Letter III: Aren't Saturated Fats Dangerous?

This is part III in a series of hypothetical letters to my doctor.


Dear Doctor,

In our last meeting, you expressed concern that I was eating too much saturated fat in my low carb diet, and that it might be harmful, or even cause a heart attack. This is probably the most common question I deal with when people learn I follow the low carb lifestyle. I am, however, a bit surprised that an educated person such as yourself raised the concern.

The short answer: no, saturated fats are not dangerous and when eaten as part of a proper low carb diet, they probably won't cause a heart attack. The idea that saturated fats and cholesterol lead to heart disease is called the "lipid hypothesis."  Gary Taubes wrote a whole book in 2007 debunking the lipid hypothesis. And before Taubes' book, Sally Fallon and Mary Enig wrote a book in 1999 debunking that myth. And before Fallon and Enig, Michael Eades, M.D. and his wife, Mary Dan Eades, M.D. wrote a book debunking the lipid hypothesis in 1996. All of these books delved deeply into the empirical medical literature and found no empirical evidence to support the lipid hypothesis.

But there is even more recent evidence.  Three recent studies all concluded that low carb diets actually improved markers of metabolic health. None of the three support the lipid hypothesis. Dr. Malcolm Kendrick demolishes the lipid hypothesis in 1 minute and 17 seconds. One study found no association between eating eggs and cardiovascular disease. Another study found that dairy consumption was not associated with cardiovascular disease. Yet another study showed that children who ate full fat cream and other saturated fats were healthier than children who did not.  Finally, a meta analysis of 21 studies of 348,000 people over an average of 14 years concluded there was no relationship between eating saturated fats and cardiovascular diseases such as heart attacks and stroke. Even the mainstream media is now hinting that we have been mislead by the lipid hypothesis, and that carbohydrates, not fat, may be the real problem. 

The most recent book I have read demolishing the lipid hypothesis is one you ought to read, as it is targeted to physicians. It is called The Art and Science of Low Carbohydrate Living, by Jeff Volek, Ph.D., R.D. and Stephen D. Phinney, M.D., Ph.D. This book takes you into the inner workings of the low carb lifestyle and addresses head on many of the myths surrounding it, such as the lipid hypothesis.

So thank you for your concern about my cardiovascular health, but I do not think the low carb diet which is high in saturated fats will cause me to die of a heart attack any time soon.

Sincerely,

The Art and Science of Low Carbohydrate Living

I just finished a most interesting book, called The Art and Science of Low Carbohydrate Living by Jeff Volek, Ph.D., R.D. and Stephen D. Phinney, M.D., Ph.D. The book is targeted at medical professionals who might be interested in treating patients with a low carb diet and it gives all of the ins and outs of the process. Only a couple of chapters (that went into the clinical application of low carb diets) were not relevant to me and my experience.  My verdict: I highly recommend this book.

It tackles all of the big questions (e.g., "Won't eating saturated fat cause you to have a heart attack?" or "All the weight lost on low carb diets is water weight") and outlines not only a comprehensive low carb eating plan, but also a low carb "maintenance" plan for eating, after you have lost your weight.

It is fully referenced and includes all of the pertinent studies backing up everything it claims. It also concludes with a section on healthy recipes for a high fat, moderate protein, low carb diet.

I must say, the book is well written, but it looks like it was self-published. Nevertheless, it is quite the resource. If my physician gives me any grief about my low carb lifestyle on my next visit in early September, I am tempted to recommend it, or even give it, to her.

Some gems from the book:

• A listing of diseases successfully treated with a low carb diet (e.g., high blood pressure, metabolic syndrome, type II diabetes, sleep apnea, etc.); see p. 170.
• An in-depth explanation of why a low LDL reading is not necessarily bad; see pp. 91-95.
• In the discussion of fructose (a sugar that partitions like fat), the authors have this gem: "Most energy drinks and sports beverages use sucrose or high fructose corn sweetener as their primary energy source. Given that the average exhausted athlete still has tens of thousands of fat calories in body energy reserves but is running out of carbohydrate (glycogen), why would one want to add a sugar that cannot be used for quick energy, with most of it eventually ending up as fat?" P. 57.
• The authors explain the "Whoosh" experience (where someone stays at the same weight for days, then, "whoosh," over night they lose several pounds); it is a function of water retention. You are losing fat and inches, your clothes are feeling looser, but for whatever reason, you are holding on to water. Eventually, you will lose the water. When that happens, whoosh, you have lost five pounds overnight! P. 73.
• The authors introduce the concept of "carbohydrate intolerance" (chapters 14 and 15). If you don't tolerate carbohydrates very well, restrict them. A lot of good things will happen to your health. So I can now say I am carb intolerant, and cite this book as proof.
• A maple walnut ice cream recipe (pp. 229-230).

Dairy Consumption Does Not Elevate Heart Attack Risk

According to a recent study, dairy consumption does not elevate heart attack risk, even after controlling for high and low consumption and several other factors.  The authors still fear saturated fat but suggest there are "protective" elements present in dairy products that prevent heart disease.  (They should read the first 100 or so pages of Gary Taubes' Good Calories, Bad Calories for a thorough debunking of the saturated-fat-causes-heart-disease myth).

I've mentioned before that for good health, one should consume butter and cream (and feed it to your children).  It is very nourishing.

Consume Butter and Cream

I weigh myself every day, even if I only report it on this blog once a week.  I have been trying an experiment recently, where I am consciously adding more fat to my diet and eating less protein.  I am striving for 75% fat, 15-20% protein, and the rest in carbs (5-10% for those of you bad at math).  In particular, I make sure I eat two or three eggs per day, use butter for cooking and seasoning, eat fatty cuts of meat (bacon!), and eat more cream (in sauces or whipped up and eaten with berries).  The weight keeps coming off.  Even though I do not make any attempt to count calories and eat until I am full (but I don't overeat), the weight keeps coming off.  So far this week, I have dropped 3.6 pounds.  Of course, I avoid most carbs except for green vegetables plus I am active (we walk a lot in Europe), and both of those activities contribute to the weight loss success.  But the butter and cream are great sources of fuel and help me to feel full. A recent study demonstrated that children who eat saturated fat and full cream dairy products were healthier than those who did not.

And I won't be dying from a heart attack any time soon.  Remember: saturated fats do not cause heart disease.  The fat in mothers' milk is 60% saturated and our brains are 60% fat.  If saturated fats are so bad, why is so much of it in mothers' milk?  We are designed to consume saturated fats (by evolution or our creator, whatever your belief system).  We've been around for a long time, and it's only in the past few decades that Americans in particular have become hung up on the concept of saturated fat.  And as our rates of saturated fat consumption have plunged (see table 1 in this linked document), cardiovascular disease has increased. Something does not compute.

So go ahead, eat butter and cream if you are following a low carb diet.  Don't gorge on it, and stop when you are full.  But eat butter and cream.  Put butter on your veggies, cook your meat in butter, make delicious sauces using cream for your meats, eat cream with your berries, add cream to your scrambled eggs, etc. and you will be healthier and lose weight.

Egyptian Mummies with Heart Disease

Apparently, there are some Egyptian mummies out there with heart disease.  So how did they get heart disease?  According to the "journalists" who wrote the above news story, from eating too much saturated fat and meat.  What idiots!  The Nile River valley and delta is one of the earliest sites for agriculture and a lot of agricultural products were grown and eaten there, plus a fair amount of fish.  The early Egyptian diet is well known, complete with pictures depicting fat Egyptians.  The agricultural products they grew in this lush delta region provided most of what they ate.  To blame the heart disease on meat and fat is to be seriously uninformed about agricultural and Egyptian history.

For the record, saturated fat and cholesterol does not cause heart disease.  In the past few years, numerous scientific studies in prominent medical and scientific journals have thoroughly debunked the cholesterol-in-saturated-fats-causes-heart-disease myth, as have several books.  Want heart disease?  Eat more carbohydrates and become diabetic.  Or smoke cigarettes.  Or lower your cholesterol level too far (in this study, the lowest rates of cholesterol were associated with the highest number of deaths from heart disease).  But stop blaming it on meat and saturated fats.

The Big Lie

Yesterday, I was attending an exporting conference (I live in a grain producing state) and learned a startling fact. In Sweden, consumers prefer more natural products, thus they prefer products like butter over margarine.  But in Denmark, they are criminalizing saturated fats.  Well, not really criminalizing, but they are heavily taxing saturated fats to get people to eat "more healthy" food.  The fools.

Read this article on The Big Lie about saturated fats by Michael Eades, M.D.  He also wrote this great article on the pitiful state of medical ignorance when it comes to health and nutrition.  It is a doozy, and if you have ever gone to the physician with a case of high blood pressure, high blood sugars, or high cholesterol, you will relate.

Interesting Research Articles

As I continue on my journey, I am discovering more and more scientific literature with conclusions that are startling.  Why did I not know this information before?  Nutritional public policy is way behind the times.  I spent a bit of time on the Metabolism Society web site and discovered many scientific studies on the impact of the LCD on cardiovascular disease, type II diabetes, obesity, cancer, etc.  Below are a few gems I found from this site.

Saturated Fat and Cardiovascular Disease.  A meta-analysis of 348,000 subjects over 5 to 23 years leads to this conclusion:  "[T]here is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD [coronary heart disease] or CVD [cardiovascular disease]."

Are Refined Carbohydrates Worse than Saturated Fat?  This article still believes saturated fats are bad, but it also concludes that replacing fat in the diet with refined carbohydrates is bad, too, and suggests adding more sources of vegetable fat and consuming non-refined carbs and lean protein.  It reports on a large scale study on the affects of saturated fat on myocardial infarction (MI; heart attacks) and concludes that "saturated fat intake was not associated with risk of MI compared with carbohydrate consumption" but that replacing saturated fat with refined carbs "significantly increased the risk of MI."

Low Carb Diets and Cardiovascular Disease.  Conclusion:  "A diet based on restricting carbohydrates leads to spontaneous caloric reduction and subsequent improvement in emerging markers of CVD [cardiovascular disease] in overweight/obese men who are otherwise healthy."

The Effect of a Low Carb Diet on People with Severe Type II Diabetes.  Conclusion:  "The 30% carbohydrate diet over 6 months led to a remarkable reduction in HbA1c levels, even among outpatients with severe type 2 diabetes, without any insulin therapy, hospital care, or increase in sulfonylureas.  The effectiveness of the diet may be comparable to that of insulin therapy."