By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Let me clear the deck right at the start. I don’t believe in the conventional medical theory that cholesterol is the primary cause of heart disease, nor that saturated fats are bad for you.
Myth: Eating saturated fat will do you in.
Fact: Not in moderation!
My Recommendation: Like everything else, you want balance in your diet, and you want the right fat, and that includes (not excludes) saturated fat.
Know Thy Fats
Here’s a short course about fats that will clear up the confusion (and here’s the longer one):
Dietary fats come in two basic forms: saturated and unsaturated. Saturated fats are those found primary in animal foods (meat, cheese, butter, eggs) and also in plant foods such as coconuts. Saturated means the fat is solid at room temperature. They are stable and “tougher” when exposed to high heat.
Inaccurate and manipulated research more than a half-century ago created a stubborn dogma that has lasted for decades and which links saturated fat and cholesterol with heart disease. The American Heart Association continues to recommend a diet based on less than 7 percent saturated fat intake. Despite its negative reputation, saturated fat is far from a dietary demon. More and more health professionals, researchers, scientists, doctors, and nutritionists are beginning to reexamine the case against saturated fat, and they’re finding that it’s based on very little solid evidence.
In 1992, William Castelli, M.D., the director of the world-famous Framingham Study, summed up the findings to that time and categorically said the following:
“In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol . . . we found that people who ate the most cholesterol, ate the most saturated fat, [and] ate the most calories weighed the least and were the most physically active.”
More recently, a review in the journal Advances in Nutrition described as “weak” the early studies showing that dietary saturated fats increased coronary artery disease or caused premature death. Over the years, the review said, data has revealed that saturated fatty acids are, in fact, “not associated with coronary artery disease and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked.” Several recent analyses indicate that saturated fats, particularly in dairy products and coconut oil, can improve health.
Amen, I say.
My only caveat with saturated fat is to avoid eating the actual fat on meat, poultry and fish, especially if the cuts are not grass-fed, organic, or wild-caught. This is because animals, like humans, store environmental toxins they’re exposed to –heavy metals, insecticides and pesticides, and possible toxic radiation– in their subcutanous fat. Whenever possible, choose organic, grass-fed or wild-caught, as animals raised in these fashions are not given antibiotics for preventative reasons and are shielded from insecticide and pesticide exposure.
The Unsaturated Fat Story
By comparison to saturated fats, unsaturated fats are liquid at room temperature, and found in two basic forms, monounsaturated (like olive oil) and polyunsaturated (fish and vegetable oils). The polyunsaturates contain essential fatty acids, nutrients used by the body as raw materials to produce a huge array of subsidiary fatty substances that perform countless basic functions in the physiology. They serve, for instance, as fundamental building blocks of cellular membranes and regulatory compounds that enhance or suppress disease processes.
The major essential fatty acids in polyunsaturated fats are alpha-linolenic acid and linoleic acid. They, in turn, are classified in “families” according to their molecular structure. The families go by the names omega-3 and omega-6.
We should be eating a proper balance of these fatty acids. But we don’t. In fact, we haven’t been doing a good job at balance for more than a hundred years, which may help explain in part why we have so much heart disease and other chronic illnesses not common in earlier times. Over the years we have been consuming huge amounts of foods with much more omega-6 content, mostly as a result of a steep rise in the use of certain cooking vegetable oils such as corn, cottonseed, sunflower, and canola oil. These oils are very high in omega-6 fatty acids.
Contributing to the imbalance as well is a typically high intake of processed foods and margarine, loaded with omega-6s.
Experts say that the overall ratio of omega-6s to omega-3s in today’s Western diet ranges from 20 to 30 to 1 instead of an evolutionary ratio of 1 or 2 to 1. This dietary shift has created an alarming imbalance that researchers believe may contribute to inflammation, blood clot formation, and blood vessel constriction. A balanced ratio in the diet is essential for normal growth and development, according to experts.
Because the typical American diet contains such an overkill of omega-6, and its major component of linoleic acid, supplementation of omega-6 is not usually needed. But omega-3 is a different story. More and more physicians recommend omega-3 supplements to patients. I’ve been doing it for years in the form of fish or squid oil, high in the beneficial fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
The Sinatra Solution
How should you approach the fats in your diet? Here are a few solid tips:
- The healthiest diets emphasize plant-based foods, high in phytonutrients, bioflavonoids, and other protective substances, along with fish and chicken. I personally believe in the 80-20 dietary rule, that is, only 20 percent of consumption should be from animal sources, including fish, chicken, lamb, and even buffalo. Epidemiological studies over the years indicate that a meat-heavy diet, and particularly red meat, does raise your risk of coronary heart disease, stroke, colorectal cancer, and diabetes. Part of the equation is that people who eat more red meat are also less physically active, more likely to smoke and drink alcohol, weigh more, eat more calories, and consume less fruits, vegetables, and grains.
- If you eat meat, try to make is grass-fed meat, which is usually organic. Typical feedlot meat is loaded with antibiotics, steroids, and hormones and is very high in inflammatory omega-6 fats.
- Raised on pasture, grass-fed meat contains less omega-6s plus a fair amount of omega-3s, resulting in a much better omega-6: omega-3 ratio.
- Prefer chicken that is organic and free-range for the same reasons as above.
- Avoid processed meats. They contribute to both inflammation in general and heart disease specifically. Processed meat is defined as any meat preserved by curing, salting, smoking, or with the addition of chemical preservatives, such as those found in salami, sausages, hot dogs, luncheon meats, and bacon.
- If you like butter and cheese, try to buy organic. Hard cheeses are a good source of vitamin K2. Avoid margarine and cut down on your milk intake.
- Reduce omega-6 fats as much as possible. Avoid highly-processed supermarket polyunsaturated oils (such as corn, canola, and safflower). They are widely used for frying, however, the heat makes them prone to unhealthy oxidation and transformations. For cooking in general I recommend coconut oil, a saturated fat least vulnerable to oxidative deterioration from heat.
- One of the common misconceptions floating around relates to my favorite oil, olive oil. For sure, extra virgin olive oil is heart-healthy, but not for use in cooking. It will break down more easily, so save it for drizzling onto vegetables and salads. If you want to cook with it, use a light version olive oil at low temperatures for shorter periods of time, such as sautéing.
- Enjoy your eggs whole – yolk and all – and don’t be swayed by the occasional skewed studies about the so-called “dangers” of eating egg yolks because of their cholesterol and fat content.
- Castelli W. Concerning the possibility of a nut . . . ” Arch Intern Med,1992:152(7):1371–72.
- Lawrence GD. Dietary fats and health: Dietary recommendations in the context of scientific evidence. Adv Nutr, 2013;4:294-302.
- An Pan, et al. Red Meat Consumption and Mortality. Arch Intern Med. 2012;172(7):555-63.
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