If you are not confused and maybe even exasperated over all the flip-flops over food in recent months, we would be amazed. The latest head-spinning headline appeared in the New York Times this week: “Study Questions Fat and Heart Disease Link.”
For years doctors and dieticians had a mantra for healthy eating: Stay away from foods containing cholesterol and saturated fat; they will clog your arteries and lead to heart attacks. It was an article of faith. Most Americans believed this and embraced skim milk, low-fat yogurt and cut back on red meat.
The French, on the other hand, were loathe to give up their Brie, Camembert, paté, boeuf bourguignon and chocolate soufflé. Cardiologists were puzzled by the “French paradox.” Despite such foods rich in saturated fat, French heart attack rates have been considerably lower than those in the U.S.
The new study published in the conservative journal, Annals of Internal Medicine (March 18, 2014), has nutrition experts and physicians shaking their heads in disbelief. The authors reviewed 72 studies involving over 600,000 volunteers. These studies represented the best research available examining the relationship between diet and heart disease. The conclusion: there is no convincing evidence that a diet containing saturated fat leads to heart disease. That seems like heresy of the highest order.
The researchers also noted that polyunsaturated fats low in cholesterol such as corn or safflower oil do not appear to protect people from heart attacks. This too contradicts the nutritional principles that have reigned in the U.S. for decades.
The only culprits that stood out in this mass of data were trans fats. The researchers found a clear link between consumption of foods high in trans fats and heart disease. Americans were once encouraged to consume margarine and shortening made of hydrogenated vegetable oil loaded with trans fats on the understanding that these low-cholesterol solid fats would be better for the heart than butter or lard. Such advice now seems to have been based more on belief than evidence.
This new analysis will no doubt make many people uncomfortable. It’s only the latest, however, in a long series of reversals that have health professionals reeling and consumers roiling.
In recent years we have seen the pillars of dietary dogma collapsing. Here is a list:
Before, cholesterol-laden yolks were thought to clog your arteries and lead to heart disease.
Now, eggs are considered an excellent source of high-quality protein.
Coconuts and avocados:
Before, these foods were off limits because of high saturated fat content.
Now, they are considered OK with potential health benefits.
Before, these were high fat treats, thought to raise cholesterol, heart attack risk and cause weight gain.
Now, nuts are known to contain good fats and data prove people who eat nuts lower their risk of heart attacks!
Before, shrimp were believed to be sinful, high in cholesterol and dangerous for those at risk of heart disease.
Now, they are considered a good source of protein and raise good HDL cholesterol.
Before, butter was a no-no because it is high in sat fat and cholesterol.
Now, butter is better than margarine made from trans fats.
Before, salt was bad, raising blood pressure and causing heart disease.
Now, data indicate that there is a sweet spot. Going too low on sodium increases the risk of death!
Before, people were told to lay off the java because it raises blood pressure and harms the heart.
Now, coffee is a known source of dietary antioxidants. It helps prevent diabetes and may partially protect against neurological diseases like Parkinson’s and dementia.
Before, chocolate was frowned upon as fattening and bad for the skin. It was also viewed as contributing to indigestion and reflux by relaxing the lower esophageal sphincter. Chocolate was featured on many lists of foods that people prone to migraine should avoid.
Now, chocolate with more cocoa flavanols than sugar is known to relax blood vessels and lower blood pressure. It may help maintain good cognitive function and reduce the risks of stroke and heart attack. While some individuals may find that chocolate triggers reflux or a migraine, most people handle it without difficulty.
Whole Milk, Cream & High-Fat Yogurt:
Before, high-fat dairy foods were believed to contribute to heart disease and obesity.
Now, studies show that both kids and adults who consume high-fat dairy are actually skinnier than those who consume skim milk and low-fat dairy products. The new research (above) shows that saturated fat found in high-fat dairy does not cause heart disease.
What are we to make of all the food confusion? If there is a take-home message from all this, it is that evidence trumps belief. For decades “experts” have made assumptions about various foods. Because egg yolks contained cholesterol, they decided that eggs caused heart disease, without any data to support that hypothesis. When research actually revealed that eggs do not cause heart disease, there has been a begrudging retreat from the hard line advice to shun eggs. But old ideas die hard. There are still many health professionals who caution against eating foods like avocados, nuts and shrimp, despite data to the contrary.
We suspect that the evidence from the new meta-analysis about saturated fat and heart disease will be challenging for most people to accept. After all, it contradicts everything we have been told about a heart-healthy diet for more than 50 years. Accepting this new analysis of 72 studies involving more than 600,000 people would mean that our thought leaders and policy makers got it wrong. In such scenarios we would prefer to shoot the messengers and pretend that the data do not exist. The story is likely to disappear without a trace and many nutrition experts will pretend it never saw the light of day. Some are already proclaiming that the meta-analysis is flawed and nonsensical and should be ignored.
What should you do? We follow the advice of Robert Lustig, MD, author of the book Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease and Michael Pollen, author of In Defense of Food, An Eater’s Manifesto. They make it very clear: “EAT REAL FOOD!” If it comes in a package with a long list of unpronounceable chemical ingredients, think twice or three times! Grandmothers instinctively knew that food grown in the garden and prepared with love was better than anything produced in a factory. Joe’s mother always believed butter was better than margarine and it turns out she was right.
What do you think? We would love to get your response to this essay. How do you deal with the food flip-flops of the last several years regarding nuts, chocolate, coffee and coconut? What do you make of the new saturated fat controversy? Share your comments below.
If you agree with the mantra to “Eat Real Food!” you may find our books, Recipes and Remedies from The People’s Pharmacy and Favorite Foods from The People’s Pharmacy worth checking out. Here are links to all our publications.