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It’s time to stop vilifying saturated fat, heart-disease researcher says

Saturated fat is found primarily in fatty meats and whole-milk dairy products.

Saturated fat is found primarily in fatty meats and whole-milk dairy products.

Adopting a diet low in saturated fat will not reduce your risk of heart disease or help you live longer, according to a provocative commentary published Thursday in the BMJ journal Open Heart.

That’s because saturated fat is not the dietary villain we have been led to believe, writes James DiNicolantonio, a cardiovascular research scientist at Saint Luke’s Mid American Heart Institute in Kansas City, Mo.

In fact, he says, our demonization of saturated fats has helped fuel the obesity and diabetes epidemic of recent decades.

DiNicolantonio is not the only heart-disease expert who is trying to get people to re-evaluate saturated fat. Last October, for example, British cardiologist Dr. Aseem Malhotra wrote a similar commentary for BMJ entitled “Saturated fat is not the major issue.”

Slowly, ever so slowly, it seems to be becoming more acceptable to question the long-standing advice that a low-fat diet is your best chance for a lean and healthy body.

Saturated fat, which is found primarily in fatty meats and whole-milk dairy products, should not, by the way, be confused with trans fats, which are artificially created and found in many fast foods and processed bakery goods. Trans fats (also called partially hydrogenated vegetable oils) are widely recognized as being a risk factor for heart disease.

Began in Minnesota

Our journey down “the wrong ‘dietary-road’” began here in Minnesota, says DiNicolantonio. In the 1950s, University of Minnesota physiology professor and obesity researcher Ancel Keys made national news when he published research involving data from six countries that he said showed a correlation between diets high in saturated fat and an increased risk of death from heart disease.

Keys’ research took on an added urgency when President Eisenhower had a heart attack in the fall of 1955. Suddenly, everybody wanted to know what they could do to keep their own heart healthy. Keys’ low-fat diet seemed a good, scientifically based idea.

But Keys “excluded data from 16 countries that did not fit his hypothesis,” writes DiNicolantonio. “Indeed, data were available at the time from 22 countries, and when all countries were looked at, the association was greatly diminished. Furthermore, no association existed between dietary fat and mortality from all causes of death.”

Despite these discrepancies, saturated fat’s “bad” reputation took hold — and quickly became permanent dietary dogma.  When the U.S. government’s first Dietary Goals for Americans (later called the Dietary Guidelines for Americans) was released in 1977, it urged people to consume more carbohydrates and less saturated fat.

“This stemmed from the belief that since saturated fats increase total cholesterol (a flawed theory to begin with) they must increase the risk of heart disease,” writes DiNicolantonio. “Moreover, it was believed that since fat is the most ‘calorie-dense’ of the macro-nutrients, a reduction in its consumption would lead to a reduction in calories and a subsequent decrease in the incidence of obesity, as well as diabetes and the metabolic syndrome.”

But that didn’t happen. Instead, it appears to have made things worse.

‘An imprecise notion’

As DiNicolantonio details in his commentary, research suggests that the current obesity and diabetes epidemics are being fueled by the overconsumption of refined carbohydrates, not saturated fat.

In fact, several recent randomized controlled clinical trials have suggested that a low-carb diet is better for weight loss than a low-fat one.

The idea that saturated fats have a harmful effect on cholesterol is also “an imprecise notion,” writes DiNicolantonio. That’s because, he says, there are two different types of low-density lipoprotein (LDL), the cholesterol that’s labelled “bad” because of its link to an increased risk of heart disease. One kind (pattern B) is small and dense; the other (pattern A) is large and buoyant.

But only the small, dense LDL is associated with cardiovascular disease. The large, buoyant LDL is considered to be benign or, perhaps, even protective against the disease.

Saturated fat and carbs have different effects on the profile of these LDLs in the body, says DiNicolantonio. A high-carb diet increases the amount of potentially harmful small, dense LDL circulating in the blood, while a high-fat diet lowers it.

DiNicolantonio also warns against replacing saturated fat with omega 6-rich polyunsaturated fats, particularly safflower oil or corn oil. Recent research, he says, suggests that doing so may actually increase rather than decrease the risk of heart disease. (Other omega 6-rich polyunsaturated fats, such as canola and soybean oils, may have a similar effect on that risk, but they haven’t been extensively studied yet, DiNicolantonio notes.)

Changing perceptions

“We need a public health campaign as big as the one demonizing saturated fat to now say, ‘You know what? We had it wrong,’” DiNicolantonio says in a podcast interview released with the commentary.

“We also need to change the public-health perception that, well, if you lower your saturated fat, you’re going to lower your cholesterol,” he adds.

The best heart-healthy diet, says DiNicolantonio, is one low in added sugars, refined carbohydrates and processed foods.

You can read the commentary in full on the Open Heart website. You can listen to the 11-minute podcast interview with DiNicolantonio at the site as well; simply scroll down to the end of the commentary.

Comments (14)

  1. Submitted by Jeff Klein on 03/07/2014 - 09:27 am.

    It’s amazing how long this realization has taken, and how deeply rooted the belief is now, to the point where we may never get rid of it.

    Look at the yogurt section in any grocery store to see an example. Just try to find one that’s not fat free. But they’re all pumped full of sugar. We really made the obesity thing worse by removing fat from foods, because then they tasted terrible so we loaded them all full of sugar to make up the difference. And now here we are…

    • Submitted by Paul Scott on 03/07/2014 - 12:46 pm.

      Yogurt is exhibit A of the the low fat/high sugar con game being played on American health.

      If you can seek it out I recommend Kalona Super Natural Brand Organic Plain Cream Top with 5% milk fat and put berries in it. I eat it every morning. Yumm!

    • Submitted by Pat Thompson on 03/07/2014 - 12:56 pm.

      So true

      That is so true, Jeff. I think this every time I stand looking at the kefir and yogurt at Seward Co-op. You can’t buy full fat kefir there. Why not?

      It’s time for stores, like the co-op, that generally try to educate consumers on this issue to educate themselves about the low fat/high sugar trap.

  2. Submitted by Paul Scott on 03/07/2014 - 10:02 am.

    Great piece

    Thanks for bringing attention to the growing acceptance that butter, coconut oil, animal fat and lard are not implicated in heart disease, as well as the heterogeniety of LDL. It’s going to be a long road to walk back the erroneous and health damaging sat-fat demonizing paradigm, but it should start here in earnest since Minnesota is the home of its creation.

  3. Submitted by Steve Titterud on 03/07/2014 - 11:50 am.

    “A campaign…to now say…We had it wrong.”

    We will hear such a campaign of admission from the U.S. medical and research community WHEN PIGS FLY.

    You’d think scientists, and in particular medical scientists, would be innoculated against this pernicious disease of dogmatic belief, but it is not so. They are as prone to herd behavior – each individual reducing the danger to itself by concurring with the group (like running in a herd) – as any other group of people.

  4. Submitted by Joel Fischer on 03/07/2014 - 12:28 pm.

    Turns out Dr. Atkins new what he was talking about.

    It’s been 10 years since the Atkins craze, but he had begun his work long before that. Perhaps we have him to thank, if nothing else, for bringing the idea of the low-carb diet’s healthfulness to the public consciousness.

    • Submitted by Lance Groth on 03/07/2014 - 02:18 pm.

      Exactly so

      There has been a lot of research into low carb eating since the Atkins diet hit its peak popularity, some of it designed to show that he was wrong, but the results almost universally indicate he was right.

      Glad to hear that the mainstream is slowly coming around to what we low carb eaters have known for a long time, but the low fat/high carb advice is going to die a very slow death. Some people have entire careers built around dispensing the wrong advice, and they will be loathe to admit they’ve been wrong all their lives. Not to mention fear of liability – if the advice of nutrionists and other health care professionals has made us all fat, hypertensive and diabetic, well, folks aren’t going to be too happy about that, are they?

  5. Submitted by Justin Dessonville on 03/07/2014 - 01:53 pm.


    I was excited to have this post sent to me by a friend this morning. I was also wary (at first). When I’ve seen stories before on HuffPo, etc. There’s always a BUT statement thrown in that lends itself to the current dietary dogma.

    This was just out and out writing based on information currently available. Kudos to Susan for doing her research on the Ancel Keys study.

  6. Submitted by Charles Holtman on 03/07/2014 - 02:27 pm.

    Also, protein will kill you

    We learned earlier this week:

    So I guess the ideal diet is now animal fat without the meat? Lard, kale and red wine for dinner tonite!

    • Submitted by Steve Titterud on 03/07/2014 - 04:48 pm.

      Mix some kamut and pearled farro in with the lard,…

      …for a little body, and it’ll go down easier after the first bowl, especially if washed down with copious red wine. Bon appetit !!

  7. Submitted by Greg Kapphahn on 03/07/2014 - 08:21 pm.

    Correlation is Not Causation

    But I suspect it’s more than coincidence that our current obesity epidemic exactly parallels the movement to take fats of all kinds out of foods, especially convenience food and snack foods.

    What the processed food industry did, of course, to make our old favorite foods palatable in their “low fat” form, was load them up with very heavily processed and refined carbohydrates.

    It seems very likely that “low fat” foods produced high fat bodies.

  8. Submitted by Susan Lesch on 03/07/2014 - 10:50 pm.

    Please be careful

    Seems to be a theme from Robert Lustig and Gary Taubes (Taubes and Andrew Weil blurbed Lustig’s book, by the way), both of whom criticize Keys.

    Much more important, Denise Minger wrote a blog post about this, “The Truth About Ancel Keys: We’ve All Got It Wrong”.

  9. Submitted by Susan Lesch on 03/10/2014 - 10:37 am.

    Please be careful II

    My comment was perhaps unclear. “We’ve All Got It Wrong” includes DiNicolantonio, Taubes and Lustig. Minger says, “When all 22 countries were analyzed, the association between fat and heart disease did not go away. It actually remained statistically significant (meaning it probably wasn’t due to chance). ”

    As stated in its introduction, the whole point of Robert Lustig’s talk “Sugar: The Bitter Truth” [1] is “to debunk” the last “30 years of nutrition information in America”. He eventually stops to ask if he succeeded, “As far as I’m concerned [the Seven Countries study] has a hole in it as big as the one in the USS Cole. Am I debunking?” at 36:30.

    I was saddened to find Ancel Keys was Lustig’s target. I prefer to side with the author (with his wife) of “The Benevolent Bean”.


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