Wednesday 26 July 2017

Popular belief that saturated fat clogs up arteries is a myth, experts say

There is little evidence linking saturated fat consumption with heart disease, diabetes and premature death.
There is little evidence linking saturated fat consumption with heart disease, diabetes and premature death.

John von Radowitz

Heart experts have been criticised for claiming it is "plain wrong" to believe that saturated fat clogs up arteries.

Three specialists argued that eating "real food", taking exercise and reducing stress are better ways to stave off heart disease than cutting out dietary saturated fat.

Writing in a respected journal, they maintained that inflammation is the chief threat to arteries and there is little evidence linking saturated fat consumption with heart disease, diabetes and premature death.

But the editorial, published in the British Journal of Sports Medicine, attracted scathing criticism for being "simplistic", "muddled" and "misleading".

The authors, led by Dr Aseem Malhotra, from Lister Hospital, Stevenage, wrote: "Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong."

Dr Malhotra and colleagues Professor Rita Redberg, from the University of California at San Francisco, and Pascal Meier from University Hospital Geneva in Switzerland and University College London, cited a "landmark" review of evidence that appeared to exonerate saturated fat.

They said relative levels of "good" cholesterol, or high density lipoprotein (HDL), were a better predictor of heart disease risk than levels of low density lipoprotein (LDL), also known as "bad" cholesterol.

High consumption of foods rich in saturated fat such as butter, cakes and fatty meat has been shown to increase blood levels of LDL.

The experts wrote: "It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids (blood fats) and reducing dietary saturated fat.

"Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 minutes a day and eating real food."

They pointed out that in clinical trials widening narrow arteries with stents - stainless steel mesh devices - failed to reduce the risk of hear attacks.

Dr Aseem spelled out a similar message in another opinion piece published in the British Medical Journal in 2013.

Leading the the critics was Professor Alun Hughes, associate director of the Medical Research Council Unit for Lifelong Health and Ageing at University College London.

He said: "This editorial is muddled and adds to confusion on a contentious topic. The authors present no really new evidence, misrepresent some existing evidence, and fail to adequately acknowledge the limitations in the evidence that they use to support their point of view."

Dr Mike Knapton, associate medical director at the British Heart Foundation, said the claims about saturated fat were "unhelpful and misleading".

He added: "Decades of research have proved that a diet rich in saturated fat increases 'bad' LDL cholesterol in your blood, which puts you at greater risk of a heart attack or stroke."

Dr Amitava Banerjee, honorary consultant cardiologist at University College London, said: "Unfortunately, the authors have reported evidence simplistically and selectively".

His view was echoed by cardiologist Dr Gavin Sandercock, director of research at the University of Essex, who said: "This editorial is not founded on good evidence. There is no such thing as 'real food' - the authors don't define what it is so it's meaningless."

However the authors found an ally in Dr Mary Hannon-Fletcher, head of the school of health sciences at the University of Ulster, who described the editorial as "the best dietary and exercise advice I have read in recent years".

She added: "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."

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