Saturated fats, or those fats originating from animal products, have long been implicated in the development of coronary heart disease (CHD). One recent study, claims that the dietary recommendations against eating saturated fat are not supported by current evidence. So, what does this all mean? Should we be ignoring recommendations from heart and nutrition specialists and allow butter, bacon and cream to enter our fridges?
First, let’s look at the study that reignited the saturated fat is good conversation. The controversial work published in the Annals of Internal Medicine reviewed data from a large number of studies that examined the relationship between dietary fat and CHD. What it found was that when comparing those who consumed the highest amount of saturated fats to those who consumed the lowest amount, there was no difference in heart disease rates. Other fats were examined in this study, too. However, these results seem to have been overlooked by the general media. The researchers found that polyunsaturated fats (omega 3 and omega 6 fats found in fish, nuts and vegetable oil) were associated with a lower risk of coronary heart disease while monounsaturated fats (found in avocados, and olive and grapeseed oil) had no effect. The only fat examined that had a truly negative effect were trans fats, which are derived from hydrogenated oils.
Back to the saturated fat part of the study as this is what has been causing much of the debate. Fats in this study were compared as a percentage of calories. This means that the only other components that can make up the remaining percentages are either protein or carbohydrates. When we look at consumption trends, several studies show that a decreased dietary intake of saturated fat brings on an increase in carbohydrates, particularly refined carbohydrates found in baked goods, crackers, and other snack foods. So, instead of rejoicing in saturated fats, we should perhaps be highlighting the fact that dietary patterns high in refined carbohydrates may be just as bad as those high in saturated fats with respect to heart disease. In fact, a 2010 literature review concluded this very notion. It found that there was no significant change to cholesterol levels when saturated fats and carbohydrates were interchanged. From some of the media reports on this current study you would think the researchers found that saturated fats were good for your health. The truth is that the study never concluded that saturated fats don’t cause heart disease, nor did it say that they are good for your health. They simply concluded that their data did not support being so restrictive of saturated fats. Other research, as well, has come to this same conclusion.
While we are not advocating to completely disregard previous guidelines, this new study does bring into question whether or not we need to put so much emphasis on restricting all saturated fats in our diet. The debate between whether saturated fats are good or not is quite polarized; it's all or nothing issue for some it seems. Instead of deciding whether saturated fats are good or bad, because you can find arguments for both sides, perhaps it’s best to take a more moderate approach on the subject. The best dietary approach is probably somewhere in between the two extreme views. And as such, here are some recommendations to help you make dietary choices in light of this new evidence. And yes, you can still enjoy butter.
Avoid trans fats. Period.
There is nothing good about trans fats. Period. Trans fats are a result of adding hydrogen to vegetable oils, and hence called hydrogenated oils. They were developed to replace saturated fats in our commercially produced foods to extend shelf life, however, they have turned out to be even worse than saturated fats because they lower the good cholesterol and increase the bad. This “new and improved” product ended up backfiring on us. So, check the food labels on the products you buy. Avoid anything that is made with hydrogenated or partially hydrogenated oils. These products ALL contain trans fats, even if the nutrition label reads 0 grams of trans fats. According to labeling laws, a food manufacturer can round a number down to 0, if there is less than 0.5 grams of a substance. This means that if a product contains 0.4 grams of trans fats, the label can say 0 grams.
Ditch the ‘low fat’, ‘no fat’ options.
When we first suspected a causal relationship between CHD and saturated fat, we didn’t replace our high fat foods with heart healthy fats, or extra portions of vegetables and legumes, but with trans fat laden hydrogenated oils and low-fat knock-offs of fat containing foods. You know the products, the low fat or fat free peanut butter, ice cream, yogurt, and cookies that populate the center aisles of the grocery store. In order to make these products lower in fat, they didn’t just take out the fat but they added additional carbohydrates to give the product the same consumer appeal as the original. We have since learned that trans fats and refined carbohydrates (especially those found in prepackaged meals, cookies, crackers and sweets) contribute to the elevation of cholesterol, perhaps even more so than that of saturated fats.
Choose whole foods rather than processed foods.
The problem when we point fingers at a nutrient, like saturated fat, is that foods don’t consist of one, single nutrient. Saturated fats which are naturally found in meat and dairy are also found in many processed foods. Along with being nutrient poor foods, many of these processed foods not only contain saturated fats but also added sugars and trans fats. And as we know, all of these in some way have been associated with heart disease. The important thing to consider here is that it may not be a single nutrient that causes heart disease. Perhaps, we need to focus on dietary patterns, like the fruit and veggie-rich Mediterranean diet which has been linked to decreased heart disease, rather than singling out specific nutrients. After all, we eat food not nutrients. So, with this sentiment, if you want to keep your heart healthy choose whole foods and skip the convenience foods.
Use butter, if you want to, but also use other oils, too.
Butter adds a certain taste profile to your dishes and you don’t necessarily need to shy away from using it. Sometimes dishes just taste better with a little bit of butter, or even coconut oil. The key here is moderation and variety. And by variety, we mean switching up the fats you use in your kitchen. Oils like olive, grapeseed and canola are great alternatives. There is also evidence that replacing dietary saturated fats, like butter, with poly- and monounsaturated fats, like canola oil and olive oil, reduces ‘bad’ cholesterol levels and coronary heart disease risk. Even the Annals of Internal Medicine study found that unsaturated fats, and in particular omega 3 fats, were associated with a decreased risk of CHD.
Choose grass fed meat and dairy products, when possible.
You’ve heard the saying “you are what you eat”, and this is not only true for humans but for animals as well. Studies show that pasture fed cows have more favourable types of fat than those fed a corn heavy feedlot diet. Grass fed cows tend to have higher levels of omega-3 fats, conjugated linoleic acid (another good fat) and vitamins A and E than feedlot cattle. Similarly, milk from pasture fed cows contains both higher levels of omega-3 and conjugated linoleic acid. Admittedly, the downfall of pasture fed meat and dairy is the higher cost but it may be worth it to shell out a few extra buck to get the healthier products. Planning a few vegetarian meals each week not only frees up a little extra cash for better quality meat and dairy but also injects some heart healthy fiber into your dietary regime.
Eat omega-3 fish twice a week.
Not only does adding fish a few times a week to your meal plan create much needed variety but it also has the potential to provide you with an boost of anti inflammatory, cholesterol lowering omega-3 fats, if you choose your fish wisely. Fatty fish, such as salmon, mackerel, trout, herring, sardines and tuna, are all sources of heart healthy omega-3 fats and can help lower your heart disease risk.
Don't ditch the whole grains.
After all this talk of refined carbohydrates driving up cholesterol and heart disease risk you may be tempted to omit carbs all together. Please don't. Carbohydrate-rich grains and cereals, particularly in their whole grain form, are still encouraged as part of a healthy diet as they are a great source of B vitamins and fiber. Choose wholewheat breads and unrefined grains like brown rice, bulger, steel cut oats, quinoa, pot barley, and amaranth most often. Limit cakes, crackers and other snack foods made with refined, white flour as these foods are more likely to have a negative impact on your health. A good rule of thumb for your grain portions is to limit them to a 1/4 of your plate, with the other 1/4 being your protein and the remaining 1/2 plate as vegetables.
Admittedly, it is hard for doctors and dietitians who have counselled time and time again against eating too much saturated fat to consider that it may not be the primary heart disease culprit. But nutrition recommendations are based on evidence-based science and we have to be open to the fact that we may not know the whole picture regarding dietary fats and heart disease. For now, there still isn’t concrete evidence that saturated fats are not associated with heart disease. However, there is some evidence that they may not be the main dietary culprit in its development. At this time, all we can do is take all the information out there from reliable sources and make reasonable recommendations.