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Todd Allen

Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review

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https://doi.org/10.1016/j.jacc.2020.05.077

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Abstract: The recommendation to limit dietary saturated fatty acid (SFA) intake has persisted despite mounting evidence to the contrary. Most recent meta-analyses of randomized trials and observational studies found no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality, and instead found protective effects against stroke. Although SFAs increase low-density lipoprotein (LDL)-cholesterol, in most individuals, this is not due to increasing levels of small, dense LDL particles, but rather larger LDL which are much less strongly related to CVD risk. It is also apparent that the health effects of foods cannot be predicted by their content in any nutrient group, without considering the overall macronutrient distribution. Whole-fat dairy, unprocessed meat, eggs and dark chocolate are SFA-rich foods with a complex matrix that are not associated with increased risk of CVD. The totality of available evidence does not support further limiting the intake of such foods.

 

Edited by Michael R
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A moderate amount of SFAs won't even elevate LDL in many cases, as I've observed in myself.

Personally, I feel that eating whole-fat dairy products on top of vegetable fats like EVOO and nuts bloats me in an uncomfortable way. Hence I prefer nonfat or lowfat dairies.

A

 

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Hmmmm.....

Disclosures!

Arne Astrup: Research funding from Danish Dairy Foundation, Arla Foods Amba and the European Milk Foundation. Speaker honorarium for Expert Symposium on the Dairy Matrix 2016 sponsored by The European Milk Foundation. Advisory Board/Consultant for McCain Foods Limited and Weight Watchers.

J. Thomas Brenna: Research funding from the National Cattlemen’s Beef Association/North Dakota Beef Council. Panel participation honorarium from Dairy Management (2017).

James O. Hill: Research funding from the National Cattlemen’s Beef Association. Member of the scientific advisory committee of the Milk Producers Education Program (Milk PEP). Member of the health and wellness advisory board for General Mills. Trustee of the International Life Science Institute.

Andrew Mente & Salim Yusuf: Research funding from the Dairy Farmers of Canada and the National Dairy Council to analyze data on dairy consumption and health outcomes in the Prospective Urban Rural Epidemiology (PURE) study, which is funded by the Population Health Research Institute (PHRI), Hamilton Health Sciences Research Institute, and more than 70 other sources (government and pharmaceutical).

Jeff S. Volek: Research funding from foundations (Lotte & John Hecht Memorial Foundation) and industry (Metagenics, National Dairy Council/Dutch Dairy Organization, Malaysian Palm Board, Pruvit Ventures). Royalties for books on ketogenic diets. Scientific advisory board for Virta Health, UCAN, Advancing Ketogenic Therapies, Cook Keto, Axcess Global and Atkins Nutritionals. Equity in PangeaKeto. Founder, chief science officer, and equity in Virta Health

Ronald M. Krauss: Research funding from Dairy Management. Scientific Advisory Board for Virta Health and Day Two. Licensed patent for method of lipoprotein particle measurement.

  --  Saul

 

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12 hours ago, Todd Allen said:

[According to the dairy industry]:

no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality

So what dietary changes DO have beneficial effects on cardiovascular disease?  As far as I know, only one diet was ever clinically proven to improve cardiovascular disease, and it didn't include dairy.

Dr.-Caldwell-Esselstyn-Heart-Disease-Rev

Edited by Gordo

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38 minutes ago, Gordo said:

As far as I know, only one diet was ever clinically proven to improve cardiovascular disease, and it didn't include dairy.

The problem is without a large cohort and without a control group following the same protocol except with a substitution of dairy you haven't shown anything with respect to dairy.

Edited by Todd Allen

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  Michael Rae:

Quote

On Esselsyn/Ornish/Pritikin/McDougall: the studies purported to support the ultra-low-fat approach are not worth the paper on which they're written (to the extent that anyone keeps hardcopies any more).

Esselsyn's and Ornish's  reports are in very small numbers of intensely-managed patients with existing CVD; neither of them have reported any actual improvement in survivorship; and there are major confounders for both.

Esselstyn is reporting a case series from his personal practice, and not (as is often claimed) a clinical trial: there was no control group, and moreover ALL of his subjects were on cholesterol-lowering drugs.(3)


 

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1 hour ago, Saul said:

Ronald M. Krauss: Research funding from Dairy Management. Scientific Advisory Board for Virta Health and Day Two. Licensed patent for method of lipoprotein particle measurement.Ronald M. Krauss: Research funding from Dairy Management. Scientific Advisory Board for Virta Health and Day Two. Licensed patent for method of lipoprotein particle measurement.

And he is considered a leading authority on lipidology.  Here's an interview from 4 years ago by that shill for big beef and dairy Rhonda Patrick: 

 

And here is a more recent interview by Dr. Peter Attia: 

 

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7 hours ago, Saul said:

Hmmmm.....

Disclosures!

Arne Astrup: Research funding from Danish Dairy Foundation, Arla Foods Amba and the European Milk Foundation. Speaker honorarium for Expert Symposium on the Dairy Matrix 2016 sponsored by The European Milk Foundation. Advisory Board/Consultant for McCain Foods Limited and Weight Watchers.

J. Thomas Brenna: Research funding from the National Cattlemen’s Beef Association/North Dakota Beef Council. Panel participation honorarium from Dairy Management (2017).

James O. Hill: Research funding from the National Cattlemen’s Beef Association. Member of the scientific advisory committee of the Milk Producers Education Program (Milk PEP). Member of the health and wellness advisory board for General Mills. Trustee of the International Life Science Institute.

Andrew Mente & Salim Yusuf: Research funding from the Dairy Farmers of Canada and the National Dairy Council to analyze data on dairy consumption and health outcomes in the Prospective Urban Rural Epidemiology (PURE) study, which is funded by the Population Health Research Institute (PHRI), Hamilton Health Sciences Research Institute, and more than 70 other sources (government and pharmaceutical).

Jeff S. Volek: Research funding from foundations (Lotte & John Hecht Memorial Foundation) and industry (Metagenics, National Dairy Council/Dutch Dairy Organization, Malaysian Palm Board, Pruvit Ventures). Royalties for books on ketogenic diets. Scientific advisory board for Virta Health, UCAN, Advancing Ketogenic Therapies, Cook Keto, Axcess Global and Atkins Nutritionals. Equity in PangeaKeto. Founder, chief science officer, and equity in Virta Health

Ronald M. Krauss: Research funding from Dairy Management. Scientific Advisory Board for Virta Health and Day Two. Licensed patent for method of lipoprotein particle measurement.

  --  Saul

 

Thank you Saul! I will ignore this research!

There’s a lot of conflicting information about saturated fats. Should I eat them or not?

The American Heart Association recommends limiting saturated fats – which are found in butter, cheese, red meat and other animal-based foods. Decades of sound science has proven it can raise your “bad” cholesterol and put you at higher risk for heart disease.

The more important thing to remember is the overall dietary picture. Saturated fats are just one piece of the puzzle. In general, you can’t go wrong eating more fruits, vegetables, whole grains and fewer calories.

When you hear about the latest “diet of the day” or a new or odd-sounding theory about food, consider the source. The American Heart Association makes dietary recommendations only after carefully considering the latest scientific evidence

Edited by Mike41

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59 minutes ago, Mike41 said:

The American Heart Association recommends limiting saturated fats

...

When you hear about the latest “diet of the day” or a new or odd-sounding theory about food, consider the source. The American Heart Association makes dietary recommendations only after carefully considering the latest scientific evidence

And here are some of their "carefully considered" endorsments...

AHACereals.jpg.414bf18f6abceee44b0b70a09f336263.jpg

Edited by Todd Allen

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It seems the situation with SFA is as confused as ever. The Cochrane Review reached the conclusion that SFA were not the primary driver of CV mortality, although substituting some SFA with polyunsaturated FA reduced CV morbidity (not mortality!) - though again, it may be a small factor:

Reduction in Saturated Fat Intake for Cardiovascular Disease

"Authors' conclusions: The findings of this updated review are suggestive of a small but potentially important reduction in cardiovascular risk on reduction of saturated fat intake. Replacing the energy from saturated fat with polyunsaturated fat appears to be a useful strategy, and replacement with carbohydrate appears less useful, but effects of replacement with monounsaturated fat were unclear due to inclusion of only one small trial. This effect did not appear to alter by study duration, sex or baseline level of cardiovascular risk. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturated fats. The ideal type of unsaturated fat is unclear."

But I keep thinking about Finland and France - both take in about the same amount of SFA, but Finland's intake has a greater proportion of intake from dairy products and meanwhile the Finnish diet does not offset that intake with the amount of F&V that the French diet does. And I keep remembering the harrowing epidemic of sky-high deaths from heart attack in Finland, and how they brought it down dramatically with the reduction of SFA intake from diary... seemingly indicting SFA.

Here's an interesting comparative study:

Differences in Coronary Mortality Can Be Explained by Differences in Cholesterol and Saturated Fat Intakes in 40 Countries but Not in France and Finland. A Paradox

"Conclusions: Over the years, France and Finland, with similar intakes of cholesterol and saturated fat, consistently have had very different CHD mortality rates. This paradox may be explained as follows. Given a high intake of cholesterol and saturated fat, the country in which people also consume more plant foods, including small amounts of liquid vegetable oils, and more vegetables (more antioxidants) had lower rates of CHD mortality. On the other hand, milk and butterfat were associated with increased CHD mortality, possibly through their effects on thrombosis as well as on atherosclerosis."

Now, I know this is an epi study, so all appropriate caveats apply, but in general the case of Finland weighs pretty heavily in my mind - after all, the governmental intervention was in effect a kind of "intervention study", even if it's still epi. So, moved by that and a lot of other studies on the effects of SFA, I personally avoid SFA.

Does it mean the case against SFA is fool-proof - no. But I'm not taking the risk, since I have access to other FA and SFA are not EFA. YMMV.

 

 

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11 hours ago, TomBAvoider said:

 "France and Finland ....had very different CHD mortality rates.

At the very least,  you gotta look at all-cause mortality,  not a single-disease,  especially given the wealth  of evidence suggesting that what may be best to reduce CHD may not be the best to reduce cancer.  Double-edged swords dangling all over the place.

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21 hours ago, Todd Allen said:

And here are some of their "carefully considered" endorsments...

AHACereals.jpg.414bf18f6abceee44b0b70a09f336263.jpg

Well yes, the AHA has a fund raising arm and they go after donors and they promote junk products. But their positions are still based on science. In fact they criticized a Favorable 2014 study on SFA based on the fact that People had replaced SFA with sugary carbs.  I don’t mistrust their overall recommendations wrt diet, exercise etc., but I realize the funding arm is going to go after money and make compromises.Is that ethical? No, but we live in a very imperfect world.

Edited by Mike41
https://www.heart.org/en/news/2018/05/01/advisory-replacing-saturated-fat-with-healthier-fat-could-lower-cardiovascular-risks?utm_campaign=sciencenews16-17&utm_content=phd06-15-17&utm_medium=phd-link&utm_source=science-news

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4 minutes ago, Mike41 said:

Well yes, the AHA has a fund raising arm and they go after donors and they promote junk products.

These junk products are loaded with refined sugars.  They acknowledge sugar is problematic.  And yet they endorse these products as "heart-healthy" in a fashion designed to encourage the purchase and consumption of these products by a gullible public.  At least the products are vegan so consumers can kill themselves with minimal guilt.

 

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To be honest, the dairy industry makes profits out of nonfat or lowfat products as well... I myself, rarely buy whole fat products any longer.

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