5) DIET TO AVOID HEART DISEASE
b) Avoiding Saturated Fats
Exactly what do we mean when we talk about saturated fat? Modern pork and beef have been slectively bred (we call this a form of genetic engineering) to produce a meat which is tender even when well cooked. This meat has saturated fat thoughout the meat. It is "marbled" with saturated fat. This marbling cannot be removed by simply cutting off the fatty portions of the meat, it is intrinsic to the meat. So there is no such thing as a lean piece of beef or pork. This is in stark contrast to wild animals. Wild animals have their fat concentrated in a layer on the outside of the body where it both acts as insulation and where it acts as a protective armor against the attacks of predators. Any hunter will confirm the presence of this external layer of fat. The feedlot cattle and hogs we consume are penned in tightly and have little chance to exercise and form high protein muscle. Instead they are feed high carbohydrate grains, corn and soy products designed to increase weight rapidly by increasing the amount of marbling in the red meat. This marbling increases the saturated fat content, increases the calorie content and increases the ability to be cooked to a point where poisonous AGEs are formed. No beneficial omega 3 fatty acids are formed. And these undesirable effects have been increasing ever since the Chinese first domesticated hogs some 6,000 years ago.
Many people have questioned the bad reputation of saturated fats with regard to heart disease. One group is the high protein physicians, and the other is the beef and dairy industry. But the data showing that saturated fats are bad for over-all health is massive and irrefutable. There is a huge body of research that shows that very high levels of saturated fats contribute to high cholesterol, atherosclerosis and heart disease (defined a disease of the large blood vessels in the body). The huge and very significant Harvard health study of nurses (80,000 nurses) conclusively concluded one should avoid saturated fats (or at least replace saturated fats with unsaturated fats) in order to avoid heart disease. The consumption of "feedlot" red meat is just unquestionably a contributor to heart disease and early death. Just a few of the references listed by Wikipedia on the subject include
1, MS Wolfe, JK Sawyer, TM Morgan, BC Bullock and LL Rudel Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African green monkeys Arteriosclerosis and Thrombosis Vol 14, 587–597
2, Lapinleimu H, Viikari J, Jokinen E, et al (February 1995). "Prospective randomised trial in 1062 infants of diet low in saturated fat and cholesterol". Lancet 345 (8948): 471–6. doi:10.1016/S0140-6736(95)90580-4. PMID 7861873.
3, Francisco Fuentes; José López-Miranda; Elias Sánchez; Francisco Sánchez; José Paez; Elier Paz-Rojas; Carmen Marín; Purificación Gómez; José Jimenez-Perepérez; José M. Ordovás,; and Francisco Pérez-Jiménez Mediterranean and Low-Fat Diets Improve Endothelial Function in Hypercholesterolemic Men Annals of Internal Medicine 19 June 2001, Volume 134, Issue 12, pp. 1115–1119
4, Rivellese AA, Maffettone A, Vessby B, et al (March 2003). "Effects of dietary saturated, monounsaturated and n-3 fatty acids on fasting lipoproteins, LDL size and post-prandial lipid metabolism in healthy subjects". Atherosclerosis 167 (1): 149–58. doi:10.1016/S0021-9150(02)00424-0. PMID 12618280. http://linkinghub.elsevier.com/retrieve/pii/S0021915002004240.
5, Hu FB, Stampfer MJ, Manson JE, et al (November 1997). "Dietary fat intake and the risk of coronary heart disease in women". N. Engl. J. Med. 337 (21): 1491–9. doi:10.1056/NEJM199711203372102. PMID 9366580. http://content.nejm.org/cgi/content/abstract/337/21/1491.
6, Kromhout D, Menotti A, Bloemberg B, et al (May 1995). "Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study". Prev Med 24 (3): 308–15. doi:url=http://linkinghub.elsevier.com/retrieve/pii/S0091743585710493. PMID 7644455.
7, Hu FB, Stampfer MJ, Manson JE, et al (December 1999). "Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women". Am. J. Clin. Nutr. 70 (6): 1001–8. PMID 10584044. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=10584044.
8, Coronary heart disease in seven countries
9, Beegom R, Singh RB (January 1997). "Association of higher saturated fat intake with higher risk of hypertension in an urban population of Trivandrum in south India". Int. J. Cardiol. 58 (1): 63–70. doi:10.1016/S0167-5273(96)02842-2. PMID 9021429. http://linkinghub.elsevier.com/retrieve/pii/S0167-5273(96)02842-2.
10, Hanne Müller, Anja S. Lindman, Anne Lise Brantsæter, and Jan I. Pedersen The Serum LDL/HDL Cholesterol Ratio Is Influenced More Favorably by Exchanging Saturated with Unsaturated Fat Than by Reducing Saturated Fat in the Diet of Women The American Society for Nutritional Sciences J. Nutr 133:78–83, January 2003
11, Mendis S, Samarajeewa U, Thattil RO (May 2001). "Coconut fat and serum lipoproteins: effects of partial replacement with unsaturated fats". Br. J. Nutr. 85 (5): 583–9. doi:10.1079/BJN2001331. PMID 11348573. http://journals.cambridge.org/abstract_S0007114501000836.
12, Abbey M, Noakes M, Belling GB, Nestel PJ (May 1994). "Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol". Am. J. Clin. Nutr. 59 (5): 995–9. PMID 8172107. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=8172107.
13, de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N (February 1999). "Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study". Circulation 99 (6): 779–85. PMID 9989963. http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=9989963.
14, http://www.aims.ubc.ca/home/modules/conference/2005/med_diet_study_1994.pdf
15, Halton TL, Willett WC, Liu S, et al (November 2006). "Low-carbohydrate-diet score and the risk of coronary heart disease in women". N. Engl. J. Med. 355 (19): 1991–2002. doi:10.1056/NEJMoa055317. PMID 17093250. http://content.nejm.org/cgi/content/short/355/19/1991.
16, World Health Organization Disease-specific recommendations
17, Trends in Intake of Energy, Protein, Carbohydrate, Fat, and Saturated Fat — United States, 1971–2000
18, Lichtenstein AH, Appel LJ, Brands M, et al (July 2006). "Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee". Circulation 114 (1): 82–96. doi:10.1161/CIRCULATIONAHA.106.176158. PMID 16785338. http://circ.ahajournals.org/cgi/content/full/114/1/82.
Having listed all this research we have to say the exact relationship remains somewhat murky. It is possible that "feedlot" saturated fat increases the likelihood of heart disease and death simply because it is such a concentrated source of good tasting calories and because it tends to be well cooked. So people overeat on the "feedlot" beef, hamburger, ham and bacon and both increase in weight and have increased levels of AGEs. Increased weight and increased AGEs then forming the basis for more heart disease and lower life expectancy. It is also possible that "feedlot" saturated fat has three actions; it increases cholesterol and triglycerides, increases calorie intake (it contains a lot of calories), and increases AGEs in the blood (it tends to be well cooked). Note that these three actions are exactly what refined carbohydrates do. Refined carbohydrates increase cholesterol and triglycerides, increase calorie intake (they increase hunger), and they increase AGEs in the blood (in this case they create the AGEs in the body itself).
One example of a food high in saturated fat is whole feedlot eggs.
"Following the study, researchers found that 131 subjects complied with study protocol of maintaining their baseline weight and eating egg supplements more than 80% of the time. At week 12, subjects in the egg group consumed 29.6% of energy from fat, an increase of 2.7% from baseline, while total fat intake in the placebo group remained relatively stable at 25.8% of energy. In addition to the increase in total fat, saturated fat and dietary cholesterol increased in the egg-fed group, 8.2% to 9.1% of calories and 187 mg/d to 601 mg/d, respectively, in contrast, saturated fat and dietary cholesterol in the placebo group decreased slightly from 7.8% to 7.3% of calories and 185 mg/d to 155 mg/d dietary cholesterol."
"The relationship between dietary fat intake and cholesterol absorption is well established, and responses to changes in dietary cholesterol are related to dietary saturated fat content. Thus, in a recent meta-analysis, a dietary cholesterol challenge of 100 mg from eggs resulted in 70% higher increase in LDL cholesterol on a high versus a low saturated fat diet. However, the response in plasma lipid and lipoprotein levels to changes in dietary cholesterol content is highly individualized."
Everyone should avoid eating eggs. There is a misconception that eggs are pure protein. Eggs have large amounts of fat in them and are not good foods for those on a diet to lose weight. Just look at the label on the eggs at the supermarket. A typical egg will have 6.5 grams of protein and 5.6 grams of fat, 1.6 grams of which is saturated fat (no carbohydrates). So 78% of an egg's calories come from fat and 23% of calories from saturated fat. This figure is even higher than the 46% fat, 19% saturated fat levels of a broiled sirloin steak. And eggs will raise the bloods LDL and triglycerides considerably. Use EggbeatersTM , which have most of the fat removed. A Harvard study found that men and women with diabetes who ate an egg a day had 1 1/2 to 2 times the risk of developing heart disease as those who ate up to one per week.
What many people don't realize is how much saturated fat is even in the "good" foods. We have compiled a list of protein sources from several sources. Note that there are some huge variations in the numbers from one list to another so this is the "average" as best it can be determined:
3 ounces of Salmon (farm raised Pink Salmon)
Calories 200
Total fat (g) 10 x 9 = 99 = 50%
Saturated Fat (g) 2 x 9 = 18 = 10% of calories, surprisingly high
Unsaturated Fat (g) 8
Protein (g) 213 ounces Canned Tuna, white albacore in Water
Calories (g) 128
Total Fat (g) 0.5
Saturated Fat (g) 0.2 x 9 = 1.8 = 1.5% of calories, very low
Unsaturated Fat (g) 0.3
Protein (g) 203 ounces of broiled Sirloin
Calories 194
Total fat (g) 10 x 9 = 90 = 46% of calories
Saturated fat (g) 4 x 9 = 36 = 19% of calories, not surprising that this is very high
Monounsaturated fat (g) 4.2
Polyunsaturated fat (g) 0.5
Protein (g) 263 ounces of Beef Round
Calories 149
Total fat (g) 4.9 x 9 = 44 = 30%
Saturated fat (g) 1.8 x 16.2 = 11% of calories, surprisingly average
Monounsaturated fat (g) 2.1
Polyunsaturated fat (g) 0.2
Protein (g) 263 ounces of Walnuts
Calories 546 WOW, look at the calories!!!!!
Total fat (g) 54 x 9 = 90%
Saturated fat (g) 4.8 x 9 = 43.2 = 8% of calories, low
Monounsaturated fat (g) 12
Polyunsaturated fat (g) 33
Dietary fiber (g) 4.2 moderately high
Protein (g) 12
Carbohydrate (g) 153 ounces white meat chicken
Calories 140
Total fat (g) 3 x 9 = 27 = 20%
Saturated fat (g) 0.9 x 9 = 8.1 = 6% of calories, good
Monounsaturated fat (g) 1.1
Polyunsaturated fat (g) 0.7
Protein (g) 163 ounces of dark meat chicken
Calories 178
Total fat (g) 9.3 x 9 = 83.7 = 50%
Saturated fat (g) 2.6 x9 = 23.4 = 13% of calories, surprisingly high
Monounsaturated fat (g) 3.5
Polyunsaturated fat (g) 2.1
Protein (g) 191/2 cup cooked Kidney Beans (red)
Calories 112
Total fat (g) 0.4 x 9 = 3.6 = 3%
Saturated fat (g) 0.1 x 9 = 0.9 = 0.8% of calories, very low!
Monounsaturated fat (g) 0
Polyunsaturated fat (g) 0.2
Dietary fiber (g) 6.6 very high and very beneficial
Protein (g) 8
Carbohydrate (low glycemic index)(g) 20If you look at this list there are some big surprises. The health benefits of salmon's omega 3 oils outweigh its saturated fat, but the total fat content and calories are high and need to be taken into account. Albacore (white) tuna in water is a much better choice than salmon. Note that beans are a much better dietary food than the numbers might suggest. The fiber content is not digestible by the body but is included in both the calorie count and the carbohydrate weight. This quirk in computation means any food with high fiber content is over counted in both calories and total carbohydrate.
Lots of cooking, such as is done to a grilled hamburger, will significantly reduce the amount of saturated fat. Reductions of up to 80% are possible. Unfortunately this overcooked protein will have large amounts of "poisoned proteins" or AGEs, which are extremely unhealthy. Well cooked meat of any type needs to be avoided at all cost by any person with type 2 diabetes. Sausage, hot dogs, pepperoni, well done steaks, hamburgers, fried chicken skins, meat loaf, etc. are all foods which have to be avoided. Paleolithic man ate his food raw or only lightly cooked.
And now for the biggest surprise of all. If an individual are unlucky enough to have "metabolic syndrome X" (sometimes called "insulin resistance syndrome") and they have tried to reduce their blood lipids by diet modification to no avail, they probably have a liver genetically programmed to put out excessive cholesterol. While it is still a very good idea to avoid saturated fats, the avoidance of saturated fat must be accompanied by vigorous exercise, medication and weight reduction in order to be effective. It is estimated that 20% to 30% of the population has Metabolic Syndrome X and that most of them are men.
Recently the newspapers around the country ran a story that announced that fats don't cause heart disease. It was based on one analysis of the same Harvard study data mentioned elsewhere. In the actual study design the intake of "good" unsaturated fats were reduced a paltry 4.8% while the intake of "bad" saturated fats were reduced an even paltrier 2.9%. Given these low intake reduction percentages it should come as no surprise that the study "showed" that fats do not affect the amount of heart disease. And the reporter's interpretation of the study had a common statistical error, simply doing a study where the statistics don't seem to show any effect one way or the other generally means just that, it didn't come to a conclusion one way or the other. Lack of evidence for an effect is not the equivalent of evidence that the effect doesn't occur. So you can't say that "fats don't cause heart disease", you can only say that the study as it was set up showed no significant difference. And this is the way the research study authors worded it. It is just that reporters often don't have the grasp of statistics that a researcher has, so the story gets picked up by the newspapers in a distorted fashion (probably at the encouragement of the meat industry). Several better studies of the same Harvard Nurses Study data and many other studies have concluded that the intake of "feedlot" saturated fats is very bad while the intake of unsaturated fats is moderately good for human health (as long as body weight is also controlled).
Having said all this about the dangers of saturated fat and heart disease, there is a major caveat. Once again, diet is the third leg of the stool. It is probably more important for someone with type 2 diabetes to lose weight and exercise than it is for that person to avoid saturated fat.
Current Chapter: 5) DIET TO AVOID HEART DISEASE
a) Introduction
b) Avoiding Saturated Fats
c) Avoiding Trans Fatty Acids
d) Benefits of Unsaturated Fats
e) Fats and Weight Loss
f) Benefits of Fiber
g) Avoiding High Glycemic Index Foods
h) Reducing Salt Intake
© Copyright 2009 All Rights Reserved.