Avoid one of these and eat the other to lower risk of dying

Dietary Fat Is Associated With Lower Death Risk

No, that is not a misprint. Despite dietary fat having been demonised for over 40 years and the consumption of whole grains (aka carbohydrates) having been praised and touted as our health saviour, it is really gratifying to see that science is now saying that dietary fat is associated with lower death risk and that high carbohydrate intake is associated with higher total mortality risk.

Isn’t it great when the contrary position you have held for many years is shown to be completely justified by science? The exact opposite of what we have been told for over 40 years should have formed the basis of dietary recommendations and food pyramids during that time.

If that had been the case, the epidemics of obesity, cancer, diabetes and autoimmune disease that plague the so called developed nations may never have occurred. Back in the 1970s these diseases were nearly non-existent (except for lung cancer), so imagine if society had not been given the wrong dietary advice 40 years ago and how much healthier nations would be now.

Imagine if we had been told dietary fat is associated with lower death risk back then.

The Prospective Urban Rural Epidemiology (PURE) Study

There have been many long term studies of population groups over the last few decades but these have generally always been focussed on wealthy first world countries. The PURE study was set up to overcome these deficiencies by recruiting individuals not only in high income countries but also middle income and poor countries.

This is a large, epidemiological study of 135,335 individuals from 18 countries aged 35-70 years (enrolled between Jan 1, 2003, and March 31, 2013) who were followed for an average of 7.4 years.

Their dietary intake was recorded using validated food questionnaires and the data obtained was analysed and used in several different though related study papers. Two of these papers were published in The Lancet at the end of August 2017.

The strength of this study data is that it has been obtained over many years and that it comes from 18 different countries in North and South America, Europe, Africa and Asia. This diversity means that the study results are applicable to many different cultures and socioeconomic backgrounds, and not just to those of wealthy countries, where, in general, access to excessive amounts of food is far greater and this can skew the results.

Associations of fats and carbohydrates with cardiovascular disease and mortality [1].

In this study the primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure).

The study found:-

Higher carbohydrate intake was associated with higher risk of total mortality but not with the risk of cardiovascular disease or cardiovascular disease mortality.
Intake of total fat and different types of fat were associated with lower risk of total mortality.
Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality.
Higher saturated fat intake was associated with lower risk of stroke.

The major message is that dietary fat is associated with lower death risk and is not associated with cardiovascular disease – contrary to what we have been told for over 40 years.

The study’s conclusion was that:-

Global dietary guidelines should be reconsidered in light of these findings.

Association of dietary nutrients with blood lipids and blood pressure [2]

In the second study published in The Lancet, the researchers examined the effect of dietary nutrients on blood lipid measurements and blood pressure. They found the data to be at odds with the current recommendations to reduce total fat and saturated fats. Specifically they found:-

Reducing saturated fatty acid intake and replacing it with carbohydrate has an adverse effect on blood lipids.
Substituting saturated fatty acids with unsaturated fats might improve some risk markers, but might worsen others.
Simulations suggest that Apolipoprotein B to Apolipoprotein A1 ratio probably provides the best overall indication of the effect of saturated fatty acids on cardiovascular disease risk among the markers tested.
Focusing on a single lipid marker such as LDL cholesterol alone does not capture the net clinical effects of nutrients on cardiovascular risk.

Conclusions

We obtain our energy either from fats or from carbohydrates, so the recommendations of recent decades to reduce dietary fat can have only one consequence, namely to increase carbohydrate intake. The above studies confound these recommendations since the results show an association with increased carbohydrate intake and lowered fat intake of

A higher risk of total mortality and
An adverse effect on blood lipids.

We do hope that the study authors’ conclusion that global dietary guidelines should be reconsidered as result of their findings can actually happen and that this saves many billions of people from unnecessary health issues in the future.

Finally, whilst these studies have demonstrated associations that ought to reshape dietary guidelines and whilst these changes should be of benefit to the majority of people, please apply a little caution while increasing your fat intake. Not all fats are good – trans fats in fried fast-food and vegetable oils in processed foods should still be avoided or minimised. See Dietary Fat Is Not the Villain and the other links to blogs below for more information.

Additionally, not everyone has a liver capable of dealing with an increase in fat in the diet. Many have comprised liver function or even genetic issues preventing complete detoxification. Monitor how you feel and listen to your body – everyone is unique and we all can react in different ways to the exact same thing.

But when making food choices just remember that the first study above demonstrated that:-

dietary fat intake is associated with lower death risk, and

higher carbohydrate intake is associated with higher death risk.

Chew on those nuggets of information!

As always, minimising carbohydrates and eating good fats, Edith and Tim at CoolWellbeing Foundation

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References