The connection between saturated fat and heart disease - a meta-analysis of...

[blowdpanis]

prospective cohort studies:

http://www.ajcn.org/cgi/content/abstract/ajcn.2009.27725v1


Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

This is going to piss a lot of people off.

It occurs to me that there is no nutrition forum at startingstrength.com. Kind of odd, since a lot of people here seem to have strong opinions on the subject.

Anyways, I'll be very curious to see the reaction to this, though I can't locate the full text at the moment to dig in a little deeper.

[coldfire]

Why is it going to piss a lot of people off? We like saturated fat.

Edit: Here is the full text: http://uploading.com/files/3335a5e5/ajcn.2009.27725v1.pdf/

[Flying Fox]

Why is it going to piss a lot of people off? We like saturated fat.
He probably wasn't talking about people here.

[zendefone]

I agree that a nutrition forum here would be great.

[WaWa Bird]

I highly recommend the movie "Fat Head." In the movie Dr. Eades and Eades explain that heart disease is caused by inflammation from eating sugar/starch/grain. This inflammation causes cholesterol to protect and heal your arteries. If cholesterol stays there too long it oxidizes, and begins to form plaque. .

[Rorschach]

Indeed. The idea that the presence of cholesterol in areas of heart disease means that cholesterol is the cause, and thus foods high in cholesterol are to be avoided is just backwards thinking.

[Rorschach]

Sometimes I really want to punch people in the face...

http://www.dailymail.co.uk/health/article-1244048/Ban-butter-save-thousands-lives-says-heart-surgeon.html

Oh how I hate the Daily Mail.

[beast]

I just saw that butter ban on my bt yahoo email news. I think they need to look at the nutrition guidelines again , they recommend 90 grams of sugar and yet only 20g of saturated, what the hell! If you eat the daily amounts you end up with a low calorie, high sugar diet. Also in Finland they may eat less butter, but I bet they eat more protein, less sugar and more fat from other saturated sources. It's the sugar and cereal companies they should worry about. I overheard someone the other day saying they were going to replace their butter with more jam for their new year diet as then it will be zero fat!

[cycomiko]

try this for a little more on the subject. FAO backed document (http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000229002)


Frank Hu and his lot also have

http://www.ajcn.org/cgi/content/abstract/ajcn.2008.26285v1

[Dastardly]

Sometimes I really want to punch people in the face...

http://www.dailymail.co.uk/health/article-1244048/Ban-butter-save-thousands-lives-says-heart-surgeon.html

Oh how I hate the Daily Mail.

Im sure you already know that it is not really a newspaper but just a paper full of scantily clad soapstars, princess diana sentimentality and fear mongering/phobia about either paedophiles or extremist muslims.

But even that crappy paper managed to actually put across a hint of the actual facts towards the bottom of the article.

Man made Trans-fats are the real concern and there is a lot of pressure on companies to stop using it. Just 3 or so years ago all the leading brands of margarine and cakes/biscuits all contained hyrdogentated fat. But there has been a rapid move to remove them all because customers are getting more concerned about food issues.

The same goes for MSG.

I am just hoping the soya issue becomes more well known by the masses. As EVERY store bough factory bread now uses a quantity of Soya flour.

And people are actually feeding soya milk to children and gasp! Babies!

[Tiburon]

If you were the National Dairy Council and you wanted to publish a study that showed no link between saturated fat consumption and CVD, it would be quite easy to to gather a bunch of studies that had different exposure assessments, different outcome assessments, different length of follow-up, etc. Then throw together all these studies, with all their differences and all their flaws, to create a pooled relative risk. One of the first lessons in Epidemiology 101 is that random misclassification will bias the risk estimate toward the null. So it's not surprising that their RR was so close to 1. (Interesting to see the bounds of the confidence interval are from 0.96 to 1.19. With a few more studies they might have found statistical significance. But that's an issue for another day.)

I'm still trying to figure out how they got it published. Having Hu from Harvard certainly helped; I didn't know he took industry money.

Instead of a meta-analysis, I would have liked to see AJCN publish a good review paper on the topic, evaluating these 21 studies in detail and using some brain cells to weigh all the evidence, instead of just having the computer spit out a pooled RR. (In one of the cited cohort studies, diet was assessed *once* over 20+ years?!?)

If this is the first meta-analysis you've read, it's worth looking at this critique of the method:
http://www.jerrydallal.com/LHSP/meta.htm

(BTW, Dallal's stats notes are fantastic http://www.jerrydallal.com/LHSP/LHSP.HTM )

[Sami]

I hate stats and I hate critically appraising papers. Does that make me a bad med student?

[Tiburon]

I hate stats and I hate critically appraising papers. Does that make me a bad med student?

No, that doesn't make you a bad med student. But it will make you a bad doctor.

[Rorschach]

You guessed right, Dastardly. ;)

Oh, and if there were any doubt, the anti-butter doctor's PR agency (what kind of doctor has a PR agency? Christ.) also does the PR for Unilever, who produce various vegetable oil spreads. This agency was the one who contacted the media with his claims.
Colour me surprised.

[nisora33]

Even if saturated fat isn't the bugaboo folks once thought it was, it doesn't automatically mean that carbs are either (not that you were implying that, blowd).

Anybody know what happens, however, when saturated fats make up a proportionately large amount of total calories or of total fats? I believe Lyle may have commented on the long-term outcome of this, I may see if I can find where.

-Stacey

[nisora33]

A word on saturated fats:

(http://www.bodyrecomposition.com/nutrition/a-primer-on-dietary-fats-part-2.html)
http://www.bodyrecomposition.com/nutrition/a-primer-on-dietary-fats-part-2.html


Passage from that link: For someone who is lean, active, eating plenty of fruits and vegetables, who is in caloric balance there appears to be no real danger (in a health context) to an increased intake of saturated fats. One study I recall in cyclists found that, as long as they were in caloric balance, an increase intake of saturated fats had no impact on blood cholesterol one way or the other.

It’s worth mentioning in this context that some research suggests that saturated fat is required for optimal hormone levels (e.g. testosterone) so trying to reduce saturated fat excessively may be a mistake for athletes in the first place.

But not all individuals are lean, active athletes who are eating lots of fruits and vegetables who are in caloric balance. For someone who is overweight (which is an inflammatory state in and of itself), inactive (which has a host of negative health effects), is under a lot of stress, not eating sufficient fruits and vegetables, etc. , saturated fats may have a very different impact on the body.

There is often also an impact of weight loss or weight gain in terms of how saturated fats affect blood lipid levels; in general when weight is lost, blood cholesterol levels improve almost irrespective of the type of fat consumed. But when weight is being gained or even maintained, often blood cholesterol levels worsen with a high saturated fat intake.

[cycomiko]

I'm still trying to figure out how they got it published. Having Hu from Harvard certainly helped; I didn't know he took industry money.

The NDC is only a component of the funding scheme for the papers. Why not mention the potential conflict of interest via the NCRR funding - silverfoil hat time - and their desire to keep saturates down....

Oh noes, one of the authors had also had a grant frm unilever wanting to keep saturates down

Of course Hu takes industry funding. With research requirements and university pressures to publish, money has to come from somewhere. Sure his government could spend less money blowing up afgans and give the money to research, but until that happens, they get money where they can.

[Tiburon]

Of course Hu takes industry funding. With research requirements and university pressures to publish, money has to come from somewhere.

Most of the nutritional epidemiologists here in Boston don't take industry money. People in our lab were very surprised to see Hu's name on research funded by National Dairy Council.

[cycomiko]

Havard has accepted industry funding for many years, the CSPI has bitched about it since the '70s

Never mind that the NDC funding was for Patty and Ron and Qi had a post-doc funding from Unilever.

But, sure, Frank may be willing to completely throw out his entire ethical beliefs so his students can get a few bucks.

The other meta-analysis i posted has a prof who has also, in the past, been funded by dairy and unilever. After selling out his beliefs for money surely he would be conflicted by having two diametrically opposed gods?

[Tiburon]

I didn't mean to imply anything about the ethics of the researchers, sorry if it came across that way. My main point is that it is very easy to throw together a bunch of heterogeneous studies and get an RR near 1. Still not sure why AJCN would publish that.

[Sami]

The thoughts of Dr Michael R. Eades.
http://www.proteinpower.com/drmike/cardiovascular-disease/saturated-fat-and-heart-disease-studies-old-and-new/

[cycomiko]

I didn't mean to imply anything about the ethics of the researchers, sorry if it came across that way. My main point is that it is very easy to throw together a bunch of heterogeneous studies and get an RR near 1. Still not sure why AJCN would publish that.

ah, thats makes it clearer.

ajcn publishes a lot of stuff, especially meta- work, that shows significant hereogeneity. Most likely because that presents the current literature at present. It futher reinforces the lack of evidence to support the current public health recommendations, as the results are pretty damn lacking.

the Skeaff & Miller paper i put up earlier has a mixture of results (some homogenous, some not) that paints a fairly similar picture. The total fat:heart disease link is lacking. The saturate;heart disease link is lacking. The replacing saturates for other fats has good evidence for heart disease, but that would bring up the relative lack of total death or longevity results on these type of trials. But the most convincing evidence is based around the inclusion of lcpufa. Ultimately they link to the Jakonsen paper from last year's ajcn.

[cycomiko]

The thoughts of Dr Michael R. Eades.
http://www.proteinpower.com/drmike/cardiovascular-disease/saturated-fat-and-heart-disease-studies-old-and-new/

lol... besaides typing out his name in full and title...

He goes into bashing mode of meta-analyses claiming all researchers manipulate the data to achieve the desired results, followed by going rah rah for a meta analyssis that was not great, and then goes off on his rant around low fat/saturates adn heart disease, doing the same thing he always does.

The best part is when he does the same thing that taubes does


Classic behavior from someone whose mind is made up. Ignore the evidence denying your hypothesis and focus on that confirming it.

pot kettle something

[Sami]

lol, I had no idea who the guy is and only just found his blog today.

I really haven't researched or read around this subject to have formed any sort of solid opinion. But I have recently taken in interest.

[Rorschach]

Anybody know what happens, however, when saturated fats make up a proportionately large amount of total calories or of total fats?

I don't have any papers to hand, but I've read about reports into polynesian tribes, inuits, native american tribes etc who get the vast majority of their calories from saturated fat, and found they had extremely low rates of heart disease etc.

Not conclusive proof, as they don't have have the levels of smoking, chemical additives, pollution etc. "civilised" societies do, but it shows that saturated fats aren't magically toxic at least.