“For every complex problem there is a solution that is simple, neat and wrong.” H.L. Mencken
“One must attend in medical practice not primarily to plausible theories but to experience combined with reason.” Hippocrates
The evolving understanding of the causes of heart disease– the major killer disease of the 20th century–is a fascinating, complex Gordian knot of a story. Contrary to popular beliefs, the cause of heart disease can not be simply and irrefutably attributed to the consumption of saturated fats (SF) and cholesterol.
Naomi Bastow (AC-T, Oct 30) railed against my mention of butter and coconut oil as healthy fats in several of my Natural Health “columns. She asked how I could be so unscientific as to recommend saturated fats? Ms.Bastow’s objections derive from her adherence to the very familiar American Heart Assocication’s (AHA) position, which is the prevailing wisdom of the day for the cause of heart disease – the lipid hypothesis. Let’s not forget that thanks to the AHA’s promotion of margerine and vegetable oils over the past couple of decades, Americans have consumed tons of trans-fats – the very worst fat villain to date.
Surely our readers know the plot line by now: eating SF and cholesterol raises cholesterol; elevated cholesterol causes heart disease; therefore, claim the lipid theorists, dietary cholesterol and SF cause heart disease. And so, for decades SF and cholesterol have carried the “bad-boy” labels in the family of fats.
If it were only so simple. The lipid hypothesis does not have the monopoly on scientific truth. It is neither incontrovertible nor absolute. Recommendations to avoid oils like butter or coconut oil are simply not based on “solid scientific facts”. If one were willing to take an open but critical mind to the body of relevant scientific literature they would find strong and persistent dissent in the scientific ranks with regard to the veracity of the lipid hypothesis. These dissenting opinions are not readily offered to the lay public, or to medical practitioners for that matter
An excellent overview of “The Soft Science of Dietary Fat” can be found in the March 30 2001 issue of Science (online at http://nasw.org/mem-maint/awards/01Taubesarticle1.html ) The author, Gary Taubes, takes us through the political, social, economic and scientific history of the evolution of the lipid hypothesis. He writes, “…despite decades of research, it is still a debatable proposition whether the consumption of saturated fats above recommended levels by anyone who’s not already at high risk of heart disease will increase the likelihood of untimely death….To put it simply, the data remains ambiguous as to whether low-fat diets will benefit healthy Americans.”
The physicians, biochemists, researchers, and statisticians who object to the causative linking of saturated fats to heart disease claim that large-scale misrepresentation and misinterpretation of the data accounts for this incorrect association. In fact, meta-analyses of all controlled and randomized trials that have used dietary modification of dietary fat as the only type of intervention have shown that neither heart disease, nor coronary or total mortality, were significantly impacted.
From the British Medical Journal 2001:322:757-763: “Despite decades of effort and many thousands of people randomized, there is still only limited and inconclusive evidence of the effects of modification of total, saturated, monounsaturated or polyunsaturated fats on cardiovascular morbidity or mortality. There is little effect on total mortality.”
And from another review of the dietary studies in the Journal of Clinical Epidemiology, 1998 June;51(6):443-60: “The harmful effects of dietary saturated fatty acids and the protective effects of dietary polyunsaturated fatty acids on atherosclerosis and coronary vascular disease are questioned.” Even Dr.Ron Krauss, who chairs the AHA Dietary Guidelines Committee, now calls it “scientifically naïve” to expect that a single dietary regime can be beneficial for everybody: “The ‘goodness’ or ‘badness’ of anything as complex as dietary fat and its subtypes will ultimately depend on the context of the individual.”
With the vilification of cholesterol and saturated fats, the layperson would never guess that they are both naturally made in significant amounts by our cells, and are critical to the optimum functioning of the human body. They are both a major component of our brains and nervous system. At least 80% of the total cholesterol in our bodies is ‘self-made’, primarily in the liver. Dr. Mary Enig, a lipid biochemist and nutritionist, reviews the vital roles of saturated fats and cholesterol at www.westonaprice.org/know_your_fats/skinny.html.
Butter and coconut oil have been used for centuries and I expect that in the future the prevailing wisdom will once again recognize them as healthy fats. They both actually have unique health benefits when consumed. Until I see convincing data to do otherwise, I will continue to recommend organic butter and coconut oil as healthy fats, used in the context of a diet with plenty of antioxidant-rich fruits and vegetables. I also urge interested lay people and medical practitioners to critically examine all of the relevant literature before they condemn one entire subset of macronutrients.