Researchers found that doctors' admonitions to avoid foods high in saturated fat like butter and cheese were "just plain wrong."
A study found that restricting saturated fat in the diet doesn’t protect against heart disease, reigniting the debate among doctors over the issue. Instead of concentrating on a single nutrient, the authors recommended a more holistic approach to health, which includes following the Mediterranean diet supplemented with large quantities of olive oil.
People are suffering from the misimpression that they have to suffer to be healthy. This is simply not so.
The belief that the saturated fat in foods like butter and cheese clogs the arteries is “just plain wrong,” according to cardiologists in the new report. This assertion is a direct challenge to the traditional medical thought that for decades has prompted the admonition to cut back on these foods.
In the editorial published in the British Journal of Sports Medicine, the authors said a key earlier study “showed no association between saturated fat consumption and all-cause mortality, coronary heart disease, CHD mortality, ischemic stroke or type‑2 diabetes in healthy adults.”
The cardiologists advised a dramatic shift in the approach to the prevention and treatment of heart disease. “Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of ‘proven to lower cholesterol’ and ‘low-fat’ foods and medications, has been misguided,” they said.
While doctors have long emphasized lowering LDL cholesterol, the report contended that a high total cholesterol to HDL cholesterol ratio is a more accurate predictor of an elevated risk for heart attack and stroke. In addition, they pointed out that cardiovascular disease is caused by inflammation.
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Therefore, they promoted an approach that gets to the root cause of the disease. This involves placing a focus on “eating ‘real food,’ taking a brisk daily walk, and minimizing stress to stave off heart disease,” they said. “Coronary artery heart disease is a chronic inflammatory condition which responds to a Mediterranean-style diet rich in the anti-inflammatory compounds found in nuts, extra virgin olive oil, vegetables and oily fish.” They advocated the daily consumption of ample quantities of healthful fat; namely, “four tablespoons of extra virgin olive oil or a handful of nuts.”
Why haven’t admonitions to cut saturated fat in the diet led to a reduction in heart disease? The answer lies in the fact that people have substituted refined and processed carbohydrates for saturated fat. Such foods produce chronically high insulin levels, a problem that triggers inflammation, which in turn contributes to hardening of the arteries. Conversely, the healthful carbohydrates that are part of the MedDiet, such as plenty of fibrous fruits and vegetables, actually fight inflammation.
Responses to the editorial exonerating saturated fat consisted of support from some quarters of the medical community, as well as sharp censure from others. Those who expressed strong disagreement said the authors failed to take into consideration a 2015 Cochrane review that linked a reduction in saturated fat intake to a 17 percent decrease in cardiovascular events.
How does lead author Aseem Malhotra address this criticism? “We didn’t use the Cochrane review because it is at best, fatally flawed, and at worst, unscientific nonsense,” he told Olive Oil Times. “The saturated fat references upon which we based our editorial are systematic reviews for primary and secondary prevention of heart disease.”
So whom should we believe? Are the authors of the new editorial correct, or should we give credence to their critics?
Olive Oil Times asked integrative physician Jacob Teitelbaum for his perspective. “It is important to look at the entire Cochrane review and not just selectively pick out a few of its data points. They key consideration is that the low saturated fat diet did not show any significant effect on overall mortality,” he said.
“As the review authors themselves noted on discussing even the one data point associating saturated fats with heart disease, this evidence was limited and circumstantial.”
“People are suffering from the misimpression that they have to suffer to be healthy. This is simply not so,” added Teitelbaum.
Common sense tells us that us that the best approach for the prevention of a medical problem is to attack the root cause, which in this case, is inflammation. Since the MedDiet is known as the anti-inflammatory diet, it offers the most effective means of promoting better cardiovascular health.