One thing that practically everyone seems to know about saturated fat is that is raises cholesterol levels. My reaction to this is, so what? This attitude may sound blasé, but it's actually based on a fundamental principle: the impact a foodstuff has on cholesterol is not the important thing, it's the impact it has on health that counts.
Our focus on cholesterol levels has allowed many drugs and food products to be marketed on the basis of their cholesterol-reducing properties, in the absence of any evidence that they actually, say, reduce the risk of heart disease or death. Classic examples of this include foods laced with cholesterol-reducing compounds known as 'sterols', and the drug ezetimibe. I've written about both of these things more than once on this site.
I've become aware that the focus on cholesterol is so ingrained, it has left people blind to the real goal of modifying one's diet or taking drugs. Even when I ask people what the point of reducing their cholesterol level is, most seem unsure or unaware. In other words, we've become so brainwashed into believing that cholesterol reduction is the Holy Grail, we are sometimes incapable of thinking beyond that.
Getting back to saturated fat, what good evidence is there that this causes heart disease? Actually, there is none. The mass of evidence simply does not link saturated fat consumption with heart disease. Such evidence (what is known as 'epidemiological' evidence) goes a long way to vindicating saturated fat, but it's not as conclusive as the results of 'intervention' studies - where individuals reduce or modify the fat in their diet to see what impact this has on their risk of disease and death.
Many studies of this type have been conducted over the last few decades. These were reviewed back in 2000 by a group of British researchers [1]. This review was actually a 'meta-analysis' (grouping together of similar studies) of 27 individual studies. The results revealed that modification of dietary fat did not lead to a significant reduction in either deaths due to cardiovascular disease or overall risk of death.
This meta-analysis was recently brought up-to-date by the same group of researchers [2]. Another decade's worth of data was added in the form of another 21 studies. The studies in this review basically came in three forms:
- studies where fat intake was reduced (usually by replacing fat with starchy foods) compared to usual or 'control' diet.
- studies where fat intake was modified (e.g. saturated fat replaced with polyunsaturated fat).
- studies where fat intake was both reduced and modified.
- Reduction of dietary fat, modification of dietary fat, or both did not reduce the risk of death due to cardiovascular disease.
- Reduction of dietary fat, modification or dietary fat, or both did not reduce overall risk of death.
- Reduction of dietary fat, modification or dietary fat, or both (without other interventions) did not reduce the risk of cardiovascular events such as heart attacks and strokes.
A couple of years ago I was presenting to a group and went through this thinking as well as the results showing that eating less saturated fat does not benefit health. I suggested that there was no point in changing the diet in a way that does not enhance health. A doctor in the audience said he disagreed with my stance because 'low-fat diets have been shown to reduce cholesterol levels'. Talk about missing the point.
Until next time,
Dr. John Briffa for The Cholesterol Truth
Comment: For a more in depth look at the benefits of saturated fat read the following articles:
Saturated Fat is Good for You
7 Reasons to Eat More Saturated Fat
Enjoy Saturated Fats, They're Good for You!
Wrongly Convicted? The Case for Saturated Fat
You've Been Living A Lie: The Story Of Saturated Fat And Cholesterol
A Big Fat Mistake
Higher saturated fat intakes found to be associated with a reduced risk of dying from cardiovascular disease