Saturated Fat: To Eat or Not To Eat, That’s The Question!

After a full week of lectures at the American Society of Bariatric Physician’s conference last week, I must say – I’ve never heard so many lectures about fat.

There was much conjecture over whether or not fat is good or bad for us to be eating. But first, how about some history. Back in 1980 when we received the first Food Pyramid from the U.S.D.A., it seemed clear that there was an association between fat in our diets and the development of heart disease. Therefore, low fat became the rage. To continue to provide Americans with highly palatable low-fat foods, the food industry responded quickly. They realized that without the fat, food just didn’t taste as good. Until, of course, they realized that we really like processed carbohydrates like High Fructose Corn Syrup (HFCS).

So, in coming years, we ate less and less fat, more and more refined carbohydrates. The average American increased their carbohydrate intake by about 200 calories per day. And our obesity rates skyrocketed. Unfortunately, we replaced something of no known, but suspected risk with something we thought was safe. Boy were we wrong!

As it turns out, the driving force behind the obesity epidemic is insulin resistance. And refined carbohydrate requires a lot of insulin to digest. These high levels quickly result in insulin resistance. In fact, it is now thought that it is insulin resistance that is causing our weight gain. This is in direct contrast to common thinking – that our weight gain is driving up insulin resistance and diabetes. Let me say this again: I believe it is the increased refined carbohydrates causing an increase in insulin resistance that is the driving force behind the obesity epidemic. To be clear, the extra 200 gm of carbohydrates elevates insulin levels resulting in insulin resistance, then weight gain follows.

Why was it thought that fat in our diets causes heart disease? It is actually true that fat in our circulating blood causes heart disease. But, there was no evidence that eating fat increases fat in our circulating blood. In fact, eating a large carbohydrate load causes increased fat in our blood! Why? because we can’t store or use the carbohydrates – just about a teaspoon of sugar is enough to provide our muscles with energy. The rest gets taken up by our livers rapidly, and gets turned into triglycerides, our circulating form of fat.

Fat on the other hand does not go through this same pathway. In fact, in a carbohydrate controlled diet, fat does not appear to elevate blood fat levels.

So, what’s the take home message? It’s time to stop villainizing fat, and return to healthy eating styles. It’s time to mind our carbs, avoid refined carbs, especially those in sugar sweetened beverages, and eat our fat! In particular, if we are going to try and eat less saturated fat (a highly debatable point among conference experts), perhaps rather than replacing it with carb we should be replacing it with Polyunsaturated Fatty Acids (PUFA’s). Or, perhaps we should stop worrying so much about Saturated Fat.

Of course, another expert suggests that we can’t take a 1-diet-fits-all approach. Some individuals clearly have increased health risk from fat intake, some don’t. But, for a Type II Diabetic, clearly the advantages lie in carbohydrate restriction, not fat restriction.

Guess we’ll have to wait and see what the next set of U.S.D.A. guidelines (in 2015) look like.

(Trans fats clearly have health risk – cakes, cookies, pies, shortening… – talk to your dietitian about how to optimize your fat intake).