Saturated fat is protective and not cause of cardiovascular disease
28 October 2013
Saturated fat has been wrongly demonised as the cause of obesity
and heart disease because of wrongly associated data from the 1970's, when the evidence is just the
opposite, argues a cardiologist on bmj.com.
Aseem Malhotra, interventional cardiology specialist registrar at
Croydon University Hospital in London, says scientific evidence
shows that advice to reduce saturated fat intake “has paradoxically
increased our cardiovascular risks”.
And he says the government’s obsession with levels of total
cholesterol “has led to the over-medication of millions of people
with statins and has diverted our attention from the more egregious
risk factor of atherogenic dyslipidaemia” (an unfavourable ratio of
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 fat intake to 10%.”
He points out that recent studies “have not supported any
significant association between saturated fat intake and risk of
CVD.” Instead, saturated fat has been found to be protective.
One of the earliest obesity experiments, published in the Lancet
in 1956, compared groups consuming diets of 90% fat versus 90%
protein versus 90% carbohydrate and revealed that the greatest
weight loss was in the fat consuming group.
And more recently, a JAMA study revealed that a “low fat” diet
showed the greatest decrease in energy expenditure, an unhealthy
lipid pattern, and increased insulin resistance (a precursor to
diabetes) compared with a low carbohydrate and low glycaemic index
Malhotra also points to the United States, where percentage
calorie consumption from fat has declined from 40% to 30% in the
past 30 years (although absolute fat consumption has remained the
same), yet obesity has rocketed. One reason, he says, is that the
food industry “compensated by replacing saturated fat with added
And despite the fact that in the UK, 8 million people take
statins regularly, he asks why has there been no demonstrable effect
on heart disease trends during this period?
Adopting a Mediterranean diet after a heart attack is almost
three times as powerful in reducing mortality as taking a statin,
writes Malhotra. “Doctors need to embrace prevention as well as
“The greatest improvements in morbidity and mortality have been
due not to personal responsibility but rather to public health,” he
concludes. “It is time to bust the myth of the role of saturated in
heart disease and wind back the harms of dietary advice that has
contributed to obesity."
Commenting on the article, Professor David Haslam, Chair of
Britain's National Obesity Forum said: "It's extremely naive of the
public and the medical profession to imagine that a calorie of
bread, a calorie of meat and a calorie of alcohol are all dealt in
the same way by the amazingly complex systems of the body. The
assumption has been made that increased fat in the bloodstream is
caused by increased saturated fat in the diet, whereas modern
scientific evidence is proving that refined carbohydrates and sugar
in particular are actually the culprits."
Professor Robert Lustig, Paediatric Endocrinologist, University
of San Francisco added: "Food should confer wellness, not illness.
And real food does just that, including saturated fat. But when
saturated fat got mixed up with the high sugar added to processed
food in the second half of the 20th century, it got a bad name.
Which is worse, the saturated fat or the added sugar? The American
Heart Association has weighed in — the sugar many times over. Plus
added sugar causes all of the diseases associated with metabolic
syndrome. Instead of lowering serum cholesterol with statins, which
is dubious at best, how about serving up some real food?”
Finally, Timothy Noakes, Professor of Exercise and Sports
science, University of Cape Town, South Africa said: "Focusing on an
elevated blood cholesterol concentration as the exclusive cause of
coronary heart disease is unquestionably the worst medical error of
our time. After reviewing all the scientific evidence I draw just
one conclusion - Never prescribe a statin drug for a loved one.”