One of the most important aspects about being a good practitioner/citizen/general person is to not believe everything you read or hear. It's not so much being skeptical as questioning the source of your information, wondering about the agenda behind the information, and just generally checking up on the facts. And one of the biggest lies perpetrated on people today is the paradigm of low fat -- that eating low fat is healthy for you and will prevent heart attacks and lengthen your life. Nothing could be further from the truth.
Heart Studies
Did you know that high cholesterol levels in women of all ages and in the elderly is associated with a longer lifespan? In fact, for women and the elderly, no appreciable difference in cardiovascular heart disease (CHD) rate is seen for ANY level of cholesterol. The scientific publication Circulation (Circulation 1992 86:3) in 1992 said, "Many studies have shown that all-cause deaths, especially deaths from cancer, are higher for individuals with cholesterol levels lower than 180." How about this one? "Those individuals with a low serum cholesterol maintained over a 20-year period will have the worst outlook for all-cause mortality." (Lancet, 2001 358:351-55.) You probably hadn't heard that, had you? What about the French? They have the highest saturated fat intake of the entire European Union, but have the lowest rates of heart disease (European CVD statistics, 2005). How did we end up with a national stance that is so anathema to what is actually healthy?
Between 1930 and 1960, the number of deaths from heart attacks went from 3,000 to 500,000. Today, 650,000 to 700,000 people die from a myocardial infarction every year. Researchers started looking into this and saw some trends. They pointed out that they were using a lot more vegetable oils and fewer animal fats. We were especially consuming liquid oils hardened by a process called partial hydrogenation such as margarine and shortening in baked goods. These researchers suggested the solution to the new health problem was to return to traditional foods and stop using these vegetable oils -- a very logical suggestion.
However, other scientists proposed a different theory -- the "diet/heart theory" or the "lipid hypothesis." This hypothesis was based on experiments with vegetarian rats who were fed huge amounts of purified, oxidized cholesterol, which caused them to develop what seemed like atherogenic plaque in their arteries leading to blockages and heart disease.
According to the diet/heart theory, the cause of heart disease was a "bad diet," containing too much cholesterol and saturated fat, which led to us having elevated levels of cholesterol in the blood, which in turn, led to the build-up of plaque in the arteries. The overall conclusion was that this bad, indulgent diet of butter and bacon was the cause of heart disease.
So, the first of many studies was done. In 1957, the Anti-Coronary Club was a study done with men eating a "Prudent Diet," substituting corn oil and margarine for butter, cold breakfast cereal for eggs and chicken and fish for beef. Nine years later, the "Prudent Dieters" had cholesterol levels 30 points less than the control (220 vs. 250), but had had eight deaths in their group versus none in the control.
Studies were done comparing countries around the world (Ancel Keys' Six Country Study is one of the most famous) but again and again, when looking at the full data, it cannot be seen that reducing saturated fat improves your health. The Six Country study is quoted repeatedly as one of the basic studies showing high fat intake equals high CHD, but in actuality, it's a 22-country study. And when you see the graph for all 22 countries absolutely no correlation between saturated fat intake and heart disease occurs. This is a great example of cherry-picked statistics.
The majority of your patients (and probably yourself) have heard again and again, in advertising, in headlines, in everyday conversation, that it's advisable to lower their cholesterol, reduce their intake of saturated fats and eat "healthy" vegetable oils. If you're interested in your own health, as well as the health of your patients, you might consider challenging those long-standing notions you think are correct.
The Skinny on Fats
There are books written on this topic (try Mary Enig's book, Know Your Fats) but the basics are this: all fats, saturated and unsaturated, are actually a combination of both. You need the characteristics and attributes of both. You NEED both saturated and unsaturated fats. And, like other processed foods, the more processed a fat is, the more dangerous it is to the body.
Without going into the chemical structure of fats (I could, but who wants to read that?), unsaturated fats include polyunsaturated and monounsaturated. A example of a polyunsaturated fat is flax oil or fish oil -- those are very unstable oils and go rancid very easily, which is why they have to be in containers that are dark and stored in refrigerators and packed with nitrogen because light, heat and oxygen all damage those fragile oils. You've heard you should have a lot of Omega 3's versus Omega 6's, right? The ratio is supposed to be 1:2 or up to 1:4, but for most people, the ratio is a very unhealthy 1:25 because they're eating so many oils that have Omega 6's. Where are they getting those oils?
Vegetable oils, that's where - there are healthy sources of Omega 6's like Black Currant Seed Oil, or Evening Primrose, but that's not what people are typically ingesting. We've heard we should be eating vegetable oils like corn, soy, safflower, canola, etc. and yes, they're technically polyunsaturated fats, but they're heavily processed. They are NOT fresh oils. Basically, to produce them, they have to heat the ingredients to such a high temperature it causes the oil to go rancid. You'd smell that rancidity, so then they undergo a chemical process to deodorize them and when you ingest those oils, an enormous amount of free radicals are introduced into your system, causing huge amounts of damage. It's distinctly possible the vegetable oil industry has had an influence on the U.S. food policy -- corn IS our biggest crop, after all, with soy running a close second.
Monounsaturated fats are like olive oil or avocados. Lard is actually a monounsaturated fat as well. Olive oil is best if it's cold-pressed, obviously (when it's fresh, since it will otherwise be damaged by heat) and there are schools of thought that think it's not healthy to cook with it -- hence the reason it's so often used on salads.
But for being all-around healthy, it's not enough to live only on olive oil. The types of fats you eat are what are used in cell membranes -- if you eat a lot of unstable, damaged oils like vegetable oils, your cells are more prone to damage and faster aging. People think that saturated fats are unhealthy, but if this was true, why are the plaques found in arteries 74 percent unsaturated fats? What about life expectancy? A study already back in 1965 showed this conclusively: patients who already had had a heart attack were divided into three groups, and after two years, the corn oil group had 30 percent lower cholesterol, but only 52 percent of them were still alive. The olive oil group had 57 percent still alive and the animal fat group had 75 percent still alive (British Medical Journal, 1965 1:1531-33).
Yes, the quality of fat is very important. You DEFINITELY don't want to be eating animal fats filled with pesticides or hormones (farmers markets often have the cleanest sources). That being said, your body desperately needs nutrients found in animal fats. Have you noticed the uproar about vitamin D in the news? The food sources of vitamin D are cod liver oil and lard - that's how people kept from getting vitamin D deficient in the winter. Vitamins A, D, K, and K2 are all found in animal fats -- even your vegetarian patients could gain an advantage by ingesting coconut oil, butter, eggs, whole milk and cheese. Studies show that choline from egg yolks and liver help the brain make critical connections and protect against neurotoxins; animal studies suggest that if choline is abundant during developmental years, the individual is protected for life from developmental decline. The best way to get that is 4-5 egg yolks per day, but with our incorrect information, people get freaked out about the cholesterol in eggs, which is, as I pointed out earlier completely unfounded.
It's a challenge to find studies discussing the nutritional benefits of fats (government health policy dictates to a large degree where the research funds are allotted), but they are there. "In studies conducted over 20 years, the Harvard School of Public Health showed that total fat intake bore no significant relation to Coronary Artery Disease risk. . . Four epidemiological studies have shown no evidence that men who eat less fat live longer or have fewer myocardial infarctions (MIs)" (Circulation 2003; 107:10). As acupuncturists, you challenge the conventional wisdom regarding the body's ability to heal itself; as nutritionists, continuing to learn and reading critically and between the lines, you will have a huge health impact on your patients and on yourself.
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