We’ve been told for years now to avoid the ‘artery-blocking’ saturated fats and to eat more ‘heart healthy’ whole grains to lower our cholesterol and reduce our risk of heart disease.. So is it true and has it worked?
If this is your first introduction to the idea that the health advice we have been given for so long in relation to diet is questionable, I completely understand that it is a lot to take in but please keep an open mind and do check out the extra resources at the end.
What are saturated fats?
Saturated fats are fats that are generally solid at room temperature. Even the word ‘saturated’ sounds like it has to be a bad thing but it just means that the fatty acid has the maximum number of hydrogen atoms or is fully “saturated” with hydrogen atoms. Polyunsaturated fatty acids contain less than the maximum amount of hydrogen atoms and have more than one double bond. So basically, this is just down to the chemical makeup of the fat – nothing more.
Foods that contain saturated fats include the fat in meat, poultry, fish, butter, coconut oil, avocado, cheese and cream. These are the ones that the Food Pyramid tells us to eat in small amounts and that low-fat diets restrict.
Do low-fat diets reduce heart disease?
Low-fat diets restrict saturated fats and are generally very high in carbohydrates – the food pyramid recommends more than 6 servings of high carb foods a day. Foods that contain a high proportion of carbohydrates include bread, pasta, cereal, potatoes but also foods containing sugar like sweets, biscuits, junk food, fizzy drinks and fruit.
The figures show that we have reduced the amount of fat in our diet over the last 40 years or so. Starting in 1980, there has been a reduction in the consumption of high fat diary and red meat and an increase in low fat diary as you can see in the diagram below. Why does a decrease in eating fat coincide with the start of the obesity epidemic and rising rates of heart disease? So reducing saturated fats in the diet has not helped to reduce heart disease.
There are even massive studies that prove that a low-fat diet does not work for heart health.
- One was the Women’s Health Initiative, which it had 48, 835 women where were randomized to either a low fat group or a control group. After 7.5 years, there was no difference in the rate of heart disease or cancer. (Also their weight loss was just 0.8lbs!)
- The other study was the MRFIT study. This was another massive trial with 12,866 men who were at a high risk of having a heart attack. One group was instructed to quit smoking, eat less saturated fat and cholesterol and increase their consumption of vegetable oils. After 7 years there was no difference in the rate of heart attacks or death.
So these studies prove that eating less saturated fats did not improve heart-health for people that reduced the fat. The bottom line is that saturated fats are not the culprit.
What should you eat to lower your ‘bad’ LDL cholesterol?
The first thing to say here, is that if you have been given your cholesterol results but not a breakdown of LDL or HDL cholesterol, it would be a good idea to ask your doctor for this. Knowing only your total cholesterol is not very useful as its made up of a number you want to be high i.e. your ‘good’ HDL cholesterol and a number you want to be low i.e. your ‘bad’ LDL cholesterol.
And even with LDL cholesterol, it is made of different particles – large fluffy harmless particles and smaller dense more dangerous particles. Although low fat diets may decrease total LDL cholesterol, studies have shown that they tend to increase the proportion of smaller dangerous particles.
In addition, a number of other studies have shown that replacing the carbohydrates with protein or fat leads to an increase of the particle size. This means that eating fat, even saturated fat instead of carbs seems to promote the forms of LDL that are harmless.
We highly recommend the New Atkins for a New You book by Dr. Stephen D. Phinney, Dr. Jeff S. Volek and Dr. Eric C. Westman if you are interested in learning about the benefits of Atkins for heart health and other conditions.
What are the best foods increase your ‘good’ HDL cholesterol?
Given the current advice to reduce saturated fats and food containing cholesterol like eggs and to eat more healthy whole-grains, you would imagine that following such a diet would do wonders for your cholesterol profile..
However, this has proven not to be the case. The following graph is a comparison of 23 studies comparing HDL cholesterol on low-fat diets and low-carb diets (like Atkins). As you can see, overall there was a much greater increase of ‘good’ cholesterol for the low-carb groups. The higher your HLD cholesterol, the better as it means your risk of heart disease is lower.
So what did the low carb group eat? Their diets would have been the same as or similar to the Atkins diet with participants eating protein, low carb veg as well as healthy fats including saturated fats. In fact, one of the best ways to increase HDL cholesterol is to eat more saturated fat like coconut oil, butter, cream, full fat meats as well as monounsaturated fats like avocados and olive oil.
What are the best foods to eat to lower triglycerides?
Triglycerides are basically fat molecules in your blood. According to many leading experts, your level of triglycerides and your ratio of triglycerides-to-HDL is a more important marker for heart disease than your total cholesterol. (Cholesterol Clarity by Jimmy Moore and Eric Westman MD is an excellent book if you want to find out more about this). The lower your level of triglycerides, the lower your risk of heart disease.
The following graph shows a decrease in triglycerides in most of the 23 studies comparing low-fat and low-carb diets:
As you can see the low-carb followers had a much higher decrease of triglycerides. It does sound counter-intuitive but the way to dramatically reduce your triglycerides is to reduce your carbohydrates, especially sugar.
The other interesting finding with these 23 randomized controlled trials (the best type of trial you can get) comparing low-fat diets with low-carb diets related to weight loss. The low-carb group lost 2 to 3 times more weight on average. The low-carb groups were not restricted in the amount they could eat whereas the low-fat groups were – meaning they were probably hungry..
So what is the best diet for Heart Health?!
According to the scientific proof, Atkins diet is better for your heart health than the currently recommended low-fat diet.
In the context of a low-carb diet, your body burns fat very efficiently so there is no need to fear saturated fats. As the studies above show, eating saturated fats improves your HDL cholesterol. So if you are following Atkins, go ahead and eat steak with the fat, eat cheese, put butter on your vegetables and have cream in your coffee!
On the other hand, eating a diet high in carbohydrates, especially sugar will make your triglycerides rise dramatically. Even whole-grain cereals or brown bread break down into sugar in your blood very quickly, so eating those foods often is not a good idea. However, sweets, biscuits, fizzy drinks and even fruit smoothies are even higher in carbohydrates so are not good for your heart health. So this Valentines day, go for the dark chocolate instead!
Cereal Killers the movie – this is an excellent movie with a great Irish sporting connection. The film follows Donal – a lean, fit, seemingly healthy 41 year old man – on a quest to hack his genes and drop dead healthy by avoiding the heart disease and diabetes that has afflicted his family. Donal’s father Kevin, an Irish gaelic football star from the 1960s, won the first of 2 All Ireland Championships with the Down Senior Football Team in 1960. When Kevin suffered a heart attack later in life, family and friends were shocked. How does a lean, fit and seemingly healthy man – who has sailed through cardiac stress tests – suddenly fall victim to heart disease?
Article from Dr Neville Wilson from the Leinster Clinic in Maynooth called Confused about Saturated Fats. Dr Wilson says “There should be no confusion about the benefits of dietary saturated fats!”
Cholesterol Clarity by Jimmy Moore and Dr. Eric C. Westman – an excellent book with contributions from 29 leading world experts on cholesterol and heart disease. This book is easy to read and will explain exactly what your cholesterol numbers mean and how you can improve your cholesterol without drugs.
New Atkins for a New You by Dr. Stephen D. Phinney, Dr. Jeff S. Volek and Dr. Eric C. Westman. In this book you will discover how scientific research has transformed the image of the Atkins Diet from “fad” to a medically validated, safe and effective treatment. The book is far more than a typical diet how-to book. Its authors have summarized hundreds of research studies published in top medical journals in a very readable way. These three international experts on the use of low-carbohydrate diets to combat obesity, high cholesterol and Type 2 diabetes, have led the way in repeatedly proving how a low-carbohydrate approach is superior to low-fat diets.
Personal story of a neuro-scientist David Diamond, Ph.D who improved his heart health by eating red-meat, eggs and butter. From being completely skeptical of this approach at the beginning he found from personal experience and extensive research that it worked in to dramatically reduce his risk of heart disease.
Authority Nutrition – the images above comparing health markers for low-fat and low-carb groups are with thanks to Authority Nutrition. Here is one eye opening article on 10 Things Dietitians Say About Low-Carb Diets That Don’t Make Sense
Healthy Diets and Science – this site contains a huge library of excellent and very readable articles based on science and what the studies really says about “healthy diets”. Here are a few on cholesterol and heart disease – that are well worth checking out.