Saturated Fat Is Your Friend, Not Foe

Saturated fat has long been vilified for increasing the risk of heart disease, but a leading cardiovascular scientist says that saturated fat isn’t necessarily the culprit—it’s just misunderstood.

In an editorial published recently in Open Heart, James DiNicolantonio, PharmD, argues that America’s war on obesity and diabetes has more to do with high consumption of carbohydrates than fat.
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He challenges some of the key studies that have supported this long-standing low-fat diet recommendation. In particular, he notes that the landmark study by Keys in 1953, which reported that an increased percentage of fat calories increases the risk of all-cause mortality, is flawed because Keys excluded data from 16 countries that did not fit his hypothesis.

This study preceded current recommendations to limit saturated fat consumption and replace it with monounsaturated fats or polyunsaturated fats. It is true that high-fat foods are “energy-dense” and without regular exercise can cause weight gain, potentially leading to obesity and diabetes. But he argues that this advice seems to have backfired, as many people are swapping high-fat foods for carbohydrates.

The evidence from randomized trials shows that a “low-carbohydrate diet reduces weight and improves lipids more than a low-fat diet,” he says. The data show that high saturated fat intake lowers small, dense LDL particles and raises large buoyant LDL particles. A higher proportion of smaller LDL particles increases the risk of atherosclerotic disease.

“The public fear that saturated fat raises cholesterol is completely unfounded as the low-density lipoprotein particle size distribution is worsened when fat is replaced with carbohydrate,” he says.

Furthermore, he notes that studies on the Mediterranean diet, which promotes a high consumption of olive oil, have shown to reduce all-cause and cardiovascular mortality compared with a low-fat diet.

“Dietary guidelines should assess the totality of the evidence,” DiNicolantonio concludes. “A public health campaign is drastically needed to educate on the harms of a diet high in carbohydrate/sugar.”

-Allison Musante, ELS

Reference
DiNicolantonio JJ. The cardiometabolic consequences of replacing saturated fats with carbohydrates or omega-6 polyunsaturated fats: do the dietary guidelines have it wrong? Open Heart. 2014;1. doi:10.1136/openhrt-2013-000032.