The Great Saturated Fat Debate
The American Dietetic Association (who is the govening body for Registered Dieitians and one of the groups responsible for influencing our dietary guidelines) is currently holding its 93rd annual meeting in Boston called the Food and Nutrition Conference and Expo (or more commonly known simply as FNCE - 'Fence-EE").
Like most group conferences, this one centers on what this group feels they do best, and that is nutrition.
However, it's not known as a heavy-science conference, but rather more knowlege sharing of nutrition. If you want really science-y nutrition conferences, you'd attend others such as the International Society for the Study of Fatty Acids and Lipids (ISSFAL). (I've been to both, so I can speak from experience).
In any matter, FNCE is the conference all Registered Dietitians try to attend each year for a few reasons - there are often some good sessions to attend about nutrition; it helps us (I'm a RD too) maintain our CEU requirements; and there is this HUGE expo with tons of free goodies - although most of the goodies are food products and something I tend to stay away from.... in any matter, people leave with much heavier suitcases than when they came.
This year, the Member Showcase main session was titled, "The Great Saturated Fat Debate". Since this is something near and dear to my heart (That's what I studied for my 7 years in grad school) I knew I had to attend and hear it (even though I was skeptical as to what the outcome would be since the ADA tends to be anti-saturated fat).
Although I wasn't able to be there in person (had to watch baby), I was able to listen to the whole talk via the internet on U-Stream, which is why I totally love technology. Awesome!
According to the session description, we were supposed to learn from the four speakers in this round-table discussion if saturated fat really matters to our hearts and if limiting its intake really results in the best prescription for health.
But, that's not quite what happened, even though some of the information was good.
Here's how it went down:
The speakers in this session were:
1) Walter Willett, MD, DrPH - the chair of the nutrition dept at Harvard and author of several nutrition books
2) Dariush Mozaffarian, MD, DrPH - assistant professor of medicine and epidemiology at Harvard Medical School and expert in dietary fat
3) Alice Lichtenstein, DSc - Director of the Cardivascular Nutrition Lab at Tufts and part of the Dietary Guidelines committee
4) Lewis Kuller, MD, DrPH - Distinguished University Professor of Public Health at UPitt
(Notice not one of these persons were a RD? Makes you wonder why RDs are considered the nutrition "experts"??? Hmmm.... not that I'm totally bashing RDs, but many (I"m one too) has to learn to admit that they don't know everything when it comes to nutrition and that they look to many non-RDs for knowledge)
Walter took the stage first and said flat out that dietary total fat is NOT related to Coronary Heart Disease. In fact, the recommendations by the dietary guidelines to tell Americans to use fats and oils sparingly for health never had ANY solid evidence or support to back it up.
Then, we all know what the outcome was: we took as much fat out of our food supply and replaced it with starch and sugar and Americans got fatter and sicker.
And, the notion that dietary fat makes you fat is not true whatsoever. In fact, he pointed out that when farmers want to fatten their cows, they use carbs... not fat!
Also, controlled clinical trials show us over and over again that lower carb, higher fat diets are more advantages for weight loss and fat loss in humans.
Overall, he said the advice in the dietary guidelines to restrict dietary fat should be removed because it's not telling us the truth about what makes up a healthy diet - in other words, a low-fat diet is not beneficial for our health.
Next up was Lewis Kuller. Dr Kuller was the advocate for low-fat diets and low-saturated fat diets saying that the biggest reason is that saturated fat drives up LDL cholesterol and this is one of the major reasons we have atherosclerosis.
He listed some studies from the 70s showing that diets high in saturated fat made total and LDL cholesterol increase and said that this is why we have heart disease. We knew it then and we should be still listening to it now.
He didn't have the most convincing arguement in my opinion, but he did try...Couple that with the fact that both Willett and Mozaffarian both looked much more healthy than this guy and they both were fat advocates where he was not... interesting.
Then Mozaffarian hit the stage - this guy is a powerhouse! He's done most of the research out there and written several papers indicating that when you replace saturated fat with carbohydrate (as we have been doing the past 30 years...) you increase the risk of heart disease.
He also pointed out that there is no relationship between saturated fat and heart disease or diabetes and that we should stop telling people to restrict it.
Instead, he recommended that we focus on telling people to consume polyunsaturated fats, rather than restrict saturated fat.
(Note, I thought this was a little weird, and was confused to as why he didn't just say "UNsaturated fat" which would also include monounsaturated fat. But, if this is his way to help people eat more nuts, seeds, avocados, unprocessed plant oils and such, so be it).
He also said that we have to stop using individual biomarkers like just LDL cholesterol or just HDL and start realizing that there's more to disease than just one or two biomarkers.
(Note, an addition from me is that we really don't know the basis of diseases like heart disease or cancer and so can't really blame just one or two items. Scientists are still trying to understand these diseases and we may hear down the road very soon that LDL cholesterol really isn't the whole picture - which is just what Mozaffarian was saying).
Finally up was Alice Lictenstein. Alice is known to be a low-saturated fat advocate. But, in this presentation, she did say that we have to stop confusing the healthy eating message - which is that fat is not bad and that low-fat diets are not a healthy diet. Still though, the media keeps reporting this and we have to stop it.
She didn't advocate saturated fat at all, but did recognize that cutting fat out from the diet is not helping anyone.
Overall - the title of this Showcase should have been more accurately labeled, "The Great Fat Debate" because the speakers didn't really address the confusion around saturated fat. They really pushed the message that we need to stop demonizing fat in the diet and instead tell people to eat more polyunsaturated fat (They didn't distinguish between omega-3 poly and omega-6) rather than to tell them to eat less saturated fat.
Hopefully our society will finally stop fearing fat because fat does NOT make us fat, nor does it make us unhealthy... but that also too depends on the source of fat. If that fat is found in baking, processed foods and faux foods, then it is an issue. But if that fat comes naturally in a food, like the fat naturally in meats, fish and fowl, the fats in nuts and seeds and the fats in olives and avocados, then we're on the road to better health and a smaller waistline.