Are Saturated Fats Bad For You?

Written by Dr. Steve Chaney on . Posted in Saturated Fats and Heart Disease

The Saturated Fat Wars Heat Up Again

Author: Dr. Stephen Chaney

Are saturated fats bad for you? 

are saturated fats bad for youI feel your pain. It is so confusing. Just a few months ago we were being told our fears of saturated fats were outdated. Saturated fats were fine. It was carbohydrates we needed to avoid.

Then, just last week the headlines blared: “Hold your horses. Saturated fats are bad for you. You need to avoid them.” No wonder you are confused!

Last week’s headlines were based on a recently published Presidential Advisory by the American Heart Association (F.M. Sacks et al, Circulation. 2017;135.00-00. DO!: 10.1161/CIR.0000000000000510). A Presidential Advisory is the AHA’s highest-level health advisory. It is meant to guide public health policy by government agencies such as the US Surgeon General’s office, the USDA, and the CDC.

However, the warnings about the dangers of saturated fat are very much like the warnings about the dangers of global warming. They have their believers and their deniers, and both sides passionately defend their positions. I understand the passion of saturated fat deniers. Foods high in saturated fat are an integral part of our heritage and our culture. It is only natural to want to believe those foods are good for us.

Because of this, I knew the AHA advisory would be controversial. After all, if someone is telling us we need to give up the foods we love, they better have darn good evidence to back up their recommendations.

I knew you, my readers, would want a scientifically accurate evaluation of the evidence, so I carefully analyzed the research studies the AHA presented in support of their recommendations. Here is what I found.

How Was The Analysis Done?

saturated fats and heart diseaseThis report was put together by the top heart disease experts, both physicians and research scientists, in the country. They examined over 50 years of research studies. They also examined meta-analyses that combined the results of multiple research studies. In short, they examined the entire body of scientific evidence on diet and heart disease.

The AHA committee used very rigorous criteria in selecting the best studies for their analysis. They only included randomized clinical trials that:

  • Had actual cardiovascular end points – heart attack, stroke, and deaths due to heart disease. Studies looking at things like LDL, HDL, particle size, inflammation etc. only give you part of the picture. They may, or may not, accurately predict risk of dying from heart disease.
  • Lasted two years or more. The fats we eat determine the fat composition of our cell membranes, and that is what ultimately determines our risk of dying from heart disease. This is the one instance it is true to say: “We are what we eat.”  However, changing the fat composition of our cell membranes does not occur overnight. It takes 2 years or more to achieve a 60-70% change in the fat composition of cell membranes.

It also takes time for any intervention to meaningfully impact heart disease risk. For example, with statin drugs it takes 1-2 years before there is a significant reduction in heart disease risk. Thus, for a variety of reasons, studies of less than 2 years duration are doomed to fail.

  • Showed the subjects stuck with the new diet for the duration of the study. Subjects find it difficult to adhere to a diet to which they are not accustomed long term and often revert to their more familiar diet. This requires either very close monitoring of what the subjects are eating or measurement of fat membrane composition to verify diet adherence, or both. Studies that only measured what the subjects were eating at the beginning of the study and then looked at outcomes months or years later may or may not be valid. Without any measurement of diet adherence, it is impossible to know.
  • Carefully controlled or measured what the saturated fats were replaced with. The importance of this criterion will be clear when we look at the results of their study.

They then did a meta-analysis of what they referred to as “core randomized trials” that met all 4 criteria. In short, this was a very rigorous and well-done analysis.

Are Saturated Fats Bad For You?

saturated fats from meatsThe main finding of the report was:

  • Replacing saturated fats from animal products with polyunsaturated fats from vegetable oils decreased the risk of heart disease by 29%. This is equivalent to statin therapy, without the side effects.
  • The conclusions of this report applied equally to the saturated fats that come from meats and dairy products.
  • About 50% of the risk reduction could be due to lowering of LDL cholesterol. The rest came from reduced arterial inflammation, increased flexibility of the arteries, increased membrane fluidity and other factors.
  • When the replacement of saturated fats with polyunsaturated fats occurred in the context of a heart healthy diet such as the Mediterranean diet, heart disease risk was reduced by 47%.

What the saturated fats are replaced with is critically important. The authors of this report calculated what would happen if we were to replace half of our saturated fat calories with equivalent calories from other foods. Replacing half of our saturated fat intake with:

  • Polyunsaturated fats (vegetable oils and fish oil), lowers heart disease risk by 25%.
  • Monounsaturated fats (olive oil & peanut oil), lowers heart disease risk by 15%.
  • Complex carbohydrates (whole grains, fruits & vegetables), lowers heart disease risk by 9%.
  • Refined carbohydrates and sugars (the kind of carbohydrates in the typical American Diet), slightly increases heart disease risk.
  • Trans fats, increases heart disease risk by 5%.
  • The authors did not address the relative value of omega-6 and omega-3 polyunsaturated fats in their report. However, I have addressed the heart health benefits of omega-3s in a previous report, Fish Oil Really Snake Oil.

Why Is There So Much Confusion?

saturated fats and LDL cholesterolYou are probably saying: “If saturated fats are so bad for me, why do I keep seeing diet books and news headlines saying I have nothing to fear from saturated fats?” The answer is pretty simple. The studies that have given rise to misleading headlines about the safety of saturated fats ignored one or more of the criteria described above that are needed to assure a valid conclusion. For example:

  • Some recent headlines claiming that saturated fats did not increase the risk of heart disease were based on studies in which saturated fats were replaced by refined carbohydrates and sugars. Other headlines were based on studies that did not measure what the saturated fats were replaced with.
  • The popular high saturated fat-low carb diets are not backed by any studies looking at their effect on heart attacks, stroke, or heart disease deaths. They are only backed by studies looking at their effect on LDL cholesterol and other imperfect markers of heart disease risk.
  • In contrast, the Mediterranean diet, which lowers saturated fat intake and contains healthy carbohydrates (whole grains, fruits and vegetables), significantly decreases the risk of heart disease. Please reference Mediterranean Diet for Heart Health.

 

What Are The Saturated Fat Deniers Saying?

 

saturated fats deniersThe saturated fat deniers have wasted no time trying to discredit the American Heart Association advisory. Maybe they can’t bear the thought of having to give up their favorite fatty foods. Or maybe they just can’t bear to admit they were wrong.

However, their claims just don’t hold water. Let me give you some examples.

  • The AHA (American Heart Association) is a tool of the pharmaceutical industry. If the AHA were a tool of the pharmaceutical industry, I hardly think their report would have stated that replacing saturated fats with polyunsaturated fats was as effective as statin drugs at reducing heart attack risk.
  • The AHA is a tool of the food industry. If the AHA were a tool of the food industry, I hardly think they would have recommended replacing fats from meat & dairy with polyunsaturated fats.
  • The AHA advisory was based on associations, which do not show cause and effect. False. The AHA committee based their recommendations on randomized clinical trials, the strongest kind of evidence. They merely said that studies looking at the association between saturated fats and heart disease were consistent with their analysis of randomized clinical trials.
  • The AHA advisory was based on LDL cholesterol, which is an imperfect predictor of cardiovascular risk. False. Again, the AHA committee based their recommendations on randomized clinical trials of cardiovascular outcomes, not on LDL levels. They merely estimated that LDL cholesterol levels contributed to about 50% of the risk they observed.
  • saturated fats mythsThe AHA committee ignored an early study in which replacing butter with polyunsaturated fats increased cardiovascular risk. False. That study actually replaced butter with margarine. It was the first study showing that trans fats are worse for us than saturated fats.
  • The AHA committee ignored recent studies that did not fit their hypothesis. False. They developed a valid set of scientific criteria for evaluating clinical studies. As described above, they simply eliminated those studies whose design does not permit a definitive conclusion.
  • The AHA recommends low fat diets containing refined carbohydrates and sugary foods, which are even worse. False. The AHA has consistently recommended low fat diets with complex carbohydrates (whole grains, fruits & vegetables). It is the food industry that corrupted their message. More to the point, this AHA Presidential Advisory specifically recommended lowering saturated fats in the context of a heart healthy diet like the Mediterranean diet.
  • The AHA recommends replacing saturated fats with omega-6 polyunsaturated vegetable fats, which can be harmful if consumed in excess. I have some sympathy with this argument. I would have preferred to have seen more emphasis on omega-3 oils in their report. There should also have been some discussion of the importance of antioxidants to protect against free radicals generated by polyunsaturated fat metabolism. However, their final recommendation to replace saturated fats with polyunsaturated fats in the context of a healthy diet like the Mediterranean diet goes a long way towards satisfying both concerns.

In short, the saturated fat deniers have no persuasive counter-argument. The evidence that saturated fat causes heart disease is simply overwhelming.

What Does This Mean For You?

replace saturated fats with polyunsaturated fatsThe time for debate is over. The evidence is overwhelming. It should be obvious to any reasonable person that saturated fats increase our risk of heart disease.

It should also be obvious that any diet that claims saturated fats are heart healthy is a myth. There are no long-term studies to back up that claim.

It is time to consider what it would mean if everyone in this country were to follow the AHA recommendations and replace half of the saturated fat in our diet with polyunsaturated fat. That would decrease our risk of heart disease by 29%.

  • 800,000 Americans die of heart disease each year. 232,000 lives would be saved.
  • Heart disease costs our nation $316 billion each year. $92 billion health care dollars would be saved.
  • Heart disease costs are expected to exceed $1 trillion by 2035. $290 billion health care dollars would be saved.

What if we decreased our risk of heart disease by 47% by coupling decreased intake of saturated fats with a heart healthy diet like the Mediterranean diet?

  • 376,000 lives would be saved.
  • $148 billion health care dollars would be saved.
  • $470 billion health care dollars would be saved by 2035.

Each of us has the ability to save our health and our lives by what we put into our mouths every day.

In addition, our health care system will soon become financially non-viable if we continue to focus on disease treatment rather than prevention. Each of us also has the ability to save our health care system by what we put into our mouths every day.

 

The Bottom Line

 

  • The link between saturated fat and heart disease risk is like global warming. It has its believers and its deniers, and both sides passionately defend their viewpoints.
  • The American Heart Association (AHA) recently released a Presidential Advisory on the relationship between saturated fats and heart disease. Because I knew their report would be controversial, I analyzed its scientific accuracy very carefully.
  • The AHA report was prepared by the top heart disease experts in the country. They reviewed over 50 years of clinical studies and used a very rigorous set of criteria to decide which studies to include in their analysis and which to exclude. In my judgement, the criteria they used were valid. Studies that fail to meet one or more of these criteria may not provide valid results. Unfortunately, several of the studies that have generated some of the recent controversy did not meet those criteria.
  • From a meta-analysis of “core studies” meeting these criteria, they concluded:
    • Replacing saturated fats from animal products with polyunsaturated fats from vegetable oils decreased the risk of heart disease by 29%. This is equivalent to statin therapy, without the side effects
    • The conclusions of this report applied equally to the saturated fats that come from meats and dairy products.
    • About 50% of the risk reduction could be due to lowering of LDL cholesterol. The rest came from reduced inflammation, increased flexibility of the arteries, and other factors.
    • When the replacement of saturated fats with polyunsaturated fats occurred in the context of a heart healthy diet such as the Mediterranean diet, heart disease risk was reduced by 47%.
  • The AHA recommends replacing half of the calories from saturated fat with healthier choices. From a detailed analysis of the data, the authors concluded which foods replace the saturated fat is very important. Replacing half of our saturated fat intake with:
    • Polyunsaturated fats (vegetable oils and fish oil), lowers heart disease risk by 25%.
    • Monounsaturated fats (olive oil & peanut oil), lowers heart disease risk by 15%.
    • Complex carbohydrates (whole grains, fruits & vegetables), lowers heart disease risk by 9%.
    • Refined carbohydrates and sugars (the kind of carbohydrates in the typical American Diet), slightly increases heart disease risk.
    • Trans fats, significantly increases heart disease risk.
  • The saturated fat deniers have already started trying to discredit the AHA advisory. I have reviewed their claims and found them to be baseless.
  • The evidence is overwhelming. It should be obvious to any reasonable person that saturated fats increase our risk of heart disease. It should also be obvious that any diet that claims saturated fats are heart healthy is a myth. There are no long-term studies to back up that claim.
  • If everyone in this country were to follow the AHA recommendations and replace half of the saturated fat in our diet with polyunsaturated fat:
    • Between 232,000 and 376,000 lives would be saved next year.
    • Between 92 and 148 billion health care dollars would be saved next year.
    • By 2035 between 290 and 470 billion health care dollars would be saved annually.

In short, each of us has the ability to preserve our health and save our lives by what we put into our mouth every day.

So, are saturated fats bad for you?  The answer is a resounding “yes.”

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Jim Campbell

    |

    Wonderfully, puts the controversy to rest.

    Reply

  • JoAnne Naro

    |

    Thank you Dr. Chaney. I always enjoy reading your very informative Health Tips. All the best to you and yours!

    Sincerely,
    JoAnne Naro
    Shaklee Associate

    Reply

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Latest Article

How to Choose the Right Pillow

Posted April 17, 2018 by Dr. Steve Chaney

Wake Up Each Morning Pain Free

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

how to choose the right pillow without headachesThe way you sleep is often a key to discovering the cause of headaches and more. If you wake up with neck pain, a headache, or you suffer from ringing in your ears, dizziness, or ear pain, there is a good possibility that it may be caused by the way you are sleeping. Your pillow may be the culprit.  But if you need to know how to choose the right pillow for you, it’s easy.   It just takes a little “investigation.”

 

How to Choose the Right Pillow if You Sleep On Your Side

Your head, neck, and spine need to always stay in a nice straight line, just as it is when you are standing up, but that takes a little thought and understanding of the way you sleep.  So, get comfy in your bed and then notice how your head is resting.

how to choose the right pillow to sleep painfreeIf you sleep on your side, your pillow needs to be just the right size, so your head doesn’t point down toward the mattress (your pillow is too soft) or up to the ceiling (your pillow is too thick). Either of these positions will make the muscles on the side of your neck stay in the contracted position for hours and pull your vertebrae in that direction, especially when you try to turn over to your other side.

Your SCM Muscle May Cause Serious Problems

You also need to notice if you turn your head a bit, especially if you are turning into your pillow or turning your head up toward away from your pillow. In either of these two cases you will be causing your sternocleidomastoid (SCM for short) to be held shortened for hours.

Your SCM originates on your collarbone and inserts into the bone behind your ear.  When it contracts you turn your head to the opposite side. However, if the muscle is tight (for example, when you’ve held your head turned toward one side for an extended period of time) and then you bring your head back so you are facing forward, the tight muscle will pull on the bone behind your ear and cause havoc.

The symptoms for a tight SCM are tinnitus (ringing in the ear), dizziness, loss of equilibrium, ear pain, headaches, pain in the eye and around the skull, pain at the top of the head, and even pain in the throat. Amazing! What’s even more amazing is that it’s rare that this muscle is considered when a medical professional is searching for the cause of your symptoms.

These are the things to know when considering how to choose the right pillow if you sleep on your side.

How To Choose The Right Pillow If You Sleep On Your Back

how to choose the right pillow for sleeping on your backIf you sleep on your back, your head should be on the mattress (not propped up with a pillow) and you should have a tiny support (like a folded washcloth) under your neck.  Or, you can have a wedge pillow that starts at your mid-back and gently raises your entire trunk and head up while still allowing your head and back to be in a straight line.

It’s always a challenge for people who toss and turn during the night, sometimes on their side and sometimes on their back.  The best thing I’ve found for this situation is to have the pillow below shoulder level so when you turn on your side your shoulder will automatically slide to the edge of the pillow while still supporting your head properly, and when you turn onto your back, the pillow will start at shoulder level so your head and neck are supported, but your head is being pushed in a way that causes your chin to move down to your chest.

hip pain causes and treatment pain freeIt’s tricky, but I can personally attest to the fact that it will work.  I can always tell when I’ve had my head tilted (I toss and turn during the night) because I will wake with a headache. When that happens I’m grateful that I know how to self-treat the muscles of my neck and shoulders so the headache is eliminated quickly.  If you already have Treat Yourself to Pain Free Living,  you can self-treat all your neck and shoulder muscles to release the tension.

How To Choose The Right Pillow If You Sleep On Your Stomach

If you sleep on your stomach, this is the one position that is so bad that it behooves you to force yourself to change your position. Your head is turned to the side and held still for hours, putting a severe strain on all your cervical and upper thoracic vertebrae. Not only will this cause headaches, tinnitus, and a list of other pains, but it can cause problems down your entire spine. It can also impinge on the nerves that pass through the vertebrae on their way to your organs.

If you do sleep that way, let me know and I’ll give you some suggestions that work to change your habit of sleeping. It takes time and energy, but the results are worth the effort.

In every case, the way you sleep may cause neck pain that won’t go away until the pillow situation is resolved.

Now you should know how to choose the right pillow for the way you sleep.

Wishing you well,

Julie Donnelly

About The Author

julie donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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