Should We Really End the War on Fat?

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The recent Time magazine cover story “Ending the War on Fat” by Bryan Walsh has the entire nutrition world talking: Could it be that everyone was wrong and that saturated fat is not the enemy, and the advice being given to avoid it for the last 30 years was not warranted? After all, instead of reducing heart disease, Americans simply got fatter.

It seems this all began in 1980 when the USDA issued its first dietary guidelines, and one of the key messages was to avoid cholesterol and fat of all sorts.  That same year the government announced the results of a $150 million study that encouraged Americans to eat less fat and cholesterol to reduce their risk of a heart attack, and the National Institutes of Health also jumped on the bandwagon, recommending that all Americans over the age of 2 reduce their fat intake.

However, over the last decade or so researchers began to state otherwise, concluding that there was no significant evidence that saturated fat is associated with an increased risk of cardiovascular disease.  Most recently a meta-analysis that I blogged about in March reached the same conclusions, as well as revealing that the intake of polyunsaturated fats (the supposedly heart healthy ones) also had no effect on heart disease.

Science will still support that saturated fat raises LDL cholesterol levels, which are associated with higher rates of heart disease. However, it has now been found that saturated fat also raises levels of so-called "good" HDL cholesterol, therefore they cancel each other out. What is new is that scientists have discovered there are two kinds of LDL particles: small, dense ones and large, fluffy ones. The large ones seem to be mostly harmless, and fat seems to raise those, while carbs seems to have an effect on the damaging small ones.

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So where does that leave us? As stated in the Time article, “The idea here was in part to cut calories, but Americans actually ended up eating more: 2,586 calories a day in 2010 compared with 2,109 a day in 1970.” I think that is exactly where the problem lies, plain and simple. We didn’t replace fat with fruits and veggies, but rather “fat-free” products and sugary carbs, not high-fiber ones. For some reason Americans believed that if it said “fat-free” on the label, than it was “calorie-free;" obviously that's not the case. Fat-free cream cheese on a bagel doesn’t make it a healthy choice.

Also, if you were to look at the size of portions served in restaurants over the last 30 years and the frequency of fast food dining, inevitably you will see that they both have grown tremendously. Perhaps that's another valid reason we are gaining weight, not solely because we thought to eliminate saturated fat from our diets. And by the way, there is lots of fat served at these establishments.

I won’t deny that saturated fat is no longer the evil once thought; I strongly advise all my patients to include fat with all meals throughout the day. Without some fat in a meal for satiety, most people will overeat. And yes, I like butter on my baked potato.  But let's not get carried away here. “Eat more fat” is not the correct message. One serving of butter on my potato is not the same as a stick. If only everyone could focus on eating a variety of whole foods that include fruits, veggies, 100-percent whole grains, dairy, and nuts, and watch their portion sizes, then I think positive change could really happen. And let’s not forget to exercise too.

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