Why Your Low-fat Diet is Killing You.

Ok that was a bit dramatic, but still…it’s true.

Why Your Low-fat Diet is Killing You.

If you’ve been following this blog for some time, you might think I’m a little obsessed with dietary fat.  You’re right.  I think – no, scratch that – I know that the past several decades of advice to eat a “low-fat diet” are inherently flawed.  My last post was also about fat, and you can read that here.  However, there is still more to say on the matter…hence today’s post!

I have been inspired to write about a few specific conditions today:  non-alcoholic fatty liver disease (NAFLD), high triglycerides, prediabetes, gout, and heart disease.  I’ve been inspired because if I hear one more medical professional recommend a “low-fat diet” as a therapeutic intervention for any of the conditions I just mentioned, I might actually lose my mind.  We’ve all heard that advice at some point throughout the past 30 years, I’m certain of it.  But it is wrong…so wrong.

First of all, the common denominator in NAFLD, high triglycerides, prediabetes, gout and heart disease is a dysfunctional metabolism.  In fact, when several of these conditions are found congregating in one individual, the diagnosis is often called “metabolic syndrome.”  These conditions all manifest in slightly different ways, but they all indicate that the individual’s system is not functioning as it should.  It could be said that the biggest contributor to ALL of these conditions is insulin resistance.  Guess what the biggest cause of insulin resistance is?  You’re right!  It’s poor eating habits!  Let’s dive into why.

Insulin has multiple important jobs in our body, but the two we’re going to focus on today include blood glucose (sugar) management and fat metabolism and storage.  Think of insulin like a key that unlocks all of your body’s cells so that glucose has a way in.  Glucose needs to get into your cells, because it is fuel for your metabolism to function properly.  One of insulin’s best friends is an enzyme called lipoprotein lipase (LpL).  LpL is like the gatekeeper for your fat cells.  When insulin in the bloodstream is elevated, that signals your fat cells to lock up tight, as your body does not need to burn any fat (it senses it has plenty of sugar to supply energy).  LpL also helps to break down triglycerides for transport into your fat cells for storage.  However, the fat cells have already been locked-up because they were told they don’t need to release any fat, and they aren’t taking in any new fat for storage.

So what now?  Well, if we are insulin-resistant, and when we eat too many carbohydrates, we have some serious issues.  We end up with a surge of blood glucose, a surge of insulin, and a bunch of triglycerides – all of whom don’t have anywhere to go but our bloodstream.  Eventually our liver becomes a dumping ground for all these triglycerides that don’t have a home, hence the development of “fatty liver.”  Those elevated blood sugars that are stuck in our bloodstream because insulin is not working properly lead us toward prediabetes (and eventually type 2 diabetes).

lowfat

Excessive carbohydrate consumption doesn’t just affect our weight, blood glucose, or our liver; it affects our entire blood vessel system and is one of the main contributors to gout.  I know, everyone with gout has been taught to “avoid purines, especially from beer and red meat.”  This advice, although partially true, is going to fail you if you have gout.  Gout is a painful arthritic condition that is caused by the accumulation of uric acid crystals in joints, most often one’s big toe, and most often in men (but also in women).  Fructose, a type of sugar, is a major contributor to the production of uric acid.  I’m not talking about fructose from whole fruit; I’m talking about fructose from added sugar – high-fructose corn syrup, plain ol’ table sugar, sugary beverages, and honey (yep, seriously).  Too much sugar, too much beer, and/or not enough fiber-rich vegetables (inadequate antioxidant intake), and omega-3 fatty acids are the biggest pathways toward developing gout.

Heart disease is not caused by cholesterol.  Ok, don’t have a heart attack from what I just said.  Cholesterol is guilty by association when it comes to heart disease.  Having cholesterol in our bloodstream is not independently why we get clogged arteries.  Having damaged arteries and damaged cholesterol is why we get clogged arteries.  I will attempt the best analogy I can think of to explain what I mean, next.

Imagine your arteries are like a big sewer drain, the kind you see all the rainwater and leaves and gook and stuff go into on the side of the street in the curb.  Typically, the sewer drains are designed to expect a decent amount of water, leaves and gook; and when it rains a lot, everything just dumps in there and travels…well somewhere…(I don’t know exactly where it goes, but stay with me here!).  Think of the sewer drain pipes as your arteries, the water as your blood, and the leaves and gook as your cholesterol.  Even when there is a ton of leaves and gook, the sewer drain somehow seems to gather it all up and it flows nicely.  But when a twig or something gets caught in a little crack or something in the sewer drain, now all the leaves and gook are collecting around that twig.  Sometimes so much leaves and gook collect around that twig, or around many twigs, that the sewer pipe flow slows down and eventually can get backed up.  That twig is like a little damaged area of your artery.  Without the twig in the sewer pipe, the leaves and gook wouldn’t have gotten stuck; without damage to your artery, the cholesterol wouldn’t have gotten stuck.

So…it’s not the presence of cholesterol that causes heart disease; sure, too much cholesterol is like too much leaves and gook in the sewer:  it increases the likelihood of clogging if damage occurs.  But, if you’re tracking here, the real problem is the damage itself.  What causes this damage in our arteries?  Many things do, but in the context of today’s discussion, it’s inadequate omega-3 fatty acids, inadequate fiber and antioxidants, too much refined/processed carbohydrate, and inadequate exercise mostly.  Antioxidants are pretty important in the case of preventing damage to our arteries, because antioxidants sort of neutralize the “bad stuff” that damages our cholesterol and our artery walls.  When we have high cholesterol, we are given medications to reduce the cholesterol; but that doesn’t solve the real issue.  Even people without high cholesterol have heart attacks.

Thanks for sticking it out this far, I’m impressed you’re not asleep!  Despite all this wordswordswords today, I am doing my absolute best to oversimplify things for the sake of explanation.  What should you do with all this info?  Well here are the major take-aways:

  • Insulin-resistance is the #1 contributor to many of our major chronic conditions, especially NAFLD, high triglycerides, prediabetes, gout, and heart disease.
  • Reducing intake of carbohydrates, especially white [enriched] flour, white rice, white pasta, sugary foods, sugary beverages, and fruit juice is critical.
    • You don’t have to completely give up carbs, just stop having them be the center of your universe.
    • Some carbs that can and should be included in your mealtime delight in very small portions are:
      • Whole starchy vegetables including white potatoes, sweet potatoes, corn, peas, legumes (kidney beans, pinto beans, etc.), and winter squash
      • 100% whole grains like whole grain bread, whole grain crackers, quinoa, brown rice, etc.
      • Whole fruits like apples, bananas, berries, pears, etc.
    • Eating vibrant, copious amounts of whole, non-starchy vegetables is critical to good health.
      • The pigments that make those plants so vibrant and beautiful are antioxidants.
      • We must have antioxidants to prevent damage to our bodies, especially our arteries.
      • Examples include dark leafy greens, tomatoes, bell peppers, carrots, and beets.
      • Just because a non-starchy vegetable may not be vibrant doesn’t mean it lacks antioxidants; the vibrancy is only one indicator.
        • Examples of pale, but antioxidant-rich vegetables, include onions, cauliflower, jicama, and daikon radishes.
      • We have to, have to, have to consume omega-3 fats.
        • The BEST sources include wild-caught fatty fish, especially salmon (even canned), tuna, sardines, halibut, and mackerel.
        • Some other good sources of omega-3 fats include flaxseed and walnuts.
        • If you truly cannot handle eating fish or flax, you really should be taking an omega-3 fish oil supplement (but that is a last resort – real foods always prevail).

Low-fat is not the answer to improving health; in fact, eating a moderate amount whole-food-based fats, especially things like avocados, olives, nuts, seeds, and fatty fish, can help you to have a more stable appetite and subsequently help you to lose weight over time if done right.  Saturated fats like butter, ghee, and coconut oil are resistant to damage from heating, and therefore less likely to contribute to damaging your arteries than oils (vegetable aka soybean oil, canola oil, corn oil, etc.).  Extra-virgin olive oil and avocado oil are some helpful fats, but best when NOT heated.

Eat real foods.  A healthy diet is one that is high in vegetables, moderate in fruits, moderate in fats, moderate in protein, and low in carbohydrates (the right kinds).  Don’t overcomplicate things.  See a registered dietitian nutritionist (especially those involved in integrative and functional nutrition) for an individualized plan of action.

xoxo – Casey

When Fat is Phat

When Fat is Phat

I have not intentionally been sending you fewer blog posts in the past few months, promise.  Gosh I hope you noticed…!  What I have been doing is analyzing a ridiculous amount of data to compile a comprehensive research paper regarding saturated fat and heart disease.  I’m not ready to spill the beans on the finished product just yet, but I’m excited to give you a little glimpse of my findings so far.

I know saturated fat has gotten raked over the coals in the mainstream for decades due to being “artery clogging.”  However, the recommendation to eat a “low-fat diet” or “low-saturated-fat diet” is based on some seriously flawed research stemming from the 1960s and 1970s.  Which, I have to say, after having utilized technological resources to help me thumb through >500 studies for this project, I have no idea how those researchers were able to truly conduct quality studies.  But anyway…

Way back in the 1960s a fella named Ancel Keys led a revolution regarding saturated fat.  He found in his infamous Seven Countries Study1 (and derivatives of it) that people who ate the most saturated fat died quicker than those who ate less saturated fat.  However, these (Seven Countries and its follow-ons) studies were observational in design (click here for more on why that would matter), and cannot prove cause and effect.  Furthermore, one huge (or would have been huge) review analyzed >3,500 studies only to find that ZERO studies exist (as of 2011) to support the recommendation to consume a “low-fat diet” for prevention or treatment of high cholesterol. No, that wasn’t a typo:  ZERO studies support that.  But gosh, the American Heart Association (AHA) is so adamant about low-fat eating!  Here is something else super interesting.  The Presidential Advisory from the AHA3 that came out in 2017 to reassure everyone that saturated fat (including coconut oil) is still bad for us was a pretty shady publication.  By study design criteria, that publication is a narrative review, which means that it has the potential to carry a lot of people’s opinions.  No information was listed regarding how they chose studies for their review, which often means that they can selectively include/exclude studies that meet their agenda (this is cutely referred to as “cherry picking data”).  Furthermore, it would take me all day to type up all of the financial support the authors received from Big Pharma and Big Food, not to mention the COUNTLESS advisory boards for Big Pharma and Big Food on which many of the authors serve.  (But you can download the full text to see for yourself here.) Bias, anyone…?

Furthermore, without getting too deep into detail here, the interventions used in nutritional studies MATTER, yet often get ignored because many people just settle in on the conclusions found.  For example, one randomized controlled trial I analyzed in my project gave group A high saturated fat and white bread, group B high monounsaturated fat with white bread and tomatoes, and group C polyunsaturated fat with white bread, tomatoes, and walnuts.  You guessed it – the group receiving saturated fat and white bread had less desirable health outcomes than the other two groups.  No kidding?  Groups B & C were given a fighting chance with receiving fiber and antioxidants from the tomatoes and walnuts.  The real thing to take from that example, is that when you are trying to compare two things, you have to actually compare two like things.  A confounding factor is something that interferes with the trial in such a way that you no longer can determine cause and effect.  If you didn’t give the saturated fat group tomatoes and walnuts as well, then you can’t possibly make a determination in comparison to the groups that had that extra fiber and antioxidants.  HOWEVER, when the early morning news shows get ahold of the conclusion statement of these types of trials, they have no expertise or analytical skills to realize that this was crappy science; they simply report “latest study proves, yet again, that saturated fat is going to kill you.”

fat

Ok, so when is she going to get to the point?  The real conclusion I have come to through 3 months of very little sleep and 53 glorious pages of results from the analysis of 349 peer-reviewed research studies (I only included 3 of them here today) on saturated fat and heart disease published since 2010 is:

  • Evidence supporting the limiting of saturated fat for the prevention or treatment of heart disease is limited at best, and evidence supporting a low-fat diet to prevent or treat high cholesterol is nonexistent.
  • Saturated fat, with the exception of specific types like stearic acid, do tend to raise both LDL (bad) cholesterol and HDL (good) cholesterol. The LDL from saturated fat intake are typically “large fluffy” in nature, and therefore less likely to “clog” your arteries.
  • Although high LDL is a risk factor for heart disease, high inflammation and/or oxidative stress has been found to be the catalyst causing the artery plaque to build, not LDL independently.
  • A low-fat diet should not be recommended for anyone, including those looking to prevent or treat high cholesterol or heart disease.
  • Future studies examining intake of saturated fat in the context of adequate omega-3 fat intake and/or fiber intake are critical to truly understanding the holistic impact of saturated fat as part of an otherwise healthy eating pattern.
  • Consumers should increase intake of whole plant foods rich in fiber as well as an increased omega-3 fat intake, as well as whole-food sources of all types of dietary fat in the spirit of prevention and treatment of heart disease.
  • Saturated fat can and should be a part of a holistic, moderate-fat-containing, eating style for most individuals, as the benefits of saturated fat cannot be disregarded.
  • US Dietary guidelines, historically and currently, seem to be based on limited and/or flawed literature surrounding the role of saturated fat in overall health as well as the prevention and treatment of heart disease.
  • Saturated fat should not be limited nor consumed in excess.
  • Whole-food saturated fat sources would be best; and use of saturated fat in cooking would be ideal to prevent excessive production of free-radicals from vegetable oils.

And there you have it.  What are some holistic sources of saturated fat?  Well, pasture-raised and/or grass-fed meats, butter (grass-fed preferred), ghee, extra-virgin coconut oil, whole-fat dairy products (yogurt, milk, cottage cheese, cheese), nuts, seeds, etc.  Including omega-3-rich fats like salmon, tuna, cod, sardines, halibut, mackerel, flaxseed, walnuts, etc., as well as TONS of whole, colorful vegetables in your daily/weekly eating routine are crucial to good health as is a little but of uncooked extra-virgin olive oil.  Have less vegetable oils and less carbs (you don’t have to give them up, nor should you; but reducing carb intake is typically beneficial for most people) and try to make your carb choices 100% whole grains, whole fruits, or starchy vegetables.

Until next time…xoxox

Casey

 

References

  1. Keys A, Menott A, Karvonen MJ, et al. REPRINT: The Diet and 15-Year Death Rate in the Seven Countries Study. American Journal of Epidemiology. 2017;185(11):1130-1142.
  2. Smart NA, Marshall BJ, Daley M, et al. Low-fat diets for acquired hypercholesterolaemia. Cochrane Database Syst Rev. 2011(2):Cd007957.
  3. Sacks FM, Lichtenstein AH, Wu JHY, et al. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. 2017;136(3):e1-e23.

Nutritional Nit-Picking and Why it Sucks

Hey!  Guess what time it is?  It’s National Nutrition Month time again!  That’s right, the entire month of March is devoted to celebrating the wonderment that is life-sustaining, nourishing sustenance, otherwise known as…healthy eating!  Furthermore, March 14th happens to be Registered Dietitian Nutritionist Day!  I know; it is difficult to contain all the excitement, isn’t it?!

Nutritional Nit-Picking and Why it Sucks

Anyway, today’s topic was brought to you by the colors black and white, because those are the colors nutritional concepts are NOT.  Every single day someone asks me a point-blank question about some food or nutrient expecting a point-blank answer.  Those of you who have spent any time around me already know that my answers are never point-blank…they are loooong and probably annoyingly informative.  The reason my answers can typically never be “cut and dry” is because nutrition simply doesn’t work that way.  Nutrition is not “black and white;” it is not always simple; rather, nutrition concepts are sometimes gray and blurry.  Let’s get to some examples, shall we?

One of my most favorite and recent examples of gray concepts happens to revolve around the most delicious yogurt in the world, Noosa.  First and foremost, please know that I do not work for Noosa, nor do I receive any sort of compensation for what I’m about to say (but Noosa – if you’re listening – some coupons for free Noosa would be DOPE; just sayin’).  I often catch a lot of flack for eating Noosa, mostly because it is “high in sugar.”  But let’s dissect the situation and make it complicated for a second.  An average Noosa can have more than 20 grams of sugar in an 8-ounce container.  Ok, ok…peel your jaw up off the floor and hear me out.  Of that 20-something grams of sugar, a significant portion is lactose.  Lactose, if you’re unfamiliar, is simply “milk sugar;” it is a natural carbohydrate (aka sugar) found in milk.  Some of those grams of sugar do come from ghastly added sugar, sure.  But here’s an important aspect to consider:  the scant amount of added not-good-for-you added sugar is typically mixed into a real fruit puree that is the essence of what makes Noosa so amazing.  That little container of joy also has roughly 12-15 grams of protein, a boatload of calcium, and some delightful little gut germs, all of which keep your insides happy.

What’s the point of my droning on and on about Noosa?  Honestly, it’s just a detailed example of something I desperately try to help people understand each day, which is to stop missing the forest for the trees.  In other words, stop getting so hung up on tiny aspects of the food you eat that you miss the chance to get NOURISHED.  If I was given the choice between plain yogurt or no yogurt, I’d pick no yogurt.  (We could get into a debate about whether or not you can or should have dairy, but that is for another day.)  What I’m getting around to is the fact that one of my major sources of calcium is Noosa.  That tiny amount of sugar in Noosa makes it so stinking tasty that I have one nearly every single day.  And, because of Noosa, I have a protein-rich and nutrient-rich snack most days around 3 pm, which prevents me from eating my children and husband when I walk in the door due to being uncontrollably hangry after a long day of work.

Don’t pass up the avocado because it “has too many calories;” you’ll miss out on a TON of fiber, potassium, B-vitamins, and antioxidants.  Don’t pass up the Noosa because it has “too much sugar;” you’ll miss out on probiotics, calcium, vitamin C, and protein.  Don’t avoid the 100% whole grain bread because it’s got “too many carbs;” you’ll miss out on magnesium, fiber, and folate.  When you take a step back from all the noise about nutrition and start to refocus on eating real foods, you don’t need to count anything or measure anything.  Ask yourself how that food got to you (without a Google search), and if you can’t figure it out, don’t eat it.  If you don’t recognize the ingredients on the package, don’t buy it.  Food should be simple, pure, and wholesome.  Food should not be created by someone in a lab wearing goggles; food should be grown and raised.  But, occasionally, indulging in stuff that sucks nutritionally but makes you have a moment of joy…well, that isn’t terrible if done sparingly.  Be smart.

Don’t get so caught up in the details that you miss little opportunities to put nourishing, tasty, amazing nutrients into your belly.  Eat mostly vegetables, some fruit, some 100% whole grains, some protein-rich foods, some fats, drink LOTS of water, and get up and move around.  Despite all the talk about sugar today, try to consume less and less and less added sugar to the best of your real-life abilities.  But try not to overthink it!  And, as always, consult a local registered dietitian nutritionist to help you work out the details and optimize the best you there is.

Love ya – mean it.
xoxo

Casey