Saturated fat controversy... what we recommend?

As of today, trans fat still the villain in the diet and unsaturated fats the good ones, but when it comes to saturated fats, it seems that the paradigm is shifting. A study published last March, questions –again- the harmful effects of saturated fats. I said again because, I remember an article in Science magazine from 2001 questioning the medical community and the US government for misinterpreting the scientific evidence, arguing that fat (whether saturated or not) are not the culprit of obesity and cardiovascular diseases, and blaming refined carbohydrates for this.

The study I was mentioning at the beginning is the one published in the Annals of Internal Medicine and is a systematic review and meta-analisis (with more that seventy studies included) concluding that current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats. Contrary to this, the latest 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk recommend a reduction of saturated fats to 5-6% of the total calories, when the 2010 Dietary Guidelines for Americans recommend a 10% of saturated fats.

The old study of the Seven Countries (1958), authored by Dr. Ancel Keys, and widely referenced because it found a correlation between saturated fats and increased LDL cholesterol and cardiovascular risk is also criticized. Many put in doubt the methodology of the study and it’s believed that Dr. Keys picked certain countries and left outside of the study countries that have high consumption of saturated fat with lower rates of heart disease, like Sweden, Germany and others.   

So, what we recommend now as food and nutrition professionals? Of course that LDL cholesterol is not the only one factor to consider when assessing cardiovascular risk. Other factors are now important like being overweight, lifestyle, other serum lipids, etc. I don’t personally believe that is necessary to further decrease saturated fat intake to 5-6% of calories. Even more, the AHA/ACC guidelines don’t distinguish the type of saturated fats, when it is believed that dairy fats and vegetable saturated fats like coconut may not affect cardiovascular risk and may be even beneficial.  I think that the answer is the total diet approach, considering ALL factors in the diet, like intake of fiber, omega 3 fatty acids, antioxidants total calories, etc. I agree with the AHA/ACC in promoting a Mediterranean style diet, encouraging consumption of vegetables and fruits, nuts, legumes, fish and vegetable oils. Lastly, we have to be careful because this reconsideration of saturated fats can be misunderstood with what people want to hear…like eating free amounts of butter, cheese and other sources of saturated fats.  

What do you think?

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