Backlash after report claims saturated fats do not increase heart risk

Saturated fat does not increase the risk of a heart attack by clogging up arteries, three cardiologists have said in a challenge to medical thinking, sparking a furious backlash.

In an editorial published in the British Journal of Sports Medicine the cardiologists also write that relying on foodstuffs marketed as “low fat” or “proved to lower cholesterol” to avoid heart disease is “misguided”.

A key previous research study, they say, “showed no association between saturated fat consumption and all-cause mortality, coronary heart disease, CHD mortality, ischaemic stroke or type-2 diabetes in healthy adults”. Instead they say that a Mediterranean-style diet and 22 minutes of walking a day are the best ways to prevent heart problems.

The paper co-authored by Pascal Meier, a cardiologist at University College London and editor of the journal BMJ Open Heart; Rita Redberg, the editor of the American journal JAMA Internal Medicine; and Aseem Malhotra, a cardiologist at the NHS’s Lister hospital in Stevenage, has triggered furious criticism from a range of experts in cardiology and evidence-based medicine. Some said the views were not based on reliable evidence and would mislead consumers and further confuse the public over which foods they should eat and which they should avoid.

They also dismiss the potential for a smaller intake of saturated fats to help prevent heart disease. “There is no benefit from reduced fat, including saturated fat, on myocardial infarction [heart attacks], cardiovascular or all-cause mortality,” they say.

Instead of adopting a low-fat diet, people seeking to cut their risk of heart problems should instead follow “an energy-unrestricted Mediterranean diet (41%) fat supplemented with at least four tablespoons of extra virgin olive oil or a handful of nuts”.

But critics responded by accusing the co-authors of naiveté, ignoring evidence which contradicts their theories and simplifying a hugely complex issue.

Dr Amitava Banrejee, a senior clinical lecturer in clinical data science and honorary consultant cardiologist at UCL, said: “Unfortunately the authors have reported evidence simplistically and selectively. They failed to cite a rigorous Cochrane systematic review which concluded that cutting down dietary saturated fat was associated with a 17% reduction in cardiovascular events, including CHD, on the basis of 15 randomised trials.”

Dr Gavin Sandercock, director of research at Essex University, rejected the trio’s claims about the benefit of “replacing refined carbohydrates with healthy high fat foods” as not true and not based on any existing evidence. “We must continue to research the complex links between fat, cholesterol and heart disease but we must not replace one myth with another”, Sandercock said.

Christine Williams, professor of human nutrition at Reading University, said the cardiologists’ dietary advice was impractical, especially for poorer people. “The nature of their public health advice appears to be one of ‘let them eat nuts and olive oil’ with no consideration of how this might be successfully achieved in the UK general population and in people of different ages, socioeconomic backgrounds or dietary preferences,” she said.

However, some experts did back the authors. Dr Mary Hannon-Fletcher, head of the school of health sciences at Ulster University, hailed their views as “the best dietary and exercise advice I have read in recent years. Walking 22 minutes a day and eating real food. This is an excellent public health message.

“The modern idea of a healthy diet where we eat low-fat and low-calorie foods is simply not a healthy option. All of these foods have been so altered they are anything but healthy. So eating real foods in moderation and exercising daily is the answer to keeping fit and healthy; it’s just too simple a message for the public to take on board,” she said.

Gaynor Bussell, a dietitician and member of the British Dietetic Association, also offered the authors qualified support. “Many of us now feel that a predominantly Med-style diet can be healthy with slightly more fats and fewer carbs, provided the fats are ‘good’ – such as in olive oil, nuts or avocados,” she said.

However, saturated fats should comprise no more than 11% of anyone’s food intake, she said – far less than the 41% fat level backed by the co-authors.

While carbohydrates should still be part of every meal, people should routinely consume high fibre or wholegrain versions, Bussell said.

Williams also accused the BJSM of publishing opinions seeking to portray saturated fats as “innocent” in the causation of heart disease in order to generate headlines. “Some would argue the journals have a very credible business model based on attracting controversy in an area of great importance to public health where clarity, not confusion, is required,” she said.

Backlash after report claims saturated fats do not increase heart risk

Is Saturated Fat Bad for You? The Reality About Saturated Fats

Is Saturated Fat Bad for You? The Reality About Saturated Fats

Healthful eating: too significantly saturated unwanted fat is nonetheless undesirable for you

The fantastic fry-up. Proceed with caution. Photograph: Alamy

Contrary to Joanna Blythman’s phone for a rethink on nationwide dietary recommendations about saturated fats, a main guidance modify at this stage would be premature (“Why virtually almost everything you have been told about unhealthy meals is wrong”, In Concentrate).

The review she highlights was certainly funded by the British Heart Foundation and its finding – that there was no association among the varieties of unwanted fat we eat and our threat of heart disease – was surprising.

But this examine alone is not enough to give the green light to eating as much saturated unwanted fat as you like. There is a wealth of evidence displaying that consuming also significantly saturated body fat raises our cholesterol amounts, which we know increases our threat of having a heart attack or stroke.

This new study isn’t going to change that, even although it plainly shows there is a lot more for us to discover out about how the body fat we eat has an effect on our chance of cardiovascular illness.

In the meantime, we will proceed to advise men and women not to target on any single nutrient in their diet plan but their diet plan as a entire. We advocate a Mediterranean-fashion diet plan, which has been associated with reduced chance of coronary heart ailment, obesity and sort 2 diabetes.  This represents a total diet plan approach with fats primarily from unsaturated sources as properly as more fruit and veggies, fish and fewer sugary and fatty treats.

Our guidance is carefully regarded and frequently reviewed it is primarily based on the evidence of robust research, funded by us and other folks.

These new findings in isolation are not enough to modify that. But there’s genuine uncertainty in the discipline and we’d welcome additional scientific studies to boost our understanding and aid us proceed to give the public the very best suggestions achievable, primarily based on robust study.

Professor Jeremy Pearson

British Heart Basis

London NW1

So things that is grown naturally, and might be discovered in the diet plan of our ancestors, is great for us. Bizarre concoctions this kind of as margarine are bad for us. Sugar, which we cannot discover in such abundance in our natural diet plan, is undesirable for us.

I guess the adage that you should not eat something that your grandmother would not recognise as foods must be amended to anything that your fantastic grandmother would not recognise as meals, with the codicil that we now know that greens are excellent for us.

“Doraseile”

On the internet contribution

The latest concentrate on sugars rather than calories as a trigger of weight problems and overweight does not aid individuals to realize that stability is key – not only in the diet plan but also in balancing calories taken in with calories expended throughout bodily exercise. The easy healthy life-style message is turning out to be lost.

Foods and Drink Federation members stay focused on operating by means of the Obligation Deal to play their part in tackling weight problems. The calorie reduction pledge, which eleven FDF members have presently signed, is straight supporting customers to decrease their calorie consumption, in some situation by also minimizing sugar.

Reformulating recipes is just a single strand of sector action on well being organizations are also creating new, more healthy alternatives and investing in client training. Calls for new structures are a distraction from the great function that is already underway, but, far more worryingly, they are perplexing public health messaging.

Men and women have entry to clear and consistent nutrition information, which involves complete sugar material, and which, in the vast vast majority of products, is also presented on the front of packets.

The labelling of additional sugars, as suggested by the chief healthcare officer in her yearly report, is not permissible below European legislation. In addition to the nutrition label, the diverse sources of sugars used in items will be listed in the substances list.

Terry Jones

Meals and Drink Federation

London WC2

Healthful eating: too significantly saturated unwanted fat is nonetheless undesirable for you

Saturated fat is not excellent for your heart. But consuming a balanced diet plan is | Jeremy Pearson

‘We were hunting at the wrong element of people’s diets – it wasn’t the eggs but the way they were cooked – in saturated bacon body fat for instance – and what they have been eaten with.’ Photograph: David Sillitoe for the Guardian

Final week we have been all offered cost-free rein to consume as much saturated excess fat as we like. The results of a research, published in the Annals of Inner Medication, advised that there is little evidence to assistance current nationwide recommendations on the kinds of fat we eat to minimize our threat of heart illness. At least that’s how some interpreted the findings of the review, which we at the British Heart Basis assisted to fund. I was described by Joanna Blythman in Sunday’s Observer as “floundering” for standing by our existing tips.

But ahead of you decide to have cream cakes for each and every meal or think about doubling the butter on your toast, we want to set the record straight.

Let us commence with the guidelines. These are national, set by the Division of Health, and primarily based on a consensus of available evidence, so they do change above time. Research into diet plan is rarely black and white and so isn’t going to modify recommendations overnight or on the basis of a single study. In this situation, though comprehensive and properly performed, the Cambridge outcomes aren’t ample to make an immediate alter. We need a lot more investigation in this spot, and also want to examine the findings alongside the total body of proof rather than other individual papers.

There is uncertainty in this spot but we are not shying away from this – we funded this investigation and we want to see a lot more scientific studies to get the answers correct rather than jumping to conclusions that may prove to be incorrect.

A very good illustration of where suggestions have moved in response to a altering picture from the proof is suggestions on consuming eggs, which Joanna Blythman mentions in her write-up. It was indeed as soon as suggested that we restrict the quantity of eggs we consume – it was imagined at the time that they raised our cholesterol, increasing our threat of cardiovascular illness. But that guidance altered in the final decade when proof showed eggs are not the difficulty. We were searching at the incorrect portion of people’s diet plans – it was not the eggs themselves but the way they were cooked – in saturated bacon body fat for example – and what they had been eaten with.

There is a wealth of evidence showing that eating also a lot saturated body fat raises our cholesterol amounts, which we know increases our danger of having a heart assault or stroke. This new research doesn’t adjust that but clearly demonstrates that there is far more for us to discover out and comprehend. It could be that with far more studies into the impacts of the different fatty acids within saturated and unsaturated fats, we may possibly uncover that some are in reality heart-healthier or less damaging than when considered. But what this research isn’t going to say is that saturated unwanted fat is good for your heart health it only tells us that it may possibly not be as damaging as we considered.

The crucial thing I want to get across – which is not “floundering” – is that this shut target on any single nutrient, whether it is saturated fat, sugar, salt or something else fully, is not really helpful. We don’t consume single nutrients – we consume food, meals and total diet programs that contain a variety of nutrients that can all influence on our heart disease danger. And in terms of diets that advertise heart health, this is what we must be focusing on and promoting.

The Mediterranean-type diet program has been associated with a diminished threat of coronary heart condition, obesity and sort 2 diabetes. This represents a total-diet strategy, with fats mainly from unsaturated sources as properly as a lot more fruit, vegetables and fish and fewer sugary and fatty treats. This diet plan is naturally reduce in saturated unwanted fat, but the benefits appear to come not from one particular certain element, but from the sum of its components.

Lastly, I feel it is essential to note that we proceed to campaign to press the government and the foods business to do much more to aid individuals make healthful options when they eat and drink. We want manufactured food items to be clearly labelled, and have had good results, so far, with campaigning for front-of-pack visitors-light labelling. This would support tackle the concern of high sugar and salt contents, as nicely as fats. Only final week we have been front and centre of a coalition calling for restrictions on junk food marketing to young children.

Our advice is meticulously regarded as and often reviewed it is primarily based on the evidence of robust analysis, funded by us and other individuals. Based mostly on these new findings we’re not advising the nation to have a cost-free rein when it comes to the volume of saturated fat currently being eaten. The sad reality is that ranges of weight problems are rising and coronary heart illness is still the UK’s single most significant killer. One way we’re fighting back is by giving people the details and guidance they want to consume a healthful balanced diet so they can help look soon after their hearts.

Uncover out more about healthy consuming on our website bhf.org.united kingdom.

Saturated fat is not excellent for your heart. But consuming a balanced diet plan is | Jeremy Pearson