Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Saturated Fat is not the major issue

bmj.com

Post reply on HN
Print view View original

11–20 of 62 posts

Re: Saturated Fat is not the major issue

#11

Post by scotch_drinker »

There have been a lot of people saying this for quite awhile. Malcolm Kendrick wrote an entire book about the poor science behind our current belief that cholesterol causes heart disease. There are many others. But in the current medical environment where doctors want to prescribe a pill to fix everything and the biogen companies have enormous influence over public policy, dissent never rises above the level of a whisper.

Smoking, cocaine, stress, these things cause heart disease. Saturated fat probably isn't even a minor issue as it relates to heart disease. Every day, millions of Americans take a pill to reduce cholesterol when it's not even an issue. But don't expect that to ever change no matter how many doctors start saying saturated fat isn't the major issue.

Re: Saturated Fat is not the major issue

#13

Post by patrickg_zill »

swombat wrote: post #3

Saturated fat has been demonised since the 1970s when a landmark study concluded that there was a correlation between incidence of coronary heart disease and total cholesterol, which then correlated with the percentage of calories provided by saturated fat, explains Malhotra. “But correlation is not causation,” he says. Nevertheless, we were advised to “reduce fat intake to 30% of total energy and a fall in saturated…

It benefited the wheat farmers and "Big Ag" so there was possibly political pressure to focus on this.

Re: Saturated Fat is not the major issue

#14

Post by gabemart »

I'm confused by the reference towards the Mediterranean diet being protective against heart disease, because it seems tangential to the argument presented in the rest of the article.

The clinical Mediterranean diet is low in saturated fat. In one of the landmark papers measuring the effects of the Mediterranean diet on CVD risk, the "prudent" Western-style diet used as a control has 11.7% of calories from saturated fat, while the experimental Mediterranean diet has 8.0% of calories from saturated fat [1]. This diet is actually within the 10% limit the article references as out-of-date advice from the 1970s.

Another large intervention study has the calories from saturated fat on a Mediterranean-style diet falling from 13.7% before intervention to 8.0% after intervention [2], again below the 10% limit.

I am not at all suggesting that the Mediterranean lowers the risk of CVD because it is low in saturated fat. It just seems odd to use it as an example of saturated fat not being linked with CVD risk without addressing the fact that the Mediterranean diet is relatively low in saturated fat, and that intervention studies using the Mediterranean diet typically reduce the % calories from saturated fat in the intervention group.

It also seems odd to use the Mediterranean diet as an example in an article that paints refined carbohydrates as a major CVD risk factor. While the Mediterranean diet is relatively higher in whole-grain carbohydrates [2], it still includes lots of refined-carbohydrate foods (think pasta), and it introduces so many other dietary changes, particularly a vast increase in consumption of fruits and vegetables [2], that one can't assume that the increase in whole grains particularly is the source of the diet's protective effects against CVD risk.

[1] http://www.drhirani.com/Assets/lyonfinalreport.pdf

[2] http://jama.jamanetwork.com/article.aspx?articleid=199488

Re: Saturated Fat is not the major issue

#15

Post by yetanotherphd »

scotch_drinker wrote: post #11

There have been a lot of people saying this for quite awhile. Malcolm Kendrick wrote an entire book about the poor science behind our current belief that cholesterol causes heart disease. There are many others. But in the current medical environment where doctors want to prescribe a pill to fix everything and the biogen companies have enormous influence over public policy, dissent never rises above the level of a whi…

You are ignoring the medical researchers who advocate for a diet low in saturated fat, and ridiculously characterizing mainstream doctors as not caring about prevention, and perhaps even wanting to cause disease so that they can treat it.

I'm on the fence on saturated fat, but it is an issue that is being debated by people who on both sides want to discover the best diet for preventing disease and lengthening life.

Re: Saturated Fat is not the major issue

#16

Post by yetanotherphd »

swombat wrote: post #3

Saturated fat has been demonised since the 1970s when a landmark study concluded that there was a correlation between incidence of coronary heart disease and total cholesterol, which then correlated with the percentage of calories provided by saturated fat, explains Malhotra. “But correlation is not causation,” he says. Nevertheless, we were advised to “reduce fat intake to 30% of total energy and a fall in saturated…

I think it's more a matter of different beliefs arising from complicated, hard to interpret evidence. It's very comforting to believe in good guys and bad guys, but the real world of research is more complex than that.

Re: Saturated Fat is not the major issue

#17

Post by yetanotherphd »

patrickg_zill wrote: post #13
swombat wrote: post #3

Saturated fat has been demonised since the 1970s when a landmark study concluded that there was a correlation between incidence of coronary heart disease and total cholesterol, which then correlated with the percentage of calories provided by saturated fat, explains Malhotra. “But correlation is not causation,” he says. Nevertheless, we were advised to “reduce fat intake to 30% of total energy and a fall in saturated…

It benefited the wheat farmers and "Big Ag" so there was possibly political pressure to focus on this.

What about "Big Dairy" or "Big Meat", they got the short end of the stick from the push to high carb low fat diets.

Industry lobbying as a theory lacks predictive power.

Re: Saturated Fat is not the major issue

#18

Post by dools »

mirsadm wrote: post #9
wwweston wrote: post #8

A related pet peeve: It's becoming difficult to find products with "all" the fat (vs "low/reduced" fat). Prime example for me: chocolate milk. It's pretty rare nowadays that I ever see anything over 1% milk used in it -- and of course the label touts the low fat formulation, but doesn't mention there's more sugar pumped in it than a can of soda. Even if this was healthier than full-fat/less sugar chocolate milk, I'd…

I think the biggest issue is that high (saturated) fat is often combined with high carb (refined sugars, starchy foods etc). My diet consists of high fat / low carb foods and it simply works (for me...). I've lost weight (without trying) and my energy levels are much more predictable and stable. I never watch how much I eat because my body will naturally stop be from overeating.

I found that "mentally" what worked for me was focusing on increasing fibre intake, rather than reducing sugar intake.

The effect is basically the same but I find it easier from a discipline perspective to focus on including more high fibre foods (even in "treats" and dessert foods) thank I do to "cut out" things that I enjoy.

Re: Saturated Fat is not the major issue

#19

Post by scotch_drinker »

yetanotherphd wrote: post #15
scotch_drinker wrote: post #11

There have been a lot of people saying this for quite awhile. Malcolm Kendrick wrote an entire book about the poor science behind our current belief that cholesterol causes heart disease. There are many others. But in the current medical environment where doctors want to prescribe a pill to fix everything and the biogen companies have enormous influence over public policy, dissent never rises above the level of a whi…

You are ignoring the medical researchers who advocate for a diet low in saturated fat, and ridiculously characterizing mainstream doctors as not caring about prevention, and perhaps even wanting to cause disease so that they can treat it. I'm on the fence on saturated fat, but it is an issue that is being debated by people who on both sides want to discover the best diet for preventing disease and lengthening life.

I'm not ignoring them, I'm specifically speaking to that population who advocate a diet low in saturated fat as a preventative measure for heart disease when there is NO causal evidence linking the two.

Also, I said nothing about them wanting to cause disease, I said they wanted to prescribe a pill to fix it, glossing over the known issues with the pill (statins in this case) in populations with no elevated risk of cardiovascular disease. I don't have any hard evidence of this other than the fact that in 2005, 29.7 million people in America purchased statins.

Why are you on the fence? What evidence have you seen that causes you doubt that saturated fats are unrelated to heart disease?

http://meps.ahrq.gov/mepsweb/data_files/publications/st205/s...

Post reply on HN