Raised cholesterol, Saturated Fats and Sugar: Who is the culprit?

Fats have had a history of bad press in the last 40 years. In particular, saturated fats.

Foods high in saturated fats include both savoury and sweet foods such as butter, lard, hard cheese, cream, fatty cuts of meat, sausages, pies, chocolate, cakes, biscuits and pastries. Saturated fats have been associated with increasing cardiovascular diseases such as heart attacks and stroke. However new evidence from a study by Dr Malhotra, published by The British Medical Journal, indicates that perhaps saturated fats aren’t the culprit after all.

So have we been deceived for the last 40 years? Are cakes, butter and pastries actually good for us? I have decided to investigate. After all, keeping up with the most up to date research is how science, nutrition and medicine progresses.

When the ‘cholesterol – heart disease relationship’ was established

It began with a groundbreaking study in the 1970s called Keys’ “Seven Countries Study” which investigated the relationship between diet and coronary heart disease (CHD). They found that saturated fat was linked to cholesterol levels, and higher cholesterol levels in the blood can increase your risk of heart attack and other cardiovascular diseases.

Thus, the downfall of saturated fat started 40 years ago, when nutritional research was just beginning. And there is some controversy surrounding this study – for example, there were originally 22 countries in the study, with Dr Keys choosing only 7 countries to show the relationship between cardiovascular health and cholesterol. Why not show the results from the other 15 countries?

The media then, like today, are always very quick to jump on any bandwagon to make cutting edge headlines such as ‘fats lead to heart attacks and death’, which is not necessarily true. The media are great at scaremongering and also very quick to point out that fats are energy dense, with 9 calories per gram and are very efficiently stored in our body.

The Findings of the Dr Malhotra Study

The science behind the new study says that it is sugar which increases cholesterol and cardiovascular disease risk. And this new study claims that saturated fats have protective effects for the heart…

So, Dr Malhotra argues that while we have been demonising saturated fats and removing fats from our foods over the last 40 years, we have significantly increased sugar levels in foods to improve taste. And subsequently, we have seen a rise in cardiovascular diseases and other diseases such as Type 2 Diabetes Mellitus.

And nowadays it is phenomenally easy to over-consume sugar. With a small bottle of coke having 13 teaspoonfuls of sugar and Yop yoghurt drinks having up to 23 teaspoonfuls of sugar it is not surprising sugar is consumed with high quantities, with many people not realising.

Responses to Dr Malhotra Study

Dr Malhotra’s study has been widely received and certainly has created shockwaves amongst scientists and researchers. There are many responses to the study, and has divided critics.

There are some very strong views against the study. For example, Dr Walsh, a UK GP argues that there has not been a single study which shows saturated fats have a protective effect on the heart.

“I sit across from patients everyday review their diet logs. I operate on them and see their insides. I cut open vessels and clear out cholesterol plaques. You can choose to believe a blogger or a journalist or you can trust in science that has been around for a long time. You choose.” Dr Walsh

Other scientists point out that Dr Malhotra fails to address the type of carbohydrate which can alter cholesterol. There are differences in sucrose (refined table sugar) and fructose (the sugar found in fruits).

So what is the verdict?

In a word – inconclusive. More research is required and thus the public are recommended to stick to the current UK guidelines on fat consumption.

A number of leading health organisations worldwide stick by current guidelines – which are to not overconsume on saturated fat; the World Health Organisation, American Dietetic Association, the NHS, the British Dietetic Association and the British Heart Foundation.

An Apple A Day…

There certainly is truth in this old wives tale. A recent study by Oxford University found that 9500 deaths can be prevented by taking statins, a cholesterol lowering drug. However, an apple a day can prevent or delay 8500 deaths annually from cardiovascular disease.

Before you start consuming great deals of butter, cakes and pastries in your diet – remember that it is your overall diet that alters your risk for cardiovascular diseases. A diet with high quantities of fruits and vegetables and small quantities of unsaturated fats (from fatty fish such as salmon or in nuts and seeds) have been shown to significantly reduce risk for cardiovascular diseases.

It becomes clearer and clearer that perhaps over-processed foods are simply the culprit and we should stick to what we know. Human bodies evolved a very long time ago, before civilization, and our bodies work best when we are eating a variety of foods such as fruits, vegetables, complex carbohydrates and some protein to go with it.

If you have any concerns about your diet or health, contact Adriana practising now at ROC Private Clinic in Harley Street, London.

References

• Champeau R. Most heart attack patients’ cholesterol levels did not indicate cardiac risk. UCLA Newsroom. 2009.http://newsroom.ucla.edu/portal/ucla/majority-of-hospitalized-heart-75668.aspx.
• Ornish, D. (1998). Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. JAMA, 280(23), p.2001.
• http://www.nhs.uk/news/2013/10October/Pages/Saturated-fat-link-with-heart-disease-questioned.aspx
• http://www.nhs.uk/livewell/goodfood/pages/fat.aspx
• http://www.nhs.uk/chq/pages/1124.aspx?categoryid=51
• http://www.nhs.uk/Livewell/Goodfood/Pages/Fat.aspx
• http://www.nhs.uk/news/2014/03March/Pages/Saturated-fats-and-heart-disease-link-unproven.aspx
• http://www.who.int/gho/ncd/risk_factors/unhealthy_diet_text/en/
• http://www.ncbi.nlm.nih.gov/pubmed/17936958
• https://www.bda.uk.com/foodfacts/FatFacts
• https://www.bhf.org.uk/heart-health/preventing-heart-disease/healthy-eating/fats-explained
• https://www.bhf.org.uk/news-from-the-bhf/news-archive/2013/december/statins-and-apples