02/23/2012 11:51 am ET Updated Dec 06, 2017

Readers Inflamed: 'The Great Fat Debate' -- Heart Month Day 23

Dr. Weil's Anti-inflammatory Food Pyramid


I knew I couldn't get away with it: ignoring the "Great Fat Debate" in my "Unsaturated Fat Tuesday" column earlier this week.

Some readers were quick to remind me of doctors, health care professionals, and laymen who say current U.S. Government dietary guidelines are behind the times regarding the relationship between saturated fats (like butter and lard) and heart disease. One reader referred me to the February 2012 issue of the journal Nutrition to prove it.


The crux of the matter is that cardiovascular disease (CVD) is increasingly thought of as an inflammation rather than a traditional "disease." Your age, gender, personal risk factors, and what you eat make a difference in when, and if, you develop this type of inflammation. Click here if you've had a heart attack.

"This gets into a fascinating and complex, but unresolved issue," says John McDermott, M.D., a retired cardiac surgeon from Syracuse, N.Y. "There certainly are more cardiac events and atherosclerosis associated with saturated fats."

But scientists aren't sure yet whether it's the saturated fats themselves or their associated protein that contribute to inflammation, aging and CVD. "The real answer," McDermott surmises, "is that they both contribute. People exposed to high levels of synthetically manufactured fat and those with high C-reactive protein levels are both more predisposed to atherosclerotic build-up in their arteries."

Newer findings confirm that saturated fatty acids (SAFAs) increase serum total cholesterol only slightly, while not increasing the risk of (CVD) at all. If this sounds like heresy wait, there's more.

Replacing saturated fat with high glycemic index dietary carbs does increase CVD, according to the Netherlands Journal of Medicine published in September 2011. Replacing SAFAs with polyunsaturated fatty acids (PUFAs) doesn't. What's more, polyunsaturated fats include omega-3 fatty acids and omega-6 fatty acids. The body needs both and in the proper ratio. But omega-3 somehow wears the white hat with omega-6 the villain of grocery store shelves. I don't have space to get into that gun fight here. So back to saturated fat.

"... My thinking on saturated fat has evolved," says health guru Andrew Weill, M.D. "One catalyst was a scientific analysis of 21 earlier studies, which showed 'no significant evidence' that saturated fat in the diet is associated with an increased risk of coronary heart disease."

"The 21 studies analyzed included nearly 348,000 participants, most of whom were healthy when they were enrolled. They were followed for five to 23 years, during which 11,000 developed heart disease or had a stroke. Looking back at the dietary information collected from these thousands of participants, the investigators found no difference in the risk of coronary heart disease, stroke, or coronary vascular disease between those individuals with the lowest and highest intakes of saturated fat. This goes completely against the conventional medical wisdom of the past 40 years. It now appears that many studies used to support the low-fat recommendation had serious flaws."

Forty years of recommending low-fat foods has steadily driven up consumption of added sweeteners, and high-fructose corn syrup in particular. Low-fat prepared foods tend to be highly sweetened, according to a study from Emory University and the U.S. Centers for Disease Control and Prevention published in April 2010. The study showed that sweeteners seem to lower levels of HDL ("good") cholesterol and raise triglycerides -- increasing the risk of heart disease.


Mehmet Oz, M.D. (pictured here with TV host Gayle King), my "go to," Oprah-approved, trusted guy recommends limiting saturated fat and its associated protein -- he posits that these actually change your genes in ways that stimulate aging and inflammation, spawning vascular diseases -- like heart disease, stroke, memory loss, impotence and, yes, even skin wrinkling -- as well as making cancer more likely.

Oz advocates limiting your intake of high-fat foods and red meat. Like Weil, he recommends a plant-based diet loaded with fruits, vegetables, whole grains and legumes. For Heart Health Month he suggests gradually making some menu changes, like rotating in his Hot Chili Sauce (relaxes blood vessels that may reduce blood pressure), kidney beans (reduce inflammation), and sweet potatoes (protect the heart). Click here for Big Daddy's Chicken Sriracha Stir-Fry, a recipe that combines all three of the powerful foods.

Considering this data, Dr. Weil no longer recommends low-fat dairy products. He believes the healthier choice is high-quality, organic dairy foods in moderation -- say, high-quality, natural cheese (ice cream or butter) a few times a week. Though he stays away from salty bacon and conventionally raised beef.

I confess that, personally, I lean toward the newer findings in my own dietary choices, but I also have a metabolism that thrives on protein. Like my parents, I have a highly protective HDL number of 108 -- when "good" is any number above 46. In my body, carbs turn quickly to sugar and my energy tanks. It's genetic. My dad had meat and potatoes running in his veins and maintained perfect cholesterol levels. Sadly, he couldn't kick his cigarettes, but that's another story. No Smoking Day isn't until March 14.

See you tomorrow.

Anti-inflammatory Food Pyramid courtesy of Dr. Weil on Healthy Aging.

Other photos via Getty.


2012-02-13-AlarmClockHeartGetty.jpgHeart attack survivors, please click on the blue Public Service banner above and take the Yale Heart Study. If you haven't had a heart attack, click and forward to someone you love who has had a heart attack. Thank you.

Heart attack survivors, please click on this link and take the Yale Heart Study. If you haven't had a heart attack, click and forward to someone you love who has had a heart attack. Thank you.

Disclosure: Suzanne O'Malley is a Senior Research Associate for the non-profit NIH-funded Yale Heart Study, application period is now open for her creative and screenwriting classes this summer at Yale Writers' Conference & Yale Summer Film Institute.


For more by Suzanne O'Malley, click here.