Trans-fats, found in many fast foods, bakery products and margarines, are generally accepted as contributing to increased cardiovascular disease. But what about saturated fats? Don’t we all ‘know’ that they are also bad for us? Not so much.
For the past four decades we have been inundated with the message that saturated fat must be removed from our diets lest we develop heart disease. This message stems from a landmark study referred to as the ‘seven countries’ study in 1970 which found that a correlation existed between the incidence of coronary heart disease and total cholesterol concentrations. But we do know that correlation is not causation. Nevertheless, we were advised to cut fat intake.
In order to meet this new requirement, expectation may be more accurate, food producers reduced the amount of saturated fats in their products. But what happens when you do that? Food doesn’t taste as good; the solution is to add sugars. Unfortunately, added sugar is probably more harmful than saturated fat in our diets. Indeed, this advice has increased our cardiovascular risk.
The advice to reduce our consumption of saturated fats is not well supported by science, and it has led to overmedication of people with statins.
But the more significant risk factor is atherogenic dyslipidemia, a condition with higher concentrations of LDL, lower levels of HDL and increased triglycerides. It is also typical of metabolic syndrome (a cluster of high blood pressure, abnormal blood sugar levels and increased waist circumference) along with insulin resistance, type 2 diabetes and obesity.
Our focus on saturated fats reflects a belief that LDL cholesterol has the greatest effect on the risk of cardiovascular disease. But research finds that may not be the whole story as the drop in LDL cholesterol from reducing saturated fat intake seems to be the wrong kind implicated in cardiovascular disease.
Research into cardiovascular disease has moved from examining treating it as a standalone disease. Now we find that two-thirds of people admitted to hospital with heart attacks have metabolic syndrome but three-quarters have normal cholesterol. This suggests that total cholesterol is not really the problem. It also tells us that treating these people with statins (to reduce cholesterol) is not effective. That is not to say statins are not helpful, just that their benefit may be independent of their effects on cholesterol.
Once we integrate all of the current research we discover findings that may contradict what we thought we knew about saturated fats. That’s okay as long as we learn from it. And what do we learn? That saturated fats play much less role in cardiovascular health than we ever thought. And that efforts at prevention should reflect that fact.
Dr. Paul Martiquet is the Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.