Butter in paper and two bottles of different types of oil, diet-heart hypothesis

The number one dietary evil in America today is saturated fat (sat fat). Ask most doctors and nutrition experts the one thing you should remove from your diet over everything else, and you are likely to be told that red meat, butter and other sources of sat fat must go. The diet dictocrats have suggested that you should substitute PUFAs (polyunsaturated fatty acids) for sat fats. The point of the exercise is to lower blood cholesterol, which has long been thought the main culprit behind heart disease.

PUFAs are found in vegetable oils, so tens of millions of Americans have followed decades of dietary recommendations and stopped cooking with butter. Instead, they have switched to “light” oils such as safflower oil. So, how did that work out? Fortunately, we have a lovely experiment that actually provides us an answer. Between 1966 and 1973 a randomized controlled trial called The Sydney Diet Heart Study (SDHS) was carried out in Australia. This is gold-standard research that trumps the usual epidemiological studies that simply look to see what people are eating on their own and how they fare.

In this study, 458 men who had recently had a “coronary event” (a heart attack or something like it) were randomly assigned to two separate dietary groups. One group was told to carry on its usual way of eating, with the expectation that it would be using the butter and ordinary margarine that was common in Australia at that time. The other group got safflower oil and margarine made from safflower oil rich in omega 6 linoleic acid. This is the most common of the PUFAs that Americans as well as Australians consume. Back in 1978 when the study results were first published, there was no analysis of which men had more heart attacks and heart attack deaths.

Scientists recently recovered the original data, dusted them off and analyzed them (BMJ, online, Feb. 5, 2013). The results were alarming. The men who had been provided with “heart-healthy” safflower oil were 60% more likely to die during the study (17.6% of them died compared to 11.8% of the men on their usual unsupervised diets). In addition, they were 75% more likely to die of coronary heart disease (16.3% of the men on the PUFA-rich diet compared to 10.1% of the men eating butter).

Even though the men consuming omega-6 PUFAs did lower their cholesterol as the investigators had hoped, this did not save their lives. Switching to a diet rich in linoleic acid was counterproductive for preventing heart disease and cardiac mortality. Here, in their own words, are the conclusions of the Australian researchers:

“In this evaluation of data from the SDHS [The Sydney Diet Heart Study], selectively increasing the n-6 PUFA LA [omega-6 polyunsaturated fatty acid linoleic acid] from safflower oil and safflower polyunsaturated margarine increased rates of death from cardiovascular disease, coronary heart disease, and all cause mortality compared with a control diet rich in SFA [saturated fatty acids] from animal fats and common margarines. This is the first published report to show an increase in mortality from cardiovascular disease and coronary heart disease, comparing this LA [linoleic acid] intervention to the control group, and demonstrating that the magnitude of increased n-6 LA intake was associated with higher risk of death.”

These results throw the traditional diet-heart hypothesis into question and suggest that overdoing on omega-6 fatty acids in the diet might not be a good idea. In fact, it might be a bad idea! And this is not the first time vegetable oils high in omega-6 fatty acids have been called into question. The Australian investigators point out that:

“These unfavorable effects of n-6 LA shown in the SDHS are consistent with two other randomized controlled trials, in which experimental dietary conditions selectively increased n-6 LA in the place of SFAs by replacing animal fats and common margarines with corn oil. Together, these three trials provide a rare opportunity to evaluate the specific effects of increasing n-6 LA without confounding from concurrent increases in n-3 PUFAs. In a pooled analysis, the increased risks of death from coronary heart disease (hazard ratio 1.33 and cardiovascular disease (1.27) approached significance. Secondary prevention trials showed significant adverse effects of n-6 LA on coronary heart disease mortality (1.84). By contrast, pooled analysis of the four randomized controlled trials that increased n-3 PUFAs alongside n-6 LA showed reduced cardiovascular mortality (0.79).”

What that means in plain English is that using vegetable oils high in omega-6 fatty acids increased the risk of death from heart disease whereas using omega-3 fatty acids actually reduced cardiovascular mortality. Our ancestors ate meat that was raised on grass rather than corn. That food was high in omega-3 fatty acids. And people who ate a Mediterranean diet also consumed foods high in omega-3 fatty acids. Olive oil is a prime example of a heart-healthy oil.

So there you have it. The diet dictocrats have been telling people to use PUFAs like safflower and corn oil because they are supposed to be “heart healthy.” Turns out they were wrong. And according to the Australian researchers, this is especially true for people who smoke or drink, exposing their bodies to excessive oxidative stress. When breakdown products of linoleic acid are oxidized, they form nasty compounds that are likely to cause clogging of coronary arteries. They now urge caution in simply substituting omega-6 PUFAs for sat fat around the world.

Once again we have learned a painful lesson. The “experts” don’t always know what is best for us. It can take decades to unscramble dietary dogma and learn that grandma’s wisdom was right after all.

To learn more about heart-healthy food and the specifics of the Mediterranean diet we suggest our book, The People’s Pharmacy Quick & Handy Home Remedies. It is loaded with common sense solutions to common problems and details about heart healthy food.

If you are having a hard time swallowing this new information we encourage you to check out the research in the BMJ for yourself. Because it does not fit with the prevailing paradigm, it is likely to sink without a trace. But when you read the original research you will see that evidence trumps long-held dietary dogma.

[BMJ, Feb. 5, 2013]

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  1. DS

    I eat a lot of coconut oil–do all my cooking with it or butter. My HDL is 100–about the same as my triglycerides. I avoid PUFAs.

  2. SS

    I am interested in coconut oil I hear it’s good for ones health but when I read on the jar saturated fat I became confused, should I use it with my somewhat high cholesterol I was using it instead of butter I mixed it with lite olive oil beat it up and placed in a container in fridg, I hope to get information on coconut oil the best as I can.

  3. D. Owen

    Research by T. Colin Campbell and many others shows that a whole foods, plant-based diet is the healthiest way to eat. And yes, such a diet is low in saturated fat and reduces your risk of heart disease.
    Bottled vegetable oil, on the other hand, is not a whole food! Bottle vegetable oil is about as processed and refined a food product as you can consume.
    The author of this article is impressed by a study which tells people to carry on their usual way of eating while one group uses butter and ordinary margarine, and the other group got safflower oil and margarine made from safflower oil. Seriously? That’s “gold standard research?” The study sounds simplistic and reductionist to me.
    People’s Pharmacy response: This study was conducted in the 1960s. It is a “placebo-controlled” trial. That design is what makes it “gold standard research.” finding the healthiest diet, of which there may be many, is still a work in progress.

  4. Dr. Neville Wilson

    The findings from the Sydney Diet Heart Study are not new, as one of your correspondents has correctly stated.
    It is a long established fact that saturated fats raise HDL-cholesterol and lower Lp(a) thereby reducing the risk for cardiovascular disease.
    By contrast, omega-6 rich poly-unsaturated fats, when not balanced with 0mega-3 poly-unsaturated fats, have the potential for inflammatory changes in the lungs, musculo-skeletal, cardiovascular and central nervous systems.
    See my commentary on this study, “LOST AND FOUND – THE FAT FACTS” at http://www.drnevillewilson.com

  5. DH

    I hope the People’s Pharmacy will do a show about this because, frankly, this whole thing is pretty confusing and upsetting.

  6. kz

    I have used primrose oil 1,000 2xdaily for years as an antinflamatory. It’s use mainly seems to keep interstitial cystitis nearly unnoticeable for many years. It is a #6 fatty acid. I also take flax oil #3 FA and fish oil for a #9 FA.
    Is this use of primrose oil at high dose a problem? I have high cholesterol and triglycerides. There is no indication of heart disease or much of arthritis. I brought my Cholesterol down by 20 points by eliminating milk and lowering cheese intake. If Primrose oil is a problem what will help inflammation?

  7. SP

    One of the best oils for cooking at higher temperatures is grape seed oil. It is neutral in taste so it doesn’t alter the flavor of foods. and high in omega 3’3, antioxidants and minerals. It lowers bad cholesterol and raises good. I have been using it for a couple of years now and like it much better than canola. It is more expensive though, so I use canola when larger quantities are required such as for deep fat frying.

  8. RG

    What about Smart Balance spread? Been using it for years. Also big user of any kind of olive oil, even in cooking and baking with it.

  9. DH

    I’m with you, MK. Smart Balance is not the same as margarine.
    I don’t have a dog with which to do the “dog test”, I’ve heard olive oil is not good to use at high heat and, depending on the food it isn’t always suitable, due to taste. Butter can also burn at high heat. For instance, what kind of oil would one use to pop popcorn if you don’t enjoy air popped corn?

  10. MK

    Totally confused! Can you give a concise summary & your recommendation much like you did on the calcium alert article. thanks……

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