What's the truth about fats? Daily Mail article 23/09/14

[Wholegrain]

There's another article about the UK nutrition guidelines on sat fat being wrong – with negative comment on vegetable oils, particularly olive oil. What's the truth about fats? What do dietitians think about this article?

dailymail.co.uk/health/arti...

[teessidesitp]

This article is based around a book by a "dietician" with no clinical education or training who believes an anecdote about herself is enough to change the course of medicine. Statements like the one below should really not be inserted in a serious article in a national newspaper, it is insulting to every researcher and the medical profession as a whole:

"Her research has found, for instance, how our love affair with the Mediterranean diet was encouraged by the opportunities for scientists and journalists to attend all-expenses-paid conferences in luxury hotels, all funded by the olive oil industry".

The reason the Mediterannean diet was examined was because the average age at death of those people around southern Europe was 5-10 years greater than that of people in the USA and UK at the time. Comments like the one above show that her "research" was likely to be flawed from the start.

There are some interesting studies regarding saturated fats (yes, transfats are not good) but there is nothing conclusive enough for NHS Choices to change its advice so far and that is to have a varied diet with small portions that includes at least 5 fruit or vegetables/day and plenty of exercise, don't smoke and cut down on alcohol.

Dieticians...........

[Emily_Jesper Partner Sense About Science]

I've asked a dietitian to join the conversation!

[Hidden]

@wholegrain It's funny you should ask, because we have an article called "Fat: the facts".

If you were reading the news yesterday, you may have seen new draft guidance on weight management from NICE (nice.org.uk/guidance/gid-ph... ) which advocates not focussing on one food or food type. It also advises to eat a Mediterranean diet which includes wholegrains!

@Teesidesitp - I don't think the author of the book being plugged in the Mail is what we'd call a dietitian in this country - she appears to be a food journalist. In the UK dietitians are professionally regulated: hcpc-uk.org.uk/aboutregistr... so the title is a protected one that can't be bandied around by unqualified practitioners (like "doctor" and "nurse", but unlike "nutritionist").

[Penel in reply to Hidden]

I'm not sure I recognise the Mediterranean diet as described by NICE. One of the joys of being in France is being able to cook in duck fat, and not trim the fat off your meat, and the idea of low fat yoghurt is laughable.

If you live at a northerly latitude, why would a Mediterranean diet be a good idea? Surely the diet that is traditional to where you live would be more appropriate and it would be easier to obtain seasonal produce.

The real problem to health seems to be from junk food, or the Standard American Diet, too much processed food and refined carbohydrates.

[johnsmith in reply to Hidden]

As we are talking about food science we really need to be straight and honest about food science and food science research.

The "Scientific America" a respected scientific magazine pointed out a number of years ago that a lot of so called food science is bogus and cannot be relied upon.

I have long ago stopped believing in what dieticians say. I have asked myself what are the facts and how have these facts been obtained. What are the confounding factors in the original research. What was the Gaussian curve obtained and how does this apply to the average person in the street who eats a wide range of items and lives a life exposed to various stresses.

What were the controls and what foods were not in the diet of the controls when the research was done.

Where was the research conducted. Research done in the tropics may not be relevant to someone living in the higher latitudes.

The question that also needs to be asked. Who paid for the research and how often was this research repeated.

I gone to meetings for the public run by a NHS hospital dietician. The public were asked what they considered to be a healthy diet. No information was given by hospital dietician on how a member of the public can determine for themselves what is a healthy diet for them.

Trying to find true facts on what is a healthy diet is a nightmare.

[Dragonmum]

Ah, the Daily Mail again, where would we be without it? The mine of all truth and knowledge.

Have to say that those of us who were young teenagers during WW2 would have been amazed to hear that we needed five fruit and veg a day to be healthy - we were lucky to see fruit five times in a year. and then it was mostly dried apple rings. Veg was spuds, onions if we were lucky and the everlasting swede, which I couldn't bring myself to eat for many years. Cabbage if you queued! So many of us remained fighting-fit on deprivation that we have become a problem for the exchequer - I don't think it's a problem that will continue for long, subsequent generations have been "digging their graves with their teeth" as my dear old gran was wont to say!

[Wholegrain]

Thanks for replying - very useful!

[writeaboutnutrition]

Some of this daily mail feature is on book content and some is about some recent papers published (after issue of book). The 'big' paper out in March of this year (Chowdhury, Uni of Cambridge) was a systematic review and met analysis of studies looking at dietary fats and heart disease, and did not observe associations with saturated fats or monounsaturated fats (but did find protective effects of unsaturated fats). Some of the conclusions may be that eating less saturated fats AND also consuming more refined carbohydrates (rather than eating more unsaturated fats) may not be heart-healthy. Certainly some critical review is needed on public health advice on fats in the diet, but certainly people should not consume more saturated fat than is currently typical in UK diets (which is what media headlines seem to say).

A comment on mediterranean diet and 'whole-grains'; I have never experienced whole grain items in Italian or greek cuisines: more an item in German or Scandinavian kitchens. A bit confusing, as nutrition message does not marry up with cultural messages

[Morphix in reply to writeaboutnutrition]

Well there's always going to be big differences in cultural diets and lifestyles (particularly in the staple food groups, ie bread/pasta/grains/corn maize), but the Mediterranean diet has been well studied and observed to promote good health, longer life expectancy and lower rates of diseases (particularly in older age groups) linked to unhealthy diets.

If you look at many Mediterranean dishes its easy to see why as they contain a lot of foods in their natural state, far less heavily processed foods appear in the diet and there's plenty of healthy fats (typically olive oil and but other plant and seed oils too).

Coming back to wholewheat/wholegrain foods.. you can find those in the Mediterranean diet too and they're a healthier choice than refined foods. For example, wholewheat pasta, wholegrain couscous, wholegrain/brown or wild rice, wholewheat breads...also walnut bread and linseed/sunflower seed breads are common over there, another healthy source of fats/plant oils not very common in UK where most people eat boring heavily refined breads which are so stripped of nutrients they have to be fortified with them.

Mediterranean's don't tend to mix foods from the same food group either like we do, they follow the portions and varied diet advice which seems to come naturally in their culture.. ie. you don't often see Italians eating bread alongside pasta. Whereas in the UK it's common to have several foods from the same group in a meal, particularly starchy foods like potato and bread... then the plate begins to look more white or brown, rather than varied and colourful!

I think it comes down to cultural differences too.. in France and Italy, Spain, all of the Mediterranean region, it's common to see families buying food from local food markets, local produce often.. they appreciate good foods. In the UK, being an island nation and very dense populated, most of our food is imported and the food supply chain is highly centralised. Food is processed and packaged for longer life due to transit and storage..

That's not to say you can't buy great locally grown produce in UK too (or even grow your own!). We just have to break out of this supermarket dependency mentality and start to look for more variety and natural food choices. Often it's a lot cheaper to buy from a local farm or food market. It's also helping local farmers, local economies and protecting our environment and traditions.

[Penel]

This paper from 2010, also found that refined carbohydrates are more of health risk than saturated fats.

ncbi.nlm.nih.gov/pubmed/200...

This meta analysis also from 2010, found that there was no significant evidence that saturated fat was associated with an increased risk of CVD.

ajcn.nutrition.org/content/...

How many more reviews do there need to be?

[Morphix in reply to Penel]

I think your comment is somewhat misleading and contradictory to the papers you're citing..

Firstly, it's important to note these are articles and scientific discussions, evaluations of previous study findings. They shouldn't be taken as dietary advice and they're not intended as advice or guidelines for the general public.

That said, here's some quotes:

"Clinical trials that replaced saturated fat with polyunsaturated fat have generally shown a reduction in CVD events", although several studies showed no effects. An independent association of saturated fat intake with CVD risk has not been consistently shown in prospective epidemiologic studies, although some have provided evidence of an increased risk in young individuals and in women. Replacement of saturated fat by polyunsaturated or monounsaturated fat lowers both LDL and HDL cholesterol."

"In the Lyon Diet Heart Study, adoption of a “Mediterranean” style diet that included an increased intake of the omega-3 (n−3) fatty acid α-linolenic acid, a reduction in saturated fat to 8% compared with 11.7% of energy, and a modest increase in fiber and total carbohydrate was associated with a 72% reduction in recurrent CHD events in patients with prior myocardial infarction."

These are quote from the first paper. These findings provide the basis for the UK Department of Health's dietary advice on not eating too much saturated fat and the importance of including healthier fats (and other foods) in the diet to lower bad cholesterol and the risk of heart disease, particularly in the at risk groups. It also supports the recommendation of a Mediterranean style diet and adopting some of their eating habits.

The message is that a varied diet with all three types of fats (but higher levels of polyunsaturated or monounsaturated rather than saturated fat) is recommended for good health and a reduced risk of heart disease.

It's important not to take individual study findings (often clinical trials in labs, not backed or support by social study models) in isolation which may seem to contradict this message and confuse sound advice which is intended for the entire population. WIthin that population there's going to be differences and variances, but the government is concerned with keeping as many people as healthy as possible, in the simpliest, least expensive and most practical way.

Remember the UK is a nation where the government/State has most of the burden of paying for the nations healthcare and also supporting those who are unfit to work to a much higher level (with housing costs, income support and all medical treatments), unlike the US. Therefore here, disease prevention is a priority in healthcare policy-making. It's far better than disease treatment and an ever-crippling NHS public expenditure in our budget. Hence the importance of giving this dietary advice to the population. You have to look at it in that context.

[LeilaBrickell]

Great article! Thanks for the share. You can't avoid these saturated fats though. People tend to buy the same foods again and again, i think it's time to read labels and find foods that are low in saturated and trans fat. You can also limit the intake of saturated fats by cutting back on red meat and full-fat dairy foods.

[Penel in reply to LeilaBrickell]

Don't confuse sat fats and trans fats. Sat fats have been eaten for centuries and come from natural sources. Trans fats aka hydrogenated vegetable fats are man made and found in processed foods, the body cannot digest them as they are artificial.

Unprocessed red meat is a healthy choice, as is full fat dairy. We need fat in our diets to produce hormones and absorb certain vitamins and minerals. What we don't need are foods like sugary breakfast cereals.

[Morphix in reply to Penel]

Too much saturated fat in the diet (above the recommended maximum daily intake) has been linked to diseases (particularly heart disease), and should be eaten in moderation. That's still the government's advice (at least for our society in the UK) and is backed by scientific studies.

That's not to say that saturated fat itself is bad and solely to blame. I'm sure some people can get away with eating a lot of it and not have any problems if their diet contains bad cholesterol lowering foods. There's different factors here (including genetics) and a lot of science involved to explain the reasons for this. Without wanting to confuse or over-complicate the issue, the government provides advice that is intended to keep most of the population healthy, even if they don't follow a perfect diet or lifestyle, and are perhaps more at risk from certain diseases.

Foods containing high levels of saturated fats such as red meat and dairy foods like hard cheese needn't be excluded from the diet, but should be eaten in moderation and should form smaller portions on the plate from those food groups, ie. all of your fat shouldn't come from dairy foods, and all of your protein shouldn't come from red meat. To follow a healthy diet you need a varied one and normal food portions.

[Morphix in reply to LeilaBrickell]

Sound advice Leila.

I agree more people should read the labels more on foods as we now have clearer labelling and unhealthy foods that contain mostly fat and high levels of saturated fat are easy to spot with the red signs.

People need not exclude things they enjoy eating tho even if they are unhealthy, it's just about moderation and compensating by eating a balanced and varied diet. The body is remarkably good at taking care of itself if it's looked after and not punished too hard constantly.

If you eat a particularly unhealthy meal, eat something good after

One of the best overlooked foods for lowering LDL cholesterol from a diet with lots of red meat or cheese is oats. A superfood, excellent source of protein and fibre (the food label on oats is green all the way across ;-), cheap and easy to cook! Not everyone likes porridge but you can make healthy flap-jacks or oat cakes without tons of butter and sugar (I use vegetable oil and apple puree). Another way is to add them to smoothies or yoghurt.

[Morphix]

There is a lot of confusing advice out there when it comes to nutrition. The Daily Mail is notoriously bad when it comes to reporting anything scientific (they have made major blunders in the past and been duped several times due to their lack of proper scientific editors and reporters), so I wouldn't take anything the DM reports seriously.

I have studied human nutrition at university level for a BSc and have seen all the studies and evidence which support the governments current advice on diet and fats.

In simple laymans terms:

There are good fats and bad fats. The good fats lower bad cholesterol and are an essential source of nutrients for the body, so a 'low fat' diet or viewing all fat as bad, is not healthy. A healthy diet should incude fat.

Good fats come from plants and fish/sea food, nuts and seeds. A general rule of thumb is good fats are liquid at room temperature (olive oil is a good one, omega oils found in fish and seeds are another) and appear in their natural or semi-natural state.

Bad fats (particularly if intake is at high-levels and there's little or no bad-cholesterol lowering fat foods in the diet), cause higher levels of bad cholesterol in the body which is linked to life-threatening or shorterning diseases, such as obesity, heart disease and cancer. General rule of thumb again, these type of fats are solid or semi-solid at room temperature and don't look natural. These types of fats are usually of animal origin (typically found in red meat and some dairy foods such as lard, butter and cheese) or heavily processed altered fats (i.e butter-like 'low fat' spreads and 'invisible fats' found in processed foods and snack foods).

Ideally, heavily processed and unhealthy snack foods should be avoided, or just eaten occasionally. A vegetarian diet has shown to be healthier than one which includes animal fats. Although eating animal fats in moderation is fine and can be healthy for those who can't or don't wish to follow a vegetarian diet.

That is the governments advice and is backed by sound scientific evidence as well as observing other cultures diets and their health.

If you look at the mediterranean style diet, and cultures in the Far East (like the Japanese who eat a lot of fish, seafood and food in its natural state), these people have healthy diets and include plenty of healthy good fats. These cultures generally enjoy fewer health diseases, live longer, and have fewer age-related health problems we commonly do in the West do.

[Penel in reply to Morphix]

Saturated fats and transfats do not have the same affect on the body. Transfats are to be avoided but saturated fats are not.

Saturated fats are not responsible for causing high levels of 'bad cholesterol,' they may raise HDL, but this is no problem unless you have a genetic condition such as Familial Hypercholesterolaemia.

'Bad cholesterol' is now known to be caused by over consumption of refined carbohydrates, and raised cholesterol levels are a response to inflammation in the body.

scientificamerican.com/arti...

[Morphix in reply to Penel]

High levels of saturated fat in the diet (above the governments recommended maximum daily intake) in an unhealthy diet (which is not balanced or varied, and excludes healthy fat sources and bad cholesterol lowering foods), is definitely associated with an increased risk of heart disease and poor health, particularly in at risk groups and the elderly (the UK has a higher portion of ageing population than many other countries and a higher healthcare cost).

A large portion of our population are prescribed LDL cholesterol lowering drugs, and more younger people are developing diabetes, heart diseases and strokes than ever before.

Yes, some people are genetically more likely to suffer the ill effects of too much LDL cholesterol and not enough HDL, while others may be able to not suffer any negative effects. As a government that writes the cheques out for those who do suffer from heart disease among others (and it's a significant number of people, heart disease is the biggest killer in the UK*), it's wise to provide advice guidelines that reduce that risk.

"LDL cholesterol is considered the “bad” cholesterol because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result. Another condition called peripheral artery disease can develop when plaque buildup narrows an artery supplying blood to the legs."

heart.org/HEARTORG/Conditio...

The American Heart Association (peer reviewed site)

* "Coronary Heart Disease is the biggest killer, causing almost 74,000 deaths each year in the UK. That's about 200 people dying every day" BBC (2013), Unhealthy Britain: nation's five big killers, bbc.co.uk/news/health-21667065

[Wholegrain]

Thanks very much Morphix - very helpful!