went up, and their CHD risk declined.

    They eat approximately 4.5x more butter than the U.S., while also eating almost 80% less sugar.

    Jay wrote on March 9th, 2011

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