The Skinny On Fats

In 1948, a random sample of 5209 citizens in the small rural village of Farmingham Massachusetts (about 2/3 of the population) volunteered to become active participants in a collaborative health study with the National Heart Institute (NHI) known as the 'Farmington Heart Study (FHS)'. The goal of this on-going study was to determine the effects of diet on cardiovascular disease. The bottom line, Dr. Kannel and his team of researchers found no direct correlation between the dietary intake of fats and elevated serum cholesterol levels. Uh...what? That's right, the scientists and researchers of the FHS complied all the results of the study in the early 1970's and published their findings in section 24 of 'The Farmingham Study An Epidemiological Investigation Of Cardiovascular Disease, The Farmingham Diet Study: Diet And The Regulation Of Serum Cholesterol'. In this report they concluded “There is no indication of a relationship between dietary cholesterol and serum cholesterol levels. If the intake of animal fat is held constant there is still no relation of cholesterol intake to serum cholesterol levels. If a multiple regression is calculated [using animal fat and dietary cholesterol] there is also little suggestion of an association between this pair of variables and serum cholesterol levels.”

That's a pretty shocking statement as many organizations including the American Heart Association (AHA) have based their dietary fat recommendations on the results of the FHS. Cardiologist Dr. Christopher Wegener in his article 'On Trial: Saturated Fat: Proven Villain or Medical Myth? States “When compared to the low-fat diet and alternative popular diets, it is the low-carbohydrate dietary strategy that has led to greater weight loss, significant increases in HDL-C with concomitant decreases in total glucose (TG), and noteworthy reductions in hemoglobin A1c. Such findings should not be surprising as such results were evident in the data on the much earlier NIH-funded Framingham cohorts which demonstrated that the subjects who ate the most fat and least amount of refined grains and sugars experienced the greatest increase in HDL-C.” If these findings are true, then why have we been taught to believe that all fats are bad for us?

In this article, I am going to try and address the differences between saturated, polyunsaturated, and monounsaturated fats. I will also try explain why they are not only necessary for proper bodily function, but how they can be beneficial for promoting weight loss. In addition, we will examine how partially hydrogenated oils (PHO's) also known as trans fats are the one bad fat that everyone can agrees that we should avoid.

Saturated Fats

Saturated fats are mostly found in animal fats (beef, pork, poultry), dairy products (butter, heavy cream, and cheese) as well as in tropical oils (coconut and palm). However, our bodies naturally make a certain amount of saturated fatty acids from the carbohydrates that we consume. Saturated fats are not the 'evil monster' that many believe them to be, and current medical research has proven that there is no direct link between the cardiovascular disease and the consumption of natural saturated fats found in most animal and or dairy products. Harvard Medical School concluded that in a meta analysis of 21 independent studies “that there was not enough evidence to conclude that saturated fat increases the risk of heart disease”.

In fact, when consumed in their natural state they may even be beneficial to your cholesterol levels as they contain many beneficial saturated fatty acids that your body needs. “Recent research has also shown that Mediterranean diets -- admittedly skimpy on red meat but hardly light on saturated fats -- have outpaced both statins and low-fat diets as a means of preventing repeat heart attacks. Other research suggests that the saturated fat in dairy foods may protect against hypertension, inflammation and a host of other dysfunctions increasingly linked to heart attacks.” (Healey, 2013). New York Times best selling author Dr. Joesph Mercola in his article regarding saturated fats states “when you reduce saturated fat and increase refined carbohydrates, you end up promoting obesity, heart disease and diabetes”. He goes on to further state “Saturated fats from animal and vegetable sources provide a number of important health benefits. In fact, your body cannot function without saturated fats! Saturated fats are needed for the proper function of your: cell membranes, heart, bones, liver, lungs, hormones, immune system, satiety (reduces hunger) and genetic regulation.”

Polyunsaturated Fats (PUFA'S)

Polyunsaturated fats can be found in fish, nuts, seeds, leafy greens, and vegetable oils. Sometimes called 'essential fats', polyunsaturated fats are used by your body to build cell membranes, are needed for proper muscle movement, help with blood clotting, fight inflammation, and are an essential component used to build myelin sheaths which are necessary for proper neuromuscular function. Unlike saturated fats, our bodies do not naturally produce the necessary polyunsaturated fats our bodies need to function properly so we must get them from the foods we eat.

According to the Harvard Medical School, “Eating polyunsaturated fats in place of saturated fats or highly refined carbohydrates reduces harmful LDL cholesterol and improves the cholesterol profile. It also lowers triglycerides”. I think the key phrase here is “in place of highly refined carbohydrates”, as many cardiologists now believe that there is no direct link between saturated fat intake and cardiovascular disease, however there is a direct correlation between heart disease and high carbohydrate intake. In their article 'The Truth About Saturated Fat' Enig and Fallon state that “Elevated triglycerides in the blood have been positively linked to proneness of heart disease, but these triglycerides do not come directly from dietary fats; they are made in the liver from any excess sugars that have not been used for energy. The source of these excess sugars is any food containing carbohydrates, particularly refined sugar and white flour”. This is why it is extremely important that Americans need to change our eating habits by reducing or eliminating the amount of highly processed and refined carbohydrates and sugars in our diet, not fats. This is especially true for people who have been diagnosed with diabetes or have cardiovascular issues.

Monounsaturated Fats (MUFA'S)

The most common monounsaturated fat found in the typical American diet is oleic acid. Oleic acid occurs naturally in vegetable and animal oils. Olive oil is one of the most common and best sources of oleic acid, but it can also be found in almond oil, peanut oil, canola oil, corn oil, avocados, sunflower oil, safflower oil, red meat, fish, whole milk, and most nuts. MUFA's are beneficial to your health by lowering “unhealthy” low density lipoprotein (LDL) cholesterol levels and increasing “healthy” high density lipoprotein (HDL) levels. According to the American Heart Association “Monounsaturated fats can help reduce bad cholesterol levels in your blood which can lower your risk of heart disease and stroke. They also provide nutrients to help develop and maintain your body’s cells. Oils rich in monounsaturated fats also contribute vitamin E to the diet, an antioxidant that most Americans need more of”.

As mentioned in our discussion on saturated fats, The Mediterranean Diet also includes a large amount of monounsaturated fats. Studies suggest that overall, the populace of Mediterranean countries consume more total fat than the populace of Northern European countries (up to 40% of total dietary intake in some regions), however most of the fat is in the form of monounsaturated fats from olive oil, fish, vegetables, and meats such as lamb. While the total fat consumption is high, the rate of cardiovascular disease and diabetes among Mediterranean populations is well below the average of Northern European and American populations.

Partially Hydrogenated Oils (PHO's) aka Trans Fats

The one type of dietary fat that everyone can agree on that is bad are 'trans fats'. Trans fats are created through a process called hydrogenation which turns liquid oils into solids such as margarine and shortening. This process of hydrogenation turns healthy vegetable oils into not-so-healthy saturated fats. During the Great Depressions (1930's) and World War II (1939 – 45), butter was in short supply and oleomargarine (originally made with beef fat) became an inexpensive and popular substitution. By 1950, manufacturers began to replace the beef fat with cheaper partially hydrogenated vegetable oils.

Soon food manufacturers began using partially hydrogenated vegetable oils (PHO's) in everything from commercial cookies and pastries to fast-food French fries. Originally believed safe, research over the last 30 years has proven that eating foods rich in trans fats not only increases the amount of harmful LDL cholesterol in the bloodstream, but reduces the amount of beneficial HDL cholesterol. In addition, trans fats create inflammation of the blood vessels, which is linked to heart disease, stroke, diabetes, and other chronic conditions. Trans fats have also been proven to contribute to insulin resistance, which increases the risk of developing type 2 diabetes. According to Enig and Fallon, “Consumption of hydrogenated fats is associated with a host of other serious diseases, not only cancer but also atherosclerosis, diabetes, obesity, immune system dysfunction, low- birth-weight babies, birth defects, decreased visual acuity, sterility, difficulty in lactation and problems with bones and tendons”.

According to TIME magazine, “In 2013, the FDA determined that PHO's do not meet their distinction of “generally recognized as safe” for human consumption”. Because of the health risks related to partially hydrogenation oils associated with trans fats, the United States Food and Drug Administration (FDA) announced in June 2016 that it is moving towards baning artificial trans fats here in the United States. “Over the next three years, food manufacturers must remove the primary source of artificial trans fat—partially hydrogenated oils (PHO's)—from their products” (TIME, 2016). Keep in mind that trans fat will not totally disappear from the American diet as they naturally occur in some products like meat and dairy products and may be present at very low levels in some oils. However, the ban on PHO's by the FDA should significantly reduce the amount of trans fats consumed by Americans which should lead to a healthier population. However, the future is yet to be determined.

So What Does It All Mean?

Saturated fats tend to have a neutral to beneficial effect on weight and cholesterol levels, whereas polyunsaturated fats which our bodies do not make are necessary for proper bodily function and must be acquired via diet. Monounsaturated fats actually lower “unhealthy” low density lipoprotein (LDL) cholesterol levels and increasing “healthy” high density lipoprotein (HDL) levels. This is why people who live in the Mediterranean, and consume a traditional Mediterranean Diet which is high in saturated and and monounsaturated fats (up to 40%) have some of the lowest cholesterol levels as well as low levels of cardiovascular disease. Countries such as the United States and Great Britain whose populations consume less saturated, polyunsaturated, and monounsaturated fats, but consume large amounts of foods that contain partially hydrogenation oils (trans fats) as well as carbohydrates have the highest rates of obesity, diabetes, and cardiovascular disease.

The following comes from an article in the News, Farmingham-Natick, Friday October 30, 1970 in which a reporter interviewed Dr. Kannel, then director of the FHS about the studies findings regarding the relationship between diet and serum cholesterol.

'Although there is no discernible relationship between reported diet intake and serum cholesterol levels in the Farmington Diet Study group, “it is incorrect to interpret this finding to mean that diet has no connection with blood cholesterol” Dr. William B. Kannel, director of the Farmingham Heart Study has stated. “It has been repeatedly demonstrated that blood cholesterol levels can be altered by changes in diet; and dietary alteration is still the most acceptable form of medical management for persons with elevated blood lipids” Dr. Kannel said. “The available evidence indicates that coronary heart disease appears to result from a combination of contributing factors and that no single factor capable of producing disease by itself has been convincingly demonstrated,” he stated.

Even the director of the FHS study Dr. William Kannel states that changing dietary habits is the best way to decrease serum cholesterol levels. Substituting saturated, polyunsaturated, and monounsaturated fats for unhealthy trans fats, and decreasing the amounts of refined sugars, and carbohydrates consumed can definitely decrease the risks of diabetes, and cardiovascular disease.

Conclusion

Going back and looking at this article I may have went into overload mode and listed more information here than was necessary. However, I hope that this article was informative and helpful. There is no doubt that some of the newer research goes against current conventional thinking when it comes to dietary fat intake. Change is inevitable, but it is a slow process, and many of my colleagues in the medical field are just not ready to make the change despite the current scientific and medical research.

On a side note, I have been on a low carbohydrate high fat diet for eight weeks. As of the writing of this article I have lost a total of 23.25 pounds, decreased my BMI from to 36.6 to 33.2. I have been able to stop taking my insulin as my blood glucose is averaging 105.7 fasting, 104.7 at midday, 107.2 before bedtime. The real proof of the effectiveness of this dietary regimen for me will be in mid December 2016 when I see my endocrinologist and my labs are drawn after being on this diet for 3 ½ months.

Whatever the results, I will post my serum cholesterol and my hemoglobin A1c as an addendum to this article so that you can see whether the choices I have made regarding my dietary fat intake have been benefited or harmed my health. As always, if you have found this article informative, we ask that you share it with your friends and family. Don't forget to send us a friend request on Facebook and or add us to your circles on Google+.

References:

American Heart Association, Monosaturated Fats, accessed October 23, 2016.

Enig, Mary, PhD, Fallon, Sally, The Truth About Saturated Fat, Dr. Axe Food Is Medicine, accessed September 28, 2016

Beyond the Olive: 9 Healthy Oils For Cooking, Dressing Dishes, Today Food February 26, 2013

Crosby, Guy, PhD, CFS, Ask The Expert: Concerns About Canola Oil, Harvard School Of Public Health, accessed October 24, 2016

Eades, Michael, MD, Framingham Follies, The Blog Of Michael R. Eades, MD, accessed October 24, 2016

Enfeldt, Andreas, MD Saturated Fat Completely Safe According To New Big Review Of Science, March 18, 2014.

Healy, Melissa, Time To End The War Against Saturated Fat? The LA Times, October 22, 2013

Mercola, Joseph DO, Saturated Fat: The Forbidden Food You Should Never Stop Eating. September 01. 2011.

Sifferlin, Alexandra, This Is Why The FDA Is Banning Trans Fats, Time, June 16, 2015

The Farmingham Study An Epidemiological Investigation Of Cardiovascular Disease, Section 24, The Farmingham Diet Study: Diet And The Regulation Of Serum Cholesterol.

The Healthiest Oils For Cooking And Frying, Atkins, accessed September 12, 2016

The 5 Best Cooking Oils For Health! Bodybuilding November 4, 2015

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Villacorta, Manuel, RD, Did You Know That Healthy Oils Don't Stop With Olive?, The Huffington Post, February 16, 2014

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