

| By Dr. Ronald Hoffman
It’s Heart Month, so be forewarned: You’re going to be subjected to the usual wrong information. Saturated fats continue to be demonized by health “authorities.” The American Heart Association persists in recommending: “Eat an overall healthy dietary pattern that emphasizes: a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish.”
It urges us to “limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, compare labels and select the leanest cuts available.” Avoid coconut oil, they warn, because it raises “bad” LDL cholesterol.
But what if their hoary exhortations do not comport with the latest scientific evidence?
A recent study suggests that recommendations to substitute poultry for red meat won’t ameliorate heart risk. The researchers were quoted as saying: “When we planned this study, we expected red meat to have a more adverse effect on blood cholesterol levels than white meat, but we were surprised that this was not the case.”
But the inference that cholesterol levels track coronary risk is a dubious leap of faith. An oft-quoted 2016 study (“Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review”) showed the opposite: for those over 60, higher levels of the so-called “bad” LDL cholesterol were associated with survival and reduced all-cause mortality.
Recently, the World Health Organization (WHO) weighed in on trans fats and saturated fats, urging an international health initiative to curtail their consumption.
In response comes a paper in the British Medical Journal (BMJ) that challenges the received wisdom that saturated fat is a bad actor. Entitled “WHO draft guidelines on dietary saturated and trans fatty acids: time for a new approach?”, the editorial acknowledges the deleterious effects of trans fats, which many advanced countries have sought to ban.
RELATED: Sorry vegans, but humans were designed to eat (some) meat
Trans fats are considered to have been responsible for 6% to 19% of all coronary heart disease events in the US in 2006 and to have caused about 2,700 deaths annually and the loss of 570,000 life years in the UK every year.
But the BMJ authors argue persuasively that saturated fats need not be incriminated with trans fats as health hazards.
They note the following:
The BMJ editorialists conclude:
“A recommendation to reduce intake of total saturated fat without considering specific fatty acids and food sources is not evidence based; will distract from other more effective food based recommendations; and might cause a reduction in the intake of nutrient dense foods that decrease the risk of cardiovascular disease, type 2 diabetes, other serious non-communicable diseases, malnutrition, and deficiency diseases and could further increase vulnerability to nutrient deficiencies in groups already at risk.”
In other words, they’re arguing against the unintended consequences of telling people world-wide to adopt a low-saturated fat diet—consequences which we’ve seen in spades here stateside where the encouraged public embrace of carbohydrate-laden “low-fat” foods has spawned an epidemic of obesity and Type 2 diabetes. The net result is more cardiovascular risk!
RELATED: Fats are worse for you than carbs? Really??
Clearly, we need a more nuanced approach to nutrition. Inclusion of foods rich in saturated fatty acids is neither “good” nor “bad” but might have different effects depending on what other foods an individual is eating, their unique genetics, and their overall health status.
New perspective has been provided on the relationship between saturated fat and heart risk via an article that just appeared in the American Journal of Clinical Nutrition. It argues that “saturated fat-induced raise in LDL cholesterol in healthy individuals could represent a normal rather than a pathologic response.” In other words, LDL is a molecular shuttle that packages cholesterol to facilitate what they term “adaptive homeostatic adjustments that serve to maintain cell membrane fluidity and hence optimal cell function.”
For my part, I keep eating generous portions of eggs, grilled meats, chicken with the skin on, rich coconut milk, macadamia nuts, and occasional grated full-fat cheese for my meat tacos—all rich in saturated fats. I’m encouraged by the fact that at age 65, an EBT heart scan revealed that I had zero coronary artery calcium, despite the fact that my cholesterol flirts with the “danger zone” in the low 200s.
I can’t in good conscience recommend that my patients follow anachronistic, top-down guidelines promoted by “experts” at the World Health Organization or the American Heart Association. They undermine their credibility and public confidence by hewing to the misguided recommendation that people avoid saturated fat.
To close, from a book I read last summer:
“Surely it was not intended that the human stomach should be loaded with the fodder of rabbits and cows, even when it has been well boiled! For what did man tame the rabbits and the cows, except that they should digest all this spinach and carrots and turn it into more concentrated food.” —Presidential Mission by Upton Sinclair (1947)
Updated February 2021
Though we think of declining estrogen as the hallmark of menopause, it's actually common for…
Up to 12 percent of Americans have ulcers at some point in life. Peptic ulcers…
Gallbladder disease is a modern illness. An estimated 20 million Americans have gallbladder disease. The…
Fragrant memories: One of the most remarkable stories of the summer comes to us from researchers at the…
Q: My daughter is seriously considering having the silver fillings in her teeth removed in…
In a previous article, I highlighted Americans' lamentable lack of health literacy and challenged readers to…
Leyla Weighs In: Sucralose (Second in a Series)
Our virtual voicemail is open 24/7, so there's no need to wait to submit your questions for Dr. Hoffman. Leave a message, and you may hear your question featured on the Intelligent Medicine radio program!