Saturated Fat—Not the cause of Heart Disease
In 1953, Ancel Keys came up with a theory that saturated fat intake increased risk for heart disease. His theory was never proven (with a complete, scientific study), but it started a snowball, and became the newest big thing. There were actually many scientists at the time who disagreed, but as the idea gained more and more momentum, and was taken on board by government, those who opposed were disregarded.
We now have loads of evidence discrediting the theory, however, it’s very slow for people to take it on. I’m sure nobody wants to admit to such a blunder. It’s so ingrained in our society; it would take a lot of guts to say, ‘Hey, we were wrong; let’s change our entire diet.’
Many studies have been initiated to prove Ancel’s theory, but all of them have ended up proving the opposite. The scientific foundation of the current ‘low-fat’ dietary advice has fallen, with no evidence to support the idea. It is only a matter of time before everyone is aware of this fact, and every health professional will have to acknowledge it. Quite a few doctors all over the world are now re-educating people that fat was never the issue. Here is a history of the major scientific studies:
1972 – Minnesota coronary study. Result: Cholesterol-lowering diet causes greater mortality
The Minnesota Coronary Study was done as early as 1972 and showed that people on a cholesterol-lowering diet had significantly greater mortality than those on a regular diet. Did we hear about it? No. The results were finally published in 1989. 17 years later! When interviewing Ivan Frantz Jr, Gary Taubes asked why the results weren’t published in 1972, and the response was “We didn’t like the results.” Ancel Keys was a collaborator for the study.
1944 – Multiple risk factor intervention trial. Result: Reducing saturated fat intake no effect on preventing heart disease.
The group following the intervention reduced their cholesterol consumption by 42%, saturated fat by 28%, and it had no effect on preventing heart disease.
“The overall results do not show a beneficial effect on coronary heart disease or total mortality from this multifactor intervention.”
1988 – Attempt to prove sat fat caused heart disease. Result: Project cancelled after 11 yrs – no evidence
In 1988, the surgeon general’s office (head of the Public Health Service Commissioned Corps (PHSCC)) decided to gather all the evidence linking saturated fat to heart disease. In 1999, after 11 years, they were unable to prove it, and they killed the project. The comment from Bill Harlan was “The report was initiated with a preconceived opinion of the conclusions, but the science behind those opinions was clearly not holding up. Clearly the thoughts of yesterday were not going to serve us very well.”
No report was ever released, but Gary Taubes (science journalist educated at Harvard and Stanford) interviewed the people involved in the project: Marion Nestle, who helped launch the project and now runs the nutrition and food studies department at New York University (NYU), and Bill Harlan, a member of the oversight committee and associate director of the Office of Disease Prevention at NIH. I spoke to Gary personally, but the findings are also documented here:
Science 30 March 2001:
Vol. 291. no. 5513, pp. 2536 – 2545
1990 – Review existing data on relations between mortality rates and cholesterol levels. Result – Those with the lowest cholesterol levels had highest mortality.
Conference to review and discuss existing data on U-shaped relations found between mortality rates and blood total cholesterol levels (TC). Study done on 1 million people. Largest analysis of effects of cholesterol on mortality that has ever been done.
1991 – Long-term Mortality After 5-Year Multifactorial Primary Prevention of Cardiovascular Diseases in Middle-aged Men. Result: Cholesterol-lowering diets twice as likely to cause death
Following up after the initial study (which was considered a success at proving the diet-heart hypothesis because heart disease ‘risk factors’ like cholesterol levels were reduced), they discovered that those who had continued with the cholesterol-lowering diet were twice as likely to die from heart disease.
“As a multiple intervention against risk factors for coronary heart disease in middle-aged men at only moderate risk seem to have failed to reduce both morbidity and mortality such interventions become increasingly difficult to justify. This runs counter to the recommendation of many national and international advisory bodies which must now take the recent findings from Finland into consideration. Not to do so may be ethically unacceptable.” Professor Michael Oliver
1999 – largest diet-heart trial ever conducted. Result: Fat intake doesn’t affect cholesterol
The Lyon Diet Heart Study by the French National Institute of Health and Medical research. 605 heart attach survivors, on two different diets. Both groups consumed completely diff amounts of fat, but the HDL, LDL and total cholesterol levels in the two groups remained virtually identical.
2001 – Study attempting to prove cholesterol should be kept low. Result: Worst mortality rates in those maintaining low cholesterol
Starting with the premise that choleseterol should be kept low to lessen risk of heart disease, they studied cholesterol levels for 20 years and compared them to mortality. Low cholesterol levels had a significant association with mortality. The worst mortality rates in those who maintained low cholesterol for significant periods of their life.
“We have been unable to explain our results. These data cast doubt on the scientific justification for lowering cholesterol to very low concentrations (<4.65 mmol/L) in elderly people.”
2004 – Study looking at impact of cholesterol levels on mortality. Result: Low cholesterol significantly associated to mortality
15 year study. In men, across the entire age range (25 to 90), and in older women, low cholesterol level was significantly associated with all-cause mortality, showing significant associations with death through cancer, liver diseases, and mental disease.
2005 – Study to determine whether fat intake increases risk for heart disease or cancer deaths. Result: High fat diets don’t increase mortality from either heart disease or cancer.
“Objective: Most current dietary guidelines encourage limiting relative fat intake to <30% of total daily energy, with saturated and trans fatty acids contributing no more than 10%. We examined whether total fat intake, saturated fat, monounsaturated, or polyunsaturated fat intake are independent risk factors for prospective all-cause, cardiovascular and cancer mortality.”
“Result: With the exception of cancer mortality for women, individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality. Current dietary guidelines concerning fat intake are thus generally not supported by our observational results.”
Researcher’s conclusions: “With our results added to the pool of evidence from large-scale prospective cohort studies on dietary fat, disease and mortality, traditional dietary guidelines concerning fat intake are thus generally not strongly supported”
2006 – Low-Fat Dietary Pattern and Risk of Cardiovascular Disease. Result: Dietary intervention died not reduce risk of CHD or stroke.
Objective: To test the hypothesis that a diet low in fat and high in vegetables, fruits, and grains to reduce cancer, would reduce CVD risk. Result: Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors.
Even with these blatantly obvious results, members of the conventional medical community made statements like this to explain away the results:
“There may have been some ‘disappointment’ that the studies didn’t always give clear answers, the findings are what they are… Now we’re in a second wave of putting the findings into perspective”.
And “Numerous studies have confirmed there are huge heart benefits from maintaining a healthy lifestyle which involves a balanced diet and regular physical activity. It is easy to identify a number of important reasons why this study did not agree with previous research.” None of those important reasons were identified.
2009 – Saturated fat not associated with heart disease mortality
Intake of saturated fat was not significantly associated with cardiovascular disease mortality, cardiovascular events, or death from cardiovascular disease.
2010 – Study. Result: No correlation between sat fat intake and heart disease
The study pooled data from 21 studies, including 348,000 adults, surveyed dietary habits and health events from five to twenty-three years, and found no difference in the risks of heart disease and stroke between people with the lowest and highest intakes of saturated fat.
2011 – Study. Result: Fat intake had no impact on heart disease
Study to determine whether reduced dietary fat prevented heart disease, July 2011. Results: “There were no clear effects of dietary fat changes on total mortality or cardiovascular mortality”
2011 – Study. Result: Cholesterol is good for us.
Researchers find that ‘bad’ cholesterol is actually good for us.
2011 – Study – health benefits of coconut oil
Studies show coconut oil helps women lose weight and elevates good cholesterol.
2012 – Systematic review and meta-analysis of randomised controlled trials on effects of low-carb diets on cardiovascular risk factors.
Low carb diets had favourable effects on weight and cardiovascular risk.
2013 – Study – Result: Replacing saturated fat with vegetable oils increases risk for heart disease and death
“Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.”
2014 – Replacing saturated fat with polyunsaturated fat does not reduce heart disease risk
“Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”
2014 – No evidence that reducing fats is beneficial for secondary prevention of heart disease
A Systematic review, meta-analysis and meta-regression on randomised controlled trials comparing reduced/modified fat diets with control diets. “Recommending higher intakes of polyunsaturated fatty acids in replacement of saturated fatty acids was not associated with risk reduction.”
2015 – Statins increase risk of heart disease
“We have collected a wealth of information on cholesterol and statins from many published papers and find overwhelming evidence that these drugs accelerate hardening of the arteries and can cause, or worsen, heart failure.”
“The hypothesis that Statins protect the heart by lowering cholesterol is flawed and that high cholesterol is not necessarily linked to heart disease.”
“I cannot find any evidence to support people taking Statins and patients who are on them should stop.” Lead Researcher, Dr Okuyama
Dr Peter Langsjoen, a heart specialist in Texas and co-author of the study, says, “Statins are being used so aggressively and in such large numbers of people that the adverse effects are now becoming obvious. These drugs should never have been approved for use. The long-term effects are devastating.”
2015 – Saturated fats not associated with all cause mortality, cardiovascular disease, heart disease, stroke, or type 2 diabetes.
Trans fats were associated with all cause mortality, cardiovascular disease, heart disease mortality.
2016 – No evidence that replacing saturated fat with unsaturated reduces mortality from heart disease
Re-evaluation of the Minnesota Coronary Experiment (randomised controlled trial done between 1968 and 73).
2016 – Replacing saturated fat with carbohydrate not favourable for heart health.
Added sugars effect CHD risk more than saturated fat.
2017 – Replacing saturated fat with mostly unsaturated is unlikely to reduce cardiovascular events.
A meta-analysis of adequately controlled randomised controlled trials showed no effect for reducing cardiovascular events, cardiovascular event mortality or total mortality. “Available evidence from randomized controlled trials provides no indication of benefit on coronary heart disease or all cause mortality from replacing saturated fat with linoleic acid rich vegetable oils.”
2017 – Editorial written by three cardiologists: Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition
“It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food.”
Food affects behaviour and learning
- Study – Processed food impacts IQ. Study published by Journal of Epidemiol Community Health
- Scientific studies – food additives and colours affect children’s behaviour and make it difficult to concentrate. Two recent studies sponsored by the British government, each involving almost 300 children. Their results were even more startling: Artificial food dyes (in combination with a common preservative) could make even children with no known behavioural problems hyperactive and inattentive. The FDA is now investigating whether they should make changes. Abstract not available, but FDA has announced they are investigating based on the studies.
- Study – Junk food lowers IQ.
1948 – today – Framingham Heart Study. Result: No association between fat intake and heart disease. No association between fat intake and cholesterol.
Longest running study, which started in 1948 and is still going (longest heart study that has ever been done).
“In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people’s serum cholesterol.” Dr William Castelli, director of the Framingham Study, 1992. The researchers also stated that they found no association between fat intake and coronary disease.
1989 – Cholesterol as risk factor for mortality in elderly women. Result: Mortality 5.2 times higher with low cholesterol levels
“Mortality was lowest at serum cholesterol 7.0 mmol/l, 5.2 times higher than the minimum at serum cholesterol 4.0 mmol/l”
Mortality was 5.2 times higher with the low cholesterol of 4.0 as opposed to the ‘high’ cholesterol of 7.0.
1991 – Serum cholesterol-coronary heart disease relationship. Result: no overall relationship between serum cholesterol level and coronary heart disease risk
“Although coronary heart disease remains a leading cause of death and disability in old age, the relationship of serum cholesterol level to risk of coronary heart disease in old age is controversial. Data for 2,388 white persons aged 65-74 … were examined to determine the relationship of serum cholesterol level to coronary heart disease incidence …there was no overall relationship between serum cholesterol level and coronary heart disease risk in either men or women.”
1992 – Association of Serum Cholesterol with Mortality. Result: High cholesterol levels decreases risk of mortality during first 10 yrs of follow-up
“During the first 10 years of follow-up…men with high cholesterol levels had lower all-cause mortality… because of their low cancer mortality”
1995 – Study – cholesterol, blood pressure, and stroke. Result: No association between cholesterol levels and stroke.
Study done over 16 years, on 450,000 people, and 13,000 strokes (between them). “There was no association between blood cholesterol and stroke”
1995 – Low serum total cholesterol concentrations and mortality. Result: Lower cholesterol directly linked to greater mortality.
“Low serum cholesterol concentrations (< 4.8 mmol/l), present in 5% (n = 410) of the men, were associated with the highest mortality from all causes, largely due to a significant increase in cancer deaths (age adjusted relative risk 1.6 (95% confidence interval 1.1 to 2.3); < 4.8 v 4.8-5.9 mmol/l) and in other non-cardiovascular deaths (age adjusted relative risk 1.9 (1.1 to 3.1)).”
1995 – Lack of association between cholesterol and coronary heart disease mortality. Result: High total cholesterol and low HDL (good) cholesterol not associated with increased heart disease or mortality
“Elevated total serum cholesterol level, low HDL-C, and high total serum cholesterol to HDL-C ratio were not associated with a significantly higher rate of all-cause mortality, coronary heart disease mortality, or hospitalization for myocardial infarction or unstable angina after adjustment for cardiovascular risk factors.”
Conclusion: “Our findings do not support the hypothesis that hypercholesterolemia or low HDL-C are important risk factors for all-cause mortality, coronary heart disease mortality, or hospitalization for myocardial infarction or unstable angina in this cohort of persons older than 70 years.”
1998 – Total cholesterol and risk of mortality in the oldest old. Result: High cholesterol associated with longevity
“In people older than 85 years, high total cholesterol concentrations are associated with longevity owing to lower mortality from cancer and infection.”
2002 – Study to determine the effect of a low-carb, high fat diet on body weight and cholesterol. Result: Sustained weight loss and significant reduction in cholesterol.
To determine the effect of a 6-month very low carbohydrate diet program on body weight and other metabolic parameters. Low carb, high fat.
Serum total cholesterol level decreased, LDL decreased, triglyceride level decreased, HDL increased. There were no .A very low carbohydrate diet program led to sustained weight loss during a 6-month period.
2002 – Total and HDL cholesterol and risk of stroke. Result: No association between cholesterol levels and stroke.
“This analysis of the EUROSTROKE project could not disclose an association of total cholesterol with fatal, non-fatal, haemorrhagic or ischaemic stroke.”
2003 – classical risk factors and their control in coronary patients. Results: Elevated cholesterol not associated with higher mortality.
“smoking, previous coronary heart disease and diabetes proved significant predictors of total, cardiovascular (CVD) and coronary heart disease (CHD) mortality. Obesity, low education, raised blood pressure, elevated total cholesterol and low HDL cholesterol, however, were not significantly associated with higher mortality rates.”
The obvious results were again explained away, “Failure to find statistically significant associations between other classical risk factors, such as blood pressure and plasma lipid levels, and mortality may be related to the extensive use of antihypertensive and lipid-lowering drugs in this cohort.”
2004 – Study comparing the effects of a low-carbohydrate, high fat diet on LDL levels. Result: High fat diet decreased LDL levels
Study designed to prove that the Atkins high fat, low carb diet was dangerous. The conventional (fat and calorie restricted) diet and the Atkins diet were compared, using obese subjects. Results: Subjects on the high fat, low carbohydrate diet had a greater decrease in LDL levels.
2004 – Study to compare the effects of a low-carbohydrate, high fat diet with those of a low-fat, low-cholesterol, reduced-calorie diet. Result: High fat, low carb diet greater weight loss and showed a significant reduction in cholesterol.
Compared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.
2006 – Effect of high fat, low carb diet on blood cholesterol levels. Result: LDL levels remained unchanged. LDL particles changed to larger, healthier LDL particles.
While the diet did not lower total LDL cholesterol, it did result in a shift from small, dense LDL to large, buoyant LDL, which could lower cardiovascular disease risk.
Westman studied 120 overweight volunteers, who were randomly assigned to the Atkins diet or the heart association’s Step 1 diet, a widely used low-fat approach. On the Atkins diet, people limited their carbs to less than 20 grams a day, and 60% of their calories came from fat.
“It was high fat, off the scale,” he said.
After six months, the people on the Atkins diet had lost an average of 31 pounds, compared with 20 pounds on the AHA diet, and more people stuck with the Atkins regimen.
Total cholesterol fell slightly in both groups. However, those on the Atkins diet had an 11% increase in HDL, the good cholesterol, and a 49% drop in triglycerides. On the AHA diet, HDL was unchanged, and triglycerides dropped 22%. High triglycerides may raise the risk of heart disease.
While the volunteers’ total amounts of LDL, the bad cholesterol, did not change much on either diet, there was evidence that it had shifted to a form that may be less likely to clog the arteries.
Sugar/Fructose – the real culprit behind heart disease and other modern disease
Sugar (including fructose) is toxic and causes heart disease, diabetes, cancer and more. Not because of the calories. “our excessive consumption of sugar is the primary reason that the numbers of obese and diabetic Americans have skyrocketed in the past 30 years,” says Dr Lustig.
Robert H. Lustig, MD, is the UCSF Professor of Pediatrics in the Division of Endocrinology, presented the University of California Osher Centre for Integrative Medicine.
Dr Lustig’s published findings:
The Fructose Epidemic – Excess sugar and fructose primary contributor to human disease. Low-fat movement increased carbohydrate consumption, which coincided with obesity epidemic.
Fructose: Metabolic, Hedonic, and Societal parallels with Ethanol – Most people consider fructose and sugar just empty calories. Fructose causes specific biologic effects, beyond the caloric intake, causing metabolic syndrome, which has been shown to contribute to cardiovascular disease and many other health issues.
The role of Fructose in the pathogenesis of NAFLD and the metabolic syndrome – Excess fructose and sugar consumption a direct link to instances of Fatty Liver Disease (NAFLD).
Just a spoonful of sugar helps the blood pressure go up – Current over-consumption of fructose directly linked to cardiovascular issues, including hypertension.
Fructose, Sugar, and Childhood Obesity – Excess fructose consumption linked directly to childhood obesity.
2011 – Study – Excess fructose linked directly to increased heart disease risk
Consumption of excess fructose and sugar increased risk factors for cardiovascular disease.
2010 – Study – Refined carbohydrates linked to heart disease
Too much bread and refined carbohydrates causes heart disease. Women who ate the most high glycemic foods had more than double the risk of developing heart disease as women who ate the fewest.
2011 – Study – Alzheimer’s linked to sugar intake
Alzheimer’s linked to insulin resistance and blood sugar. Source is an interview with Dr. Larry McCleary, 19th Annual World Congress on Anti-Aging and Aesthetic Medicine, held in Orlando, FL, April 7-9, 2011, discussing the results of his studies.
2009 – Studies – fructose and sugar consumption increases risk for modern disease
Dr Richard Johnson clinical trial showing fructose and sugar increases risk for diabetes, high blood pressure, kidney disease, and obesity.
“We’ve just finished a clinical trial where we gave a low fructose diet to overweight and obese adults from Mexico City.” Dr. Johnson says.
“We tried two different low fructose diets, but first, before we go into that, we think that the effects of fructose are independent of its energy intake. So, table sugar (sucrose) — which contains fructose and glucose — although there is a caloric component, we think that the effects of fructose are not specifically related to the calories but rather to its mechanism, of which uric acid is a driving part.
… [Uric acid levels] being too high seems to really increase the risk for diabetes and high blood pressure, kidney disease and obesity. And in fact, there are more and more papers coming out showing that connection.”
Study abstract: Johnson RJ, Perez-Pozo SE, Sautin YY, Manitius J, Sanchez-Lozada LG, Feig DI, Shafiu M, Segal M, Glassock RJ, Shimada M, Roncal C, Nakagawa T. Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes? Endocr Rev 2009; 30: 96-116
Studies consistently show that low-carb diets outperform low-fat, calorie controlled diets. Most show a greater loss with the low-carb diet, and those that show the same loss show a greater improvement in cholesterol profile and/or glycemic control in the low-carb group.
- Adiponectin Changes in Relation to the Macronutrient Composition of a Weight-Loss Diet. 2011
- Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents. 2010
- The effect of a low-carbohydrate, ketogenic diet versus a low- glycemic index diet on glycemic control in type 2 diabetes mellitus. 2008
- Weight loss with a low-carbohydrate, mediterranean, or low-fat diet. 2008
- Comparison of the Atkins, Zone, Ornish, and learn Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. The a to z Weight Loss Study: A Randomized Trial. 2007
- A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. 2007
- Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes–a randomized controlled trial. 2006
- Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High- Protein vs High-Carbohydrate/Low-Fat Diet. 2005
- The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat. A Randomized Trial. 2004
- Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. 2004
- A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia. A Randomized, Controlled Trial. 2004
- A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. 2003
- A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity. 2003
- Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. 2003