Dr. Ron’s Research Review – June 14, 2017

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This week’s research review is a book review of The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet by Nina Teicholz

The Big Fat Surprise upends conventional wisdom about fats with the groundbreaking claim that more, not less, dietary fat, including saturated fat, leads to better health, wellness, and fitness.

Ancel Benjamin Keys proposed the so-called “diet-heart hypothesis” that convinced a generation to avoid fat and turn instead to sugar, carbohydrate and processed vegetable oils. (Andrade et al., 2009)
The “low-fat” diet has come under considerable fire based on recent studies.
Dietary guidelines should shift focus away from reducing saturated fat, and from replacing saturated fat with carbohydrates, specifically when these carbohydrates are refined. To reduce the burden of CHD, guidelines should focus particularly on reducing intake of concentrated sugars, specifically the fructose-containing sugars like sucrose and high-fructose corn syrup in the form of ultra-processed foods and beverages. (DiNicolantonio et al., 2016)

Teicholz also argues that the Mediterranean Diet is not the healthiest because if its overuse of olive oil, which was the result of influence by the olive oil industry funding.
Olive oil was seldom used in traditional Italian cooking. For instance, it is only mentioned as a substitute for butter in the recipe for Pasta Marinata and as a rub in Fillet of Beef in The Cook’s Decameron Italian dishes (Waters, 1901). 
In 1952 the Pastene Company published Recipes For Tasty Dishes Cooking with Olive Oil, similar to The Crisco Cookbook (1912) that promoted hydrogenated shortening.

Teicholz recommends fats with the most saturation and least processing. Saturated fats include dairy, eggs, meats and coconut oil. Monounsaturated fats include lard, chicken and duck fat, and olive oil. Polyunsaturated omega-6 fats include corn and soybean oil. Chemically processed oils include peanut and canola oil, plus the omega-3 fish and flaxseed oils.

Dr. Ron


 

Articles

Ancel Keys and the lipid hypothesis: From early breakthroughs to current management of dyslipidemia
            (Andrade et al., 2009) Download
Starting in the 1940s pioneering American physiologist Ancel Keys helped establish the epidemiological link between cholesterol and cardiovascular disease. Once Keys and others clarified the role of dietary saturated fat in disease development, early intervention studies examined the effects of diet and drug therapy. In the 1990s large trials of statins confirmed the benefits of lipid-lowering therapy for primary and secondary prevention of  ...

The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease.
            (DiNicolantonio et al., 2016) Download
Dietary guidelines continue to recommend restricting intake of saturated fats. This recommendation follows largely from the observation that saturated fats can raise levels of total serum cholesterol (TC), thereby putatively increasing the risk of atherosclerotic coronary heart disease (CHD). However, TC is only modestly associated with CHD, and more important than the total level of cholesterol in the blood may be the number and size of low-density lipoprotein (LDL) particles that contain it. As for saturated fats, these fats are a diverse class of compounds; different fats may have different effects on LDL and on broader CHD risk based on the specific saturated fatty acids (SFAs) they contain. Importantly, though, people eat foods, not isolated fatty acids. Some food sources of SFAs may pose no risk for CHD or possibly even be protective. Advice to reduce saturated fat in the diet without regard to nuances about LDL, SFAs, or dietary sources could actually increase people's risk of CHD. When saturated fats are replaced with refined carbohydrates, and specifically with added sugars (like sucrose or high fructose corn syrup), the end result is not favorable for heart health. Such replacement leads to changes in LDL, high-density lipoprotein (HDL), and triglycerides that may increase the risk of CHD. Additionally, diets high in sugar may induce many other abnormalities associated with elevated CHD risk, including elevated levels of glucose, insulin, and uric acid, impaired glucose tolerance, insulin and leptin resistance, non-alcoholic fatty liver disease, and altered platelet function. A diet high in added sugars has been found to cause a 3-fold increased risk of death due to cardiovascular disease, but sugars, like saturated fats, are a diverse class of compounds. The monosaccharide, fructose, and fructose-containing sweeteners (e.g., sucrose) produce greater degrees of metabolic abnormalities than does glucose (either isolated as a monomer, or in chains as starch) and may present greater risk of CHD. This paper reviews the evidence linking saturated fats and sugars to CHD, and concludes that the latter is more of a problem than the former. Dietary guidelines should shift focus away from reducing saturated fat, and from replacing saturated fat with carbohydrates, specifically when these carbohydrates are refined. To reduce the burden of CHD, guidelines should focus particularly on reducing intake of concentrated sugars, specifically the fructose-containing sugars like sucrose and high-fructose corn syrup in the form of ultra-processed foods and beverages.

 

References

Andrade, J, et al. (2009), ‘Ancel Keys and the lipid hypothesis: From early breakthroughs to current management of dyslipidemia’, BCJM, 51 66-72. PubMed:
DiNicolantonio, JJ, SC Lucan, and JH O’Keefe (2016), ‘The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease.’, Prog Cardiovasc Dis, 58 (5), 464-72. PubMed: 26586275