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“No study published over the last 20 years has reported a relationship between dietary cholesterol intake and heart disease risk in the general population.”
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Image by zJMac

Straightforward facts on dietary fat and health
It’s actually an essential nutrient, and our obsession with dietary cholesterol is misguided, experts say

By David Feder Special to the Tribune

August 26, 2009

We’ve become a culture where a serving of fettuccine Alfredo is nicknamed " heart attack on a plate" and french fries are frequently mentioned with the prefix "artery-clogging."

Rarely does an article about dietary fat inform us that fat is an essential nutrient without which we would surely die. However, for most of us, fretting over dietary fat and cholesterol is unnecessary.

For generations, experts have prescribed a set of rules for everyone based on risk factors of illness in only one segment of the population.

"The results of cholesterol and heart disease research was not meant to be applied to healthy people or the world at large," said Dr. Donald McNamara, a cholesterol research scientist and director of Eggs for Health Consulting in Laurel, Md. He compares such an approach to "prescribing the same pair of glasses to everyone."

Few experts argue that for those with cholesterol levels outside the norm, or with high risk factors for cardiovascular disease, dietary change often can be a valid intervention. But when it comes to high-fat foods such as burgers, cheese, butter and cream being liberally shunned by those bent on lowering their cholesterol intake, it’s time to lard the conversation with a little straightforward science on dietary fat and health.

Your body knows how to handle dietary fat, and if you’re not overweight and have no other high-risk conditions, your risk of heart disease is probably low. That means even if you occasionally eat several slices of pizza with a Haagen-Dazs chaser, you needn’t punish yourself with guilt and worry. The stress will probably do more damage than the Super Bowl special you just ate. According to Mark Anthony, nutrition science instructor at St. Edward’s University, Austin, Texas, and author of "Gut Instinct: Diet’s Missing Link," analysis of the research into cholesterol and disease is bearing this out.

In 2006, scientists at the University of Surrey in Guildford, England, published a comprehensive analysis of multiple studies on dietary cholesterol and serum cholesterol in the British Nutrition Foundation Nutrition Bulletin. Their conclusion was emphatic: "The idea that dietary cholesterol increases risk of coronary heart disease (CHD) by turning into blood cholesterol is compelling in much the same way that fish oil improves arthritis by lubricating our joints."

Specifically, the team noted, "the scientific evidence to support a role for dietary cholesterol, [or the cholesterol we eat, as opposed to serum cholesterol, which is the cholesterol in our bloodstream], in CHD is relatively insubstantial in comparison with the incontrovertible link between its circulating blood relative in LDL cholesterol and CHD."

McNamara concurs: "No study published over the last 20 years has reported a relationship between dietary cholesterol intake and heart disease risk in the general population." He also points to data from the famous "Seven Countries Study" that analyzed subjects with the same levels of cholesterol, across different cultures. Absolute rates of heart disease varied widely. Another eye-opening statistic cited by McNamara is that roughly half the incidents of heart disease occur in people with normal cholesterol.

The type of fat in your diet does matter to some degree. Trans fat, derived predominantly from highly processed oils, was shown to be more strongly associated with cardiovascular disease. It was ultimately subjected to strict labeling and voluntarily removed from thousands of foods and beverages.

However, many research studies have shown that natural fat in foods such as eggs and dairy products has no effect on the risk for cardiovascular disease. Some studies have shown a positive effect of dairy consumption on reduction of disease risk. Saturated fats from sources other than eggs and dairy, such as from meat, once were associated with increased disease risk. Later studies are proving the issue to be more complex than that. And studies of saturated fats from plants such as coconut and palm oil are revealing positive health benefits.

Most important, mono- and polyunsaturated fats from olive oil, nut oils and vegetable oils, and the omega oils found in fish, flax and nuts boast thousands of studies backing their benefit to health for everything from protection against cancer, heart disease, certain birth defects, depression, cognitive decline and more.

Authors of the Harvard School of Public Health OmniHeart Study comparing popular diets and food intake concluded that, "in the setting of a healthful diet, partial substitution of carbohydrate [with] monounsaturated fat can further lower blood pressure, improve lipid levels and reduce estimated cardiovascular risk."

Simply put, the connection between the amount of fat we eat and the fat clogging our arteries and stopping our hearts turns out to be far more complicated than a blanket prescription of " low-fat diets for everyone" can address.

It doesn’t negate the value of eating a balanced diet, with the majority of calories coming from fruits, vegetables and whole-grain foods. But it does mean that, if we have been taking care of ourselves by maintaining a healthy weight and staying active, we don’t have to seek penance every time we butter our toast.

David Feder is a registered dietitian and director of S/F/B Communications Group, a national co-operative of food, health and nutrition experts.


Copyright © 2009, Chicago Tribune

Good Calories, Bad Calories
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Image by Earthworm
In this 460 page, brain taxing book, Gary Taubes, a journalist specializing in public health, nutrition and diet and a correspondent for Science magazine, offers a crash course in the history of nutrition science especially as it relates to disease. Since the 1940s such study turns out to be a misguided mish mash of pet theories and arrogant assumptions by a few crusader doctors refusing to look at the inconvenient truths revealed by lesser egos.

By page 50 I was convinced that fat in one’s diet, has no effect whatsoever on cholesterol. In fact if it does, you have a rare disorder. But because of an influential doctor named Ancel Keys, several decades of expensive study was devoted to proving that fat did raise cholesterol which in turn would contribute to heart disease. No conclusive evidence could be found, yet Keys had so convinced his colleagues that fat was the culprit that when other contrary evidence was revealed, researchers still continued to try to believe Keys was right and misinterpreted the results. Thus a group of doctor buddies were able to influence government dietary recommendations, (a project put forth by George McGovern in his run-up to becoming a presidential candidate) and that pretty much fixed it.

Outsider, outlier doctors, who worked in the Navy for instance or with missionaries, and had seen the effects of colonization on the health of populations overseas i.e. Africa, observed that the diseases of civilization—heart disease, hypertension, stroke, cancer, diabetes, peptic ulcers, cavities, periodontal disease, diverticulitis, gallstones, hemorrhoids, varicose veins, constipation, dementia, asthma, appendicitis and even aging—were non-existent until these populations started to eat the diet of the new settlers. And that the introduced diets included large amounts of carbohydrates. As for the carbohydrates in rice eating nations of Asia, it was a starvation level diet that kept the carbohydrates from causing the usual havoc. All blood sugar is consumed if you don’t eat much to begin with. However, per this book, precious few studies, on the subject, have been devoted to Asian populations. (Comments on Amazon regarding this book suggests that the traditional Chinese diet is much higher in fat than has been realized and all parts of the animal were eaten so was not a rice based diet per se.)

Carbohydrates are the preferred diets of colonizers because of the ease with which they are transported; think shipments of grain. It is also the food of agriculture, especially industrialized agriculture derived from excessive use of petroleum, as we know, thus the term peak carbohydrates comes to mind. And perhaps why the increasing popularity of the Paleo diet as an alternative narrative, now that we’re here on the downward slope, but I digress.

The study of nutrition was actually heading in the right direction between 1910 and 1940 and obesity was being successfully treated with low carb, high fat diets. But World War II derailed this trend for a number of reasons. One of which was that the best studies were being done by Germans and Austrians, but once the English and Americans defeated Germany, and English became the world language no one could be bothered with the Germans for any intellectual contribution. Another reason was that those, such as Ancel Keys, who observed changes in the diet of wartime populations, became convinced that the removal of farmed meat from the diet led to lower mortality (although not by much it turns out). Nor did he consider that the population replaced the meat with fish or ate horse meat as my mother did. The authors of "The China Study" also used this historical anecdote to back up claims that a vegetarian diet kept everyone healthier, but neither story accounts for the shortage of diesel fuel which made everyone walk more and the sugar rationing of the time and rationing of tea and biscuits.

Keys then went on to insist that heart disease was on the rise and with the heart attack suffered by President Eisenhower, the public, too, were convinced that this was so. And nobody could let the fat culprit go after that. Especially when nutrition scientists insisted that the body followed the laws of physics i.e. thermodynamics rather than biochemistry. This was particularly hard on fat people because doctors insisted that a calorie eaten was a calorie that had to be expended in activity or obesity would result. This was no more true than to insist that eating would make you taller. Earlier studies had already proven that neither diet nor exercise would make people lose weight because basically you cannot maintain a starvation diet. It only needed the biochemistry studies to prove it.

As it turned out body fat is not released for use as energy by exercising (because locked down by body chemistry—you gain quickly, but lose only a little) so any attempt to exercise for weight loss has very little result especially because increased hunger results so you eat to compensate. (Adrenaline will mobilize fat storage release and so does smoking.) It was also discovered that fat was not created in the body until certain biochemical reactions involving insulin took place, so over-eating did not necessarily make people fat. Even when this was revealed, doctor’s still stubbornly clung to the original flawed thinking. Which makes me wonder if obesity serves the same purpose for doctors as homosexuality did for the psychiatric community. Namely as an example of gluttony as a moral deficit. (Homosexuality as an example of depravity and general immorality.)

Nothing was helpful in revealing the true culprit until diabetes research could really take hold. It was then that insulin was revealed to be the regulator of energy within the body and the relationship discovered between carbohydrates and the production of insulin within the body. The author also provides the relevant science (which I’ll cover in my next report). Since it was known that diabetics were more prone to heart disease, cancer, obesity and suffered dementia twice as much, it occurred to some to ask if diabetics were the canary in the coal mine. And all the diseases of civilization were related to insulin activity. In fact one researcher did determine that the artherogenic profile for heart disease was seen in diabetics—high triglycerides and low HDL.

It wasn’t until a 2007 study that enough information about lipoprotein metabolism existed to lay the whole cholesterol/fat relationship to rest, but such news didn’t make the cover of Time so the public is none the wiser and doctors already in the field don’t appear to want to know. I’m glad that the research is finally getting a grip on this whole issue of metabolic syndrome and is now being taught in medical schools, but I agree with the author that it’s a sorry state of affairs when doctors don’t even care to prove some of their basic assumptions of biochemistry and diet, but just assume they know all they need to know.

Deadly Emus, Marboro, New Jersey
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Image by flickr4jazz
Whilst driving past the wild, open fields of nearby Marlboro, New Jersey, I came across a “mob” of wild, free-range native New Jersey emus. Yes, a group of emus are called a “mob” just like a group of crows is called a “murder” of crows!

I used to eat emu meat all the time when I lived in Arizona and I can say for a fact that they are particularly delicious if cooked properly. A typical emu weighs about 150 pounds and stands about 5 foot high, though they can stretch a bit farther up if they want to look over something. They are quite fast and can run at speeds up to 35 to 40 miles per hour. Due to the age of the species, they are sometimes referred to as “living dinosaurs.” They do have a sharp claw which, unlike an ostrich, probably won’t kill you if you get kicked. It can however, cause a great deal of pain and a nasty infection depending upon what the particular emu has been stepping in.

The emu is prized for its meat, its feathers, and particularly its oil which can be used for burns, chapped skin, and cuts to the skin. The emu meat tastes much like beef. It is lower in cholesterol and fat than beef and is promoted by the American Heart Association.

According to the Uncyclopedia, “The common Emu (not to be confused with the sadistic emu) is a very dangerous bird. They normally grow to about eight feet tall, but specimens on steroids have been known to reach fifteen feet. They have deadly sharp beaks that can disembowel a human in under two seconds, large talons capable of tearing through tires like paper, feathers that can take your heart out while it’s still beating. And sometimes if you feed one, it will try to bite you.” Also, “Chickens can run around with their heads cut off. With emus it’s even worse – they can run around for two days sans cranium. The Australian government advises all home-slaughtering enthusiasts to build a pen sturdy enough to contain a headless emu for at least 48 hours.“

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