Two major newspapers (The Guardian and The Daily Express) had lead articles today suggesting that high fat consumption is not as bad as once believed, especially in terms of developing cardiovascular diseases. I personally feel one article was a little more balanced that the other but I will leave that for you to decide. Much of these two articles focuses on an opinion, or as BMJ.com categorizes it an “Observation”, from Dr. Aseem Malhotra. His peer-reviewed opinion focuses, to some extent, on recent studies which illustrate health benefits of foods traditionally associated with high fat intakes. While Dr. Malhotra makes some interesting points, he is unfortunately intertwining his argument regarding dietary fats with the prescription of statins as well as confusing total fat intakes with those of saturated fatty acids. While dietary fat recommendations are made with the prevention of cardiovascular disease in mind they are not solely recommended for that reason. Dietary fat intake recommendations have been developed to address caloric needs/intake, fat type (e.g. saturated, monounsaturated and polyunsaturated), fatty acid distribution (e.g. essential fatty acids, omega-3 fatty acids, omega-6 fatty acids) and cholesterol intake.
Dr. Malhotra also states that the trends in fat consumption in the USA support his opinion due to the decreases in the percent of fat as calories consumed by Americans. However, this can be misleading as trends in total caloric intakes in the USA had been rising for decades until they recently began to decline. Also, fat or calorie intakes are not the only cause of obesity – reduced energy expenditure is also directly linked to increasing obesity rates.
Balancing healthy fat intakes, using the current recommendations as a guideline, as part of a varied diet is important for maintaining good health. Therefore, readers should be cautious how they interpret these newspaper articles and Dr. Malhotra’s opinion on saturated fat, total fat and statins.
Fats and Oils Info:
- Exhaustive list of various edible oils showing the relative proportions of saturated, monounsaturated, polyunsaturated and omega-3 fatty acids or a simplified version of common fats/oils (www.canolainfo.org).
- American Heart Association Fats 101 – good resource for those who want to brush up on their fats and oils terminology.
- British Heart Foundation – Healthy eating recommendations including advice on fat intakes.
On a separate but related note for those who are interested, Dr. Malhotra does cite two recent and interesting studies in his review:
A recent study by Ebbeling et al. (2013), demonstrating that consumption of isocaloric test diets, which differed in macronutrient composition, resulted in differences in resting energy expenditure (REE) and total energy expenditure (TEE). In the Ebbeling study, the “low-fat” diet had the lowest energy expenditures (REE and TEE), which from a health and weight management perspective would be the least desirable.
The PREDIMED Trial was a very large observational study with three randomly assigned groups:
- Control group: Advice to reduce fat intakes
- Intervention 1: Mediterranean diet supplemented with extra-virgin olive oil
- Intervention 2: Mediterranean diet supplemented with mixed nuts
The primary end-point for the study was a cardiovascular event, which included myocardial infarction, stroke, or death from any other cardiovascular causes. The authors reported significantly lower cardiovascular incidences in both Mediterranean diets compared to controls and concluded that the Mediterranean diet was responsible for the lower incidences. However, the results of this trial produced a fair amount of comment on how the data should be interpreted. One particular comment from Lawrence Appel and Linda Van Horn, which I am inclined to agree with, suggests that because of the quantity of the supplemented foods (extra-virgin olive oil and mixed nuts) consumed the data may be more reflective of the supplements foods versus the diet as a whole?