tag:theconversation.com,2011:/au/topics/saturated-fat-5118/articlesSaturated fat – The Conversation2023-11-13T14:43:04Ztag:theconversation.com,2011:article/2169152023-11-13T14:43:04Z2023-11-13T14:43:04ZBad food choices: clearer labels aim to help South Africans pick healthier options<p>South Africans have a hard time figuring out which foods are unhealthy when they go shopping. But this is about to change.</p>
<p>South African supermarkets currently sell <a href="https://doi.org/10.1017/S1368980022000374">large amounts of unhealthy, ultra-processed foods</a>. Packaged foods in particular have high levels of sugar, salt and saturated fat – all things that are bad for our health.</p>
<p><a href="https://www.nature.com/articles/s41366-020-00650-z">Research</a> shows that the consumption of these foods is linked to increasing rates of obesity and related diseases such as diabetes.</p>
<p>Many countries have been looking for better labelling systems which help consumers understand whether a product is unhealthy. Countries that have adopted simpler labelling systems have seen consumers making <a href="https://www.oecd-ilibrary.org/content/paper/c1f4d81d-en">healthier choices</a> about food. </p>
<p>South Africa’s health minister published draft <a href="https://www.gov.za/sites/default/files/gcis_document/202304/48428rg11572gon3287.pdf">food labelling regulations</a> in April. These will introduce a new labelling scheme, limit advertising of unhealthy foods, and restrict the use of misleading health claims.</p>
<p>The draft regulations propose clearer food labels, which include a new triangle highlighting that the food contains ingredients that are unhealthy. These logos will be placed on the front of a product.</p>
<p>We are part of the <a href="https://www.globalfoodresearchprogram.org/nutrient-warning-labels-work-in-south-africa-results-from-a-randomized-controlled-trial">working group</a> that advised the Department of Health on front-of-package nutrition labelling, drawing on our expertise in dietetics, nutrition, public health and the law. </p>
<p>We worked with consumers and experts on food labelling, advertising and obesity prevention to create a system designed to work well in South Africa.</p>
<p>But it was a complicated process. This is how we did it. </p>
<h2>How do we know which food is unhealthy?</h2>
<p>The first step is to find a way to identify unhealthy foods. There are <a href="https://www.emro.who.int/nutrition/reduce-fat-salt-and-sugar-intake/index.html">international guidelines</a> on how much sugar, salt and saturated fat people should be eating. These can be used to measure whether a food has too much of these ingredients. </p>
<p>Figuring out whether a food is unhealthy can be tricky, but luckily, other countries around the world have adopted systems like this before, known as <a href="https://doi.org/10.3390/nu13082584">nutrient profile models</a>, and we could build on what they had already done. </p>
<p>We looked at what foods were being sold in South African supermarkets. We searched for nutrient profiling models that identify unhealthy foods and work well in other countries and tested these on the South African food supply.</p>
<p>We found that the <a href="https://doi.org/10.3390/nu13082584">Chilean model</a>, which focuses only on unhealthy ingredients, sugar, sodium and saturated fat, would work well because it was simple to implement and was able to identify unhealthy products very easily and accurately. </p>
<p>We then modified the Chilean model to make it work for South Africa.</p>
<h2>Choosing the right label</h2>
<p>The next thing to decide was what kind of label South Africa should use. There are lots of different systems but not all work well. </p>
<p>One uses colour coding. For example, a low level of salt would get a green marker while high sugar would get a red one.</p>
<p>There are also descriptive labels which don’t tell consumers whether the amounts are good or bad – just whether they are present.</p>
<p>Then there are warning labels, often shaped like traffic signs, to alert consumers to the high levels of unhealthy ingredients such as saturated fat, sugar and salt.</p>
<p>We looked at how to design a label that would be <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257626">understandable</a> to the average South African. We consulted South Africans on each element of the label, from the wording and size to the symbols and colour.</p>
<p>We developed a black triangle – inspired by a danger warning sign – which would stand out on colourful food packages and included pictures so that anyone, even those who can’t read or speak English, would be able to understand them.</p>
<p>The last part of this work was a nationally representative randomised, control trial of different labelling systems. Almost <a href="https://www.sciencedirect.com/science/article/pii/S0195666322003749">2,000</a> people across different income groups and education levels participated. </p>
<p>We also found that the warning labels led to consumers <a href="https://www.sciencedirect.com/science/article/pii/S0195666322003749">changing their minds</a> about what food they would consider buying.</p>
<p>Earlier this year, South Africans had the opportunity to give comments on the regulations that will see this labelling system implemented. Now it’s up to the department to decide when and how to put these regulations into action.</p>
<p>Hopefully soon all South Africans will be able to see at a glance which foods are bad for their health.</p><img src="https://counter.theconversation.com/content/216915/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Safura Abdool Karim receives funding from Bloomberg Philanthropies. </span></em></p><p class="fine-print"><em><span>Makoma Bopape receives funding from Bloomberg Philanthropies</span></em></p><p class="fine-print"><em><span>Rina Swart receives funding from Bloomberg Philanthropies, the National Department of Health and the DSI/NRF COE in Good Security. </span></em></p><p class="fine-print"><em><span>Tamryn Frank receives funding from Bloomberg Philanthropies. </span></em></p>Countries that have adopted clear food labels have seen the health benefits. Researchers explain how a new system to alert South African consumers to unhealthy choices was developed.Safura Abdool Karim, Postdoctoral fellow, Johns Hopkins UniversityMakoma Bopape, Lecturer in Department of Human Nutrition and Dietetic, University of LimpopoRina Swart, Professor, University of the Western CapeTamryn Frank, Researcher, University of the Western CapeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2117482023-09-15T00:56:34Z2023-09-15T00:56:34ZHow can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?<figure><img src="https://images.theconversation.com/files/545897/original/file-20230901-17-zovk4b.jpg?ixlib=rb-1.1.0&rect=2%2C0%2C1908%2C1279&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/white-ceramic-bowls-with-supplements-7615572/">Nataliya Vaitkevich/Pexels</a></span></figcaption></figure><p>Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options. </p>
<p>Could taking supplements over this time help?</p>
<p>You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">Got high cholesterol? Here are five foods to eat and avoid</a>
</strong>
</em>
</p>
<hr>
<h2>Why are we so worried about cholesterol?</h2>
<p>There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins.</p>
<p><strong>Low-density lipoprotein or LDL cholesterol</strong></p>
<p>This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an <em>increased</em> risk of heart disease and stroke. </p>
<p><strong>High-density lipoprotein or HDL cholesterol</strong></p>
<p>This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a <em>reduced</em> risk of heart disease and stroke. </p>
<p>Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cut avocado, glass of olive oil, green herbs and cut lemon on timber background" src="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">You can find unsaturated fat in foods such as olive oil and avocado.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/food-background-fresh-organic-avocado-lime-253287091">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-healthier-butter-or-margarine-19777">Health Check: what's healthier, butter or margarine?</a>
</strong>
</em>
</p>
<hr>
<h2>Fibre is your friend</h2>
<p>An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">soluble fibre</a>.</p>
<p>This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces. </p>
<p>You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">Fiber is your body's natural guide to weight management – rather than cutting carbs out of your diet, eat them in their original fiber packaging instead</a>
</strong>
</em>
</p>
<hr>
<h2>Fibre supplements, such as psyllium</h2>
<p>There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include:</p>
<ul>
<li><p><strong>natural soluble fibres</strong>, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats)</p></li>
<li><p><strong>synthetic soluble fibres</strong>, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel)</p></li>
<li><p><strong>natural insoluble fibres</strong>, which bulk out your faeces, such as flax seeds.</p></li>
</ul>
<p>Most of these supplements come as fibres you add to food or dissolve in water or drinks. </p>
<p>Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials.</p>
<p>These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person stirring in psyllium into glass of water, bowl of psyllium next to glass" src="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">You can mix psyllium fibre into a drink or add it to your food.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-adds-spoon-psyllium-fiber-mix-2031428417">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-are-you-eating-the-right-sorts-of-fibre-20089">Health Check: are you eating the right sorts of fibre?</a>
</strong>
</em>
</p>
<hr>
<h2>Probiotics</h2>
<p>Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces.</p>
<p>Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising. </p>
<p>In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%.</p>
<p><a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings.</p>
<p>Most of these studies use probiotics containing <em>Lactobacillus acidophilus</em> and <em>Bifidobacterium lactis</em>, which come in capsules or powders and are consumed daily.</p>
<p>Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-should-healthy-people-take-probiotic-supplements-95861">Health Check: should healthy people take probiotic supplements?</a>
</strong>
</em>
</p>
<hr>
<h2>Red yeast rice</h2>
<p><a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins.</p>
<p>A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins.</p>
<p>However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Red yeast rice capsules" src="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=274&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=274&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=274&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=344&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=344&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=344&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Red yeast rice is often used in Asia and some European countries to lower cholesterol.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/red-yeast-rice-supplement-capsules-on-1625852824">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Diet and supplements may not be enough</h2>
<p>Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol.</p>
<p>But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role.</p>
<p>Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.</p><img src="https://counter.theconversation.com/content/211748/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council, Queensland Health, Mater Misericordia and the Royal Australian College of General Practitioners. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>If you try supplements, you still need to eat a healthy diet, exercise, reduce your stress, quit smoking and get enough sleep. Even then, they may still not be enough.Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2041002023-04-20T03:10:34Z2023-04-20T03:10:34ZCoronation Quiche anyone? You’ll need to fork out A$35. Here are cheaper and healthier options<figure><img src="https://images.theconversation.com/files/521744/original/file-20230419-20-hg9dc3.jpg?ixlib=rb-1.1.0&rect=1%2C0%2C1052%2C703&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.royal.uk/coronation-quiche-0">www.royal.uk</a></span></figcaption></figure><p>If you are a monarchist, or just enjoy the tradition of the royal family, you may have heard about the Coronation Quiche – made with spinach, broad beans and tarragon.</p>
<p>The idea is for us to make it and share it with friends and family during the coronation celebrations in May. King Charles and Queen Consort Camilla have just shared a <a href="https://www.royal.uk/coronation-quiche-0">recipe</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1647917367798939648"}"></div></p>
<p>As dietitians, we’re interested in the quiche’s nutritional value. So we analysed its contents and found that although it’s quite a healthy dish, we could make a healthier version. Spoiler alert: the original recipe contains lard (pork fat).</p>
<p>We’ve also found we could make the quiche using cheaper or more easily available ingredients.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/king-charles-iii-will-be-crowned-in-may-the-ritual-has-ancient-origins-heres-what-we-can-expect-191262">King Charles III will be crowned in May. The ritual has ancient origins – here's what we can expect</a>
</strong>
</em>
</p>
<hr>
<h2>What exactly is a quiche?</h2>
<p>Today, most people consider quiche a French dish that’s essentially a savoury pie. It typically consists of a pastry crust filled with a mixture of eggs, cream and cheese, plus various other ingredients such as veggies, meat and herbs. </p>
<p>Quiche can be served hot or cold. You can have it for breakfast, lunch or dinner with salad or veggies. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/platinum-pudding-a-history-of-desserts-with-royal-connections-175264">Platinum pudding: a history of desserts with royal connections</a>
</strong>
</em>
</p>
<hr>
<h2>How much does it cost?</h2>
<p>Quiches are usually quite economical to make. Most of the basic ingredients are cheap, and you can adapt the fillings depending on what’s in the fridge or left over from recent meals.</p>
<p>Let’s see if this applies to the Coronation Quiche. We split the costs into typical quantities you can buy at the shops (for instance, six eggs) and the costs to make the quiche (which only needs two eggs).</p>
<p>If you make the quiche from scratch and have to buy the ingredients in quantities sold in the shops, this will cost you almost A$38. Although this may seem a lot, you’ll have some ingredients left over for another meal.</p>
<p>So how much do the ingredients cost for one quiche? We worked it out at
$12 for the entire quiche, or $2 a serve. Quite reasonable!</p>
<p><iframe id="4kwy0" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/4kwy0/5/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>Can you make it even cheaper?</h2>
<p>Busy lives and the rising cost of living are front of mind right now. So here are a few things you can do to save time and money when making a Coronation Quiche:</p>
<ul>
<li><p>buy pre-made pastry. Keep any sheets you don’t use for the quiche in the freezer</p></li>
<li><p>use <a href="https://theconversation.com/are-home-brand-foods-healthy-if-you-read-the-label-you-may-be-pleasantly-surprised-189445">home-brand products</a> where possible </p></li>
<li><p>consider vegetable shortening as it is a little cheaper than lard</p></li>
<li><p>buy vegetables in season and from a farmers’ market</p></li>
<li><p>can’t find tarragon? Try seasonal and cheap herbs such as parsley, basil or rosemary</p></li>
<li><p>can’t find broad beans? Try cheaper pulses such as edamame or cannellini beans. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-home-brand-foods-healthy-if-you-read-the-label-you-may-be-pleasantly-surprised-189445">Are home-brand foods healthy? If you read the label, you may be pleasantly surprised</a>
</strong>
</em>
</p>
<hr>
<h2>How nutritious is the Coronation Quiche?</h2>
<p>We also looked at the Coronation Quiche’s nutritional profile. We expressed quantities for the whole quiche, and per serve.</p>
<p><iframe id="OnW3S" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/OnW3S/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>The healthy … and the not so healthy</h2>
<p>This quiche has high amounts of healthy protein and fibre that come from the broad beans and eggs. </p>
<p>One serving of this quiche gives you about 18-25% of your daily protein and about 10% of your daily fibre requirements, which is great.</p>
<p>But the quiche has high levels of saturated fat, mostly from its high amounts of lard, butter and cream.</p>
<p>Saturated fat has been linked to an increased risk of <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011737.pub3/full">cardiovascular events</a>, such as heart attacks and stroke, because it raises levels of LDL cholesterol (the bad kind of cholesterol). </p>
<p>This LDL cholesterol can build up in the walls of arteries and form plaques, leading to arteries hardening over time and increasing the risk of heart attack and stroke. So, high amounts of saturated fats is something we want to avoid eating too much of, especially if we have cardiovascular disease. It’s also something we want to avoid if we’re trying to lose weight.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Pouring jug of cream into mixing bowl" src="https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/521811/original/file-20230419-24-axsfat.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The quiche has high levels of saturated fat, mostly from its high amounts of lard, butter and cream.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cream-pouring-into-bowl-ready-whip-1088041406">TayaJohnston/Shutterstock</a></span>
</figcaption>
</figure>
<p>For an average Aussie consuming roughly 9,000 kilojoules per day, the recommended maximum intake of saturated fat is about 24 grams. </p>
<p>Just one serve of this quiche has about 17g of saturated fat, which means there’s not much wriggle room for other foods after you have a slice. </p>
<p>You may be better off trying <a href="https://nomoneynotime.com.au/healthy-easy-recipes/clares-rolled-oats-quiche">this quiche</a> instead, as it has half the amount of saturated fat as the Coronation Quiche. You could even try a <a href="https://www.wellplated.com/crustless-quiche/">crustless quiche</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-is-margarine-actually-better-for-me-than-butter-82445">Health Check: is margarine actually better for me than butter?</a>
</strong>
</em>
</p>
<hr>
<h2>4 ways to make a healthier quiche</h2>
<p>Here are a few swaps to help make this recipe healthier:</p>
<p><strong>1. Use low-fat options</strong>. If you’re watching your weight and looking to reduce the kilojoules of the quiche, swap the full-fat cheddar cheese, milk and double cream to low-fat products. This will reduce the total fat content per serve from 29.6g to 15g and save 112.2 kilojoules per serve</p>
<p><strong>2. Ditch the lard</strong>. Swap the lard for butter to save 15g of total fat per serve. This may change the texture of the quiche slightly but it will reduce the kilojoules </p>
<p><strong>3. Use feta</strong>. Swap the cheddar cheese for feta cheese, which has fewer kilojoules per gram</p>
<p><strong>4. Add extra veggies</strong>. This increases the fibre content of the quiche and adds loads of extra nutrients. </p>
<hr>
<p><em>Correction: This story has been updated to price butter at $3.70 per 250 grams. An error was made in the original calculation.</em></p><img src="https://counter.theconversation.com/content/204100/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>Coronation Quiche may be fit for a king. But with a few tweaks, can be made to suit your budget. Hint: store-bought pastry is cheaper.Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1725372021-11-29T11:55:11Z2021-11-29T11:55:11ZHeart disease risk from saturated fats may depend on what foods they come from – new research<figure><img src="https://images.theconversation.com/files/434405/original/file-20211129-25-rm6jk1.jpg?ixlib=rb-1.1.0&rect=0%2C10%2C6709%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Our health is affected by the combination of nutrients foods contain.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-eating-tasty-yogurt-berries-granola-1093191254">New Africa/ Shutterstock</a></span></figcaption></figure><p>Heart disease is a major cause of death worldwide – responsible for some <a href="https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death">9 million deaths</a> a year. But it is preventable, and health behaviour changes – such as exercising more, quitting smoking and eating healthier – are often recommended.</p>
<p>One <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">diet change</a> commonly recommended by experts is to <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814995/SACN_report_on_saturated_fat_and_health.pdf">eat fewer saturated fats</a> – and instead consume polyunsaturated fats (typically found in nuts, vegetable oils and fish), which are considered healthier. But <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.120.019814">our new research</a> suggests that instead of only paying attention to the amount of saturated fat we consume, we should also look at what food sources the saturated fat is coming from. </p>
<p>Until now, most research on saturated fats has focused solely on looking at saturated fat and its link with heart disease. But foods contain many different types of nutrients. This is why it’s important to investigate which foods containing saturated fats are linked to heart disease, rather than only considering saturated fat alone. This is what our research set out to do.</p>
<p>Our research drew on data from the University of Cambridge’s <a href="https://link.springer.com/article/10.1007%252Fs10654-006-9096-8">EPIC-CVD study</a>, which looked at the cardiovascular health of middle-aged people in ten European countries. This included 10,529 participants who developed heart disease during the study, whom we compared against 16,730 participants who did not. Participants were randomly selected from the 385,747 participants of the EPIC study to ensure our findings were representative of the whole study population. We also looked at data on their dietary habits as part of our analysis.</p>
<p>We made sure to take into account various factors that may be related to heart disease – such as a person’s age, sex, physical activity levels, whether they smoked or drank alcohol and whether they were overweight or obese. This minimised the chances that our findings about fat consumption and heart disease might actually be explained by these other factors. </p>
<p>We found no overall link between the amount of saturated fats participants consumed and their risk of developing heart disease. But this picture was different when we looked at foods that are typical sources of saturated fats. </p>
<p>We found that people who ate more saturated fats from red meat and butter were more likely to develop heart disease. The opposite was true for those who ate more saturated fats from cheese, yoghurt and fish – which were actually linked to a lower risk of heart disease. These findings are in line with what <a href="https://www.tandfonline.com/doi/full/10.1080/10408398.2017.1392288">earlier research</a> has shown about the link between <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.118.038813">these foods and heart disease</a>. These findings show us that the link between heart disease and saturated fats depends on what food sources it comes from.</p>
<figure class="align-center ">
<img alt="A medium-rare steak, sliced up on a wooden board and covered in butter." src="https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/434407/original/file-20211129-15-170t188.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Red meat and butter were associated with a greater risk.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sliced-grilled-medium-rare-barbecue-steak-465836414">Natalia Lisovskaya/ Shutterstock</a></span>
</figcaption>
</figure>
<p>One caveat with our research is that it’s based on observing the associations between diet and health. As such, this cannot prove cause and effect. However, conducting a randomised controlled trial, where participants would be randomly assigned a certain diet to follow for many years, would probably be impractical – and many participants may not wish to stick to a specific diet for the length of the study. </p>
<h2>More than one nutrient</h2>
<p>Foods are more than just the sum of their parts. They contain many different nutrients, vitamins, minerals and properties that may act together to prevent or cause certain diseases.</p>
<p>For example, although cheese and yoghurt contain saturated fats, they also contain nutrients such as vitamin K2 and probiotics. Each of these nutrients may affect <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781235/">heart disease</a> risk <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743821/">through different</a> interrelated pathways – such as by their effects on blood sugar, cholesterol levels or inflammation.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/22802735/">Previous studies</a> have <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(14)70146-9/fulltext">also shown</a> that different saturated fats carry different levels of risk when it comes to heart disease. For instance, palmitic acid (a sub-type of saturated fat) is more abundant in red meat compared to cheese and yoghurt. Research shows that it may have a detrimental effect on the <a href="https://apps.who.int/iris/handle/10665/246104">levels of cholesterol</a> circulating in our blood – a well known risk factor for heart disease.</p>
<p>In contrast, pentadecanoic acid (another sub-type of saturated fat, commonly found in dairy) is generally linked with <a href="https://pubmed.ncbi.nlm.nih.gov/22802735/">lower risk</a> of heart disease. This shows us that ultimately, our health is affected by the <a href="https://pubmed.ncbi.nlm.nih.gov/31270106/">combination of all the nutrients</a> and bioactive components (including vitamins, minerals and phytochemicals) in the foods we eat. This is why it’s important to consider the foods we eat alongside the nutrients they contain. </p>
<p>Preventing heart disease depends on numerous factors, such as being physically active, not smoking and adopting a healthier diet. But as our research shows, reducing saturated fat intake may not be enough for reducing risk. Rather, it’s about focusing more on reducing foods such as red meat and butter which are linked to a significantly higher risk than other foods that contain saturated fats.</p><img src="https://counter.theconversation.com/content/172537/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marinka Steur received funding from Medical Research Council Epidemiology Unit (MC_UU_00006/3) and was also supported by the British Heart Foundation for part of this work. She declares no conflict of interest.</span></em></p><p class="fine-print"><em><span>Nita Forouhi receives funding from Medical Research Council Epidemiology Unit (MC_UU_00006/3) and National Institute of Health Research Cambridge Biomedical Centre Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014). She is an NIHR Senior Investigator. She declares no conflict of interest. </span></em></p>We found a greater risk of heart disease with saturated fats from red meat and butter – but a lower risk with saturated fats from cheese, yoghurt and fish.Marinka Steur, Career Development Fellow, MRC Epidemiology Unit, University of CambridgeNita Forouhi, Programme Leader, MRC Epidemiology Unit, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1703402021-11-03T19:24:27Z2021-11-03T19:24:27ZPublic acceptance of sin taxes on sugar or fat not dependent on evidence<figure><img src="https://images.theconversation.com/files/430021/original/file-20211103-17-fan43j.jpg?ixlib=rb-1.1.0&rect=87%2C52%2C2576%2C1882&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">British Columbia introduced a tax on sugar-sweetened beverages in April.</span> <span class="attribution"><span class="source">(AP Photo/Elaine Thompson) </span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/public-acceptance-of-sin-taxes-on-sugar-or-fat-not-dependent-on-evidence" width="100%" height="400"></iframe>
<p>It’s easy to assume that public health measures, such as taxing unhealthy foods, are most successful when they are based on the best available evidence. However, <a href="https://doi.org/10.1353/pbm.0.0085">research suggests that evidence-based policy-making</a> doesn’t always <a href="https://doi.org/10.1111/padm.12655">dictate public response</a>. Researchers have also noted tensions between different types of evidence when establishing the legitimacy of a policy. </p>
<p>We study <a href="https://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity/news/news/2012/10/can-fiscal-policies-reduce-noncommunicable-diseases2">taxes placed on foods that are deemed unhealthy</a>, and find scientific evidence has not dominated the debates over the legitimacy of these measures. Instead, a food tax’s chances of survival are based on the ability of political interests to create a successful narrative surrounding the policy’s purpose. </p>
<p>We compare Denmark, which implemented and quickly repealed a tax on saturated fats in 2011-12, and Ireland, which implemented a sugar-sweetened beverage tax in 2018 that has remained in place. </p>
<h2>A tale of two taxes</h2>
<p>Our findings demonstrate how certain public health measures are made acceptable to the public. They tell us about the importance of narratives in the successful implementation of <a href="https://www.cbc.ca/news/canada/british-columbia/b-c-tax-changes-affecting-sugary-drinks-netflix-vaping-products-come-into-effect-april-1-1.5939189">similar food taxes in Canada</a>. They also raise questions about when similar narratives may be relevant to other types of public health measures.</p>
<p>What shaped public discussion and controversy over food taxes in Denmark and Ireland? In both these countries, the success or failure of the tax depends on two factors. First, <a href="https://doi.org/10.2307/2939044">how sympathetic</a> were potential “winners and losers” under the tax? Second, did <a href="https://doi.org/10.1177%2F0010414008325283">previous policies</a> provide a template for the public to understand and potentially accept the tax?</p>
<h2>A short-lived fat tax in Denmark</h2>
<p>Denmark’s “fat tax” has been <a href="https://www.washingtonpost.com/news/worldviews/wp/2012/11/11/what-the-world-can-learn-from-denmarks-failed-fat-tax/">described as a failure</a> due to its quick repeal. The 2.3 per cent tax on foods high in saturated fats was adopted with the goal of addressing Denmark’s <a href="https://www.oecd.org/els/health-systems/49105858.pdf">obesity rates and lifestyle-related illnesses</a>. However, it faced backlash after its introduction in October 2011 and was repealed in November 2012. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A nutrition label for potato chips lying on top of potato chips" src="https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/430038/original/file-20211103-27-14ry3h6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Denmark’s 2.3 per cent tax on foods high in saturated fat faced backlash after its introduction in October 2011, and was repealed in November 2012.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Denmark made the decision to adopt the fat tax based on a recommendation from expert committees studying the “obesity crisis.” Experts indicated that a tax on fats would potentially have positive effects on public health. They also raised concerns about the impact on <a href="https://atv.dk/sites/atv.dk/files/media/document/Rapport_ATV_Economic_nutrition_policy_tools_December_2007.pdf">low-income groups</a>. However, the limited expert support for this policy was not a central point of discussion in the media narratives.</p>
<p>Although Denmark has historically had <a href="https://www.skm.dk/skattetal/satser/satser-og-beloebsgraenser-i-lovgivningen/satser-og-beloebsgraenser-lovfortegnelse/">high taxes on certain food products</a> to generate revenue, these taxes were not framed as health policies. The public was unfamiliar with both the idea of a health tax, and paying more for the goods the fat tax targeted. This meant the media narrative focused on the tax’s negative impacts on consumers and industry rather than its health implications.</p>
<p>The fat tax primarily targeted the meat and dairy industries in Denmark. Industry stakeholders argued that the tax would severely <a href="http://dx.doi.org/10.1038/ejcn.2014.224">impact jobs</a>, low-income households or push consumers to buy groceries outside of Denmark. The media narrative pointed to the tax targeting dietary staples, which made common purchases more expensive.</p>
<p>The dominant media narrative was that the fat tax was harmful to Denmark’s economy, essential industries and families. There were experts that supported or critiqued the public health evidence behind the tax. However, the primary reasons for backlash against the tax were unrelated to scientific evidence. Instead, they were centred on the social and economic impacts on Danes. </p>
<h2>A stable sugar tax in Ireland</h2>
<p>Ireland’s sugar-sweetened drinks tax was implemented as an effort to address what experts identified as a <a href="https://www.rcpi.ie/news/publication/the-race-we-dont-want-to-win/">childhood obesity crisis</a>. It was backed by the Royal College of Physicians of Ireland and the Irish Heart Foundation. While the expert support for a health tax was stronger in Ireland than it was in Denmark, the construction of a sympathetic narrative in support of the sugar tax did not rest on the quality of evidence.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A row of soda cans" src="https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=150&fit=crop&dpr=1 600w, https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=150&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=150&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=189&fit=crop&dpr=1 754w, https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=189&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/430051/original/file-20211103-21-1bof04s.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=189&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ireland’s tax on sugar-sweetened beverages was a success.</span>
<span class="attribution"><span class="source">(Pixabay)</span></span>
</figcaption>
</figure>
<p>At that time, Coca-Cola was <a href="https://www.independent.ie/irish-news/health/coca-cola-ads-target-children-aged-seven-obesity-expert-30551144.html">under fire in the media for its advertising campaigns</a> said to be targeting children during an obesity epidemic. The Irish media compared this to tobacco companies, as both “<a href="https://www.irishtimes.com/news/ireland/irish-news/not-so-sweet-news-for-the-world-s-most-iconic-brand-1.1767109">industries sell a product that is associated with a major public health risk</a>” and sometimes advertise to vulnerable populations. Ireland had previously established a tobacco tax to curb consumption, so the concept of a health tax was familiar, but also sympathetic as it could benefit children. </p>
<p>The design of the tax was also familiar because of Ireland’s existing value-added tax (VAT) system, which is a tiered system that taxes goods at different rates. Sugary drinks were already taxed at the highest rate at 23 per cent, alongside foods that are typically considered unhealthy such as alcohol or sweets. Although the tax <a href="https://www.revenue.ie/en/companies-and-charities/excise-and-licences/sugar-sweetened-drinks-tax/index.aspx">increased the price of sugar-sweetened beverages further</a>, the public was already familiar with paying more for sugary drinks as non-essential goods.</p>
<p><a href="https://assets.gov.ie/8374/69cc40ce0f764c25b9091e28d2350c94.pdf">Beverage companies reacted similarly to stakeholders in Denmark</a>. However, due to the negative perception of the beverage industry, and the sympathetic frame of the childhood obesity crisis, industry opposition was not portrayed sympathetically in the media. </p>
<p>The childhood obesity crisis was the priority in media coverage, and those critiquing the policy did not have a strong narrative to support their arguments. Overall, the beverage tax maintained longevity due to the familiar and positively framed narrative supporting the policy.</p>
<h2>Canada’s first sugar tax</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Soda bottles on retail shelves" src="https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/430042/original/file-20211103-23-u36732.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The scientific basis for health taxes on foods may have minimal impact on the success of these policies.</span>
<span class="attribution"><span class="source">(AP Photo/Matt Rourke)</span></span>
</figcaption>
</figure>
<p>In April 2021, British Columbia became the first Canadian province to <a href="https://www.cbc.ca/news/canada/british-columbia/b-c-tax-changes-affecting-sugary-drinks-netflix-vaping-products-come-into-effect-april-1-1.5939189">introduce a tax on sugar-sweetened beverages</a>, a move that the government described as a response to <a href="https://www.cbc.ca/news/canada/british-columbia/why-b-c-is-now-taxing-sugary-carbonated-drinks-1.5467775">advice from health professionals</a>. If B.C.’s sugary drinks tax is successful, it could inspire other provinces to follow suit. While the tax could have health benefits, the scientific basis for health taxes on foods appears to have minimal impact on whether these policies are implemented and stay in place. </p>
<p>In the media narratives surrounding the European cases, scientific evidence was unimportant. Instead, a successful narrative defending the tax rested on two factors. First was the familiarity of the tax due to existing policies. Second was the framing of the target population: the tax was seen to help children in Ireland, and hurt essential industries in Denmark. </p>
<p>Understanding the role of narratives can inform how these policy choices are designed and justified, and provide lessons for policy-makers in Canadian provinces.</p><img src="https://counter.theconversation.com/content/170340/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katherine Boothe receives funding from the Social Sciences and Humanities Research Council of Canada and the McMaster Future of Canada Project.</span></em></p><p class="fine-print"><em><span>Nicole Fiorillo does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>B.C. recently began taxing sugary drinks. Examples from Europe show the scientific basis for taxing unhealthy foods may have little impact on whether these taxes are adopted or remain in place.Nicole Fiorillo, Research Assistant, Political Science, McMaster UniversityKatherine Boothe, Associate Professor, Political Science, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1634622021-07-06T13:39:49Z2021-07-06T13:39:49ZFat: why are we so confused about whether or not we should include it in our diet?<figure><img src="https://images.theconversation.com/files/409899/original/file-20210706-17-1wdwmo3.jpg?ixlib=rb-1.1.0&rect=41%2C0%2C4608%2C3069&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fat gives us energy and helps us absorb certain vitamins.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/food-sources-omega-3-healthy-fats-417496159">colnihko/ Shutterstock</a></span></figcaption></figure><p>You’d be forgiven for being confused about whether or not you should eat fat. For a long time, people were told to stay well away from it entirely. But lately, fat seems to be back on the table – but only certain types of fat.</p>
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<p>With so many conflicting messages about which types of fat to eat, it’s no wonder many people are confused about whether or not they should it. Here are just a few reasons why the advice about fat is so confusing – and how much fat you should really eat.</p>
<p>Some fat is essential in our diet as it gives us energy and helps us absorbs certain vitamins, including vitamin A, D and E. But there are many different types of fats and eating too much of certain types can be harmful to us. Unsaturated fats (also called monounsaturated or polyunsaturated) are known as “good” fats and are important for helping us lower cholesterol and keep our heart healthy. Unsaturated fats can be found in foods such as avocados, olive or peanut oils, and fish.</p>
<p>But saturated fats can be bad for us when eaten in excess, and can raise cholesterol and increase risk of heart disease. Trans fats can also increase cholesterol levels. Foods that contain saturated and trans fats include butter, cheese, bacon, biscuits and fried foods.</p>
<h2>Fat is important</h2>
<p>Many health authorities worldwide agree fat is an important part of a healthy diet – but that we should only get so many calories daily from fats.</p>
<p>The <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet#:%7E:text=Energy%20intake%20(calories)%20should%20be,1%2C%202%2C%203">World Health Organization</a> (WHO) recommends people get no more than 30% of their daily calories from fat – of which only 10% of daily calories should be from saturated fats, and less than 1% from trans fats.</p>
<p>The UK’s recommendations are much <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814995/SACN_report_on_saturated_fat_and_health.pdf">the same</a>, limiting saturated fats to only 10% of our <a href="https://www.nhs.uk/live-well/eat-well/different-fats-nutrition/#:%7E:text=Most%20people%20in%20the%20UK,of%20saturated%20fat%20a%20day">daily calorie intake</a> – around 30g per day for men (around 270 calories) and 20g for women (around 180 calories).</p>
<p>But in Europe, health recommendations suggest fat should comprise <a href="https://www.efsa.europa.eu/en/press/news/nda100326#:%7E:text=Intakes%20of%20fats%20should%20range,account%20their%20specific%20developmental%20needs">between 20-35%</a> of our total daily calories. There’s also no recommendations for how many calories should be from saturated or trans fats – just that these should be <a href="https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2010.1461">limited</a>. In the US, people are only advised to limit saturated fat intake to <a href="https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf">less than 10% of daily calories</a>. </p>
<p>So while there seems to be agreement in how much fat people should eat, the slight variations in these recommendations – as well as variations in how much of certain types of fat we should eat – might explain the confusion over whether or not we should eat fat and how much of it we should eat.</p>
<h2>Misleading advice</h2>
<p>If all the different recommendations weren’t confusing enough, there’s also a lot of information out there that’s either too simplistic or incorrect. This makes the recommendations about eating fat all the more complicated.</p>
<p>For example, the Joint British Societies (which publishes recommendations to help people reduce their risk of cardiovascular disease) recommends that only around <a href="https://www.guidelines.co.uk/cardiovascular/jbs-cardiovascular-disease-prevention-guideline/251614.article">10% of a person’s total fat</a> intake should come from saturated fats. As typically we consume 30-40% of our calories from fat, and international and government bodies recommend that around 30% of daily calories should come from fat, limiting saturated fats to 10% of this would mean they’d make up only 3% of our day’s calories. This would amount to little more than about 7g of saturated fat -– around two teaspoons of butter.</p>
<p>This differs from many other recommendations – such as from WHO – which states 10% of all the calories people eat daily should come from saturated fats. It’s also unclear whether such a <a href="https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000510">strict restriction</a> of saturated fats would have any benefit and would be difficult for many people to achieve as a variety of healthy foods – such as olive oil – can also contain saturated fats.</p>
<figure class="align-center ">
<img alt="An overview of different biscuits and pastries, which are high in saturated fats." src="https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/409901/original/file-20210706-13-1amt28s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Oversimplified advice on saturated fats is also confusing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mix-sweet-cookies-close-136828667">Africa Studio/ Shutterstock</a></span>
</figcaption>
</figure>
<p>There’s also a lot of advice that’s too simplistic, which can be inadvertently misleading.</p>
<p>For example, one tip the <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating/fats-explained">British Heart Foundation recommends</a> for swapping saturated for unsaturated fats is to use a spray oil or measuring oils, instead of just pouring it straight from the bottle.</p>
<p>But this doesn’t account for the fact that different types of oil have different saturated fat levels. Sunflower oil, for example, is already low in <a href="https://core.ac.uk/download/pdf/35338265.pdf">saturated fat</a>, so using less would significantly reduce calories but only modestly reduce saturated fat levels.</p>
<p>Other advice from the British Heart Foundation includes avoiding frying foods and switching to semi-skimmed milk. But focusing on methods that have a minimal effect on saturated fat levels can make it more confusing to know which foods (and fats) to avoid. The easiest way to avoid saturated fats is avoiding foods like pies, cakes and biscuits. These foods are high in saturated fats and tend to be the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428836/#SD1">greatest sources</a> of them in most peoples’ diets.</p>
<h2>Getting the right amount</h2>
<p>Research suggests that we should get around a third of our <a href="https://pubmed.ncbi.nlm.nih.gov/25787998/">energy from fat</a> – two-thirds of which should be unsaturated fats. </p>
<p>Of course, certain food sources will contain different types of fats, and different levels of fats. For example, avocados and pies are both high in fat. But avocados are high in healthy monounsaturated fats, which are good for heart health and can lower cholesterol. Pies, on the other hand, are high in saturated fats, which can be bad for your heart and cholesterol levels.</p>
<p>The easiest way to make sure you’re eating enough of the right fats is to avoid foods that contain saturated and trans fats – such as butter, hard cheeses, pies, biscuits, pastries, cakes, processed meats and crisps. These foods are also high in salt, carbohydrates and sugar, so can also have other health harms such as increasing risk of <a href="https://www.nhs.uk/live-well/eat-well/salt-nutrition/#:%7E:text=A%20diet%20high%20in%20salt,for%20a%20lower%2Dsalt%20diet.">high blood pressure</a>. </p>
<p>Instead, try including sources of healthy fats – such as avocados, olive oil, nuts and fish. This will ensure that you’re not only getting enough fat in your diet, but that you’re getting the right kind of fats (around 75g a day for women and 90g for men).</p>
<hr>
<p><em>This article has been amended to give the correct amount of saturated fats represented by 3% of our daily calories.</em></p><img src="https://counter.theconversation.com/content/163462/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor is affiliated with British Dietetic Association</span></em></p>Even health authorities can’t seem to agree on dietary guidelines.Duane Mellor, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1160572019-05-07T23:22:03Z2019-05-07T23:22:03ZWhy cheese may help control your blood sugar<figure><img src="https://images.theconversation.com/files/272355/original/file-20190502-103049-1coe4vd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A study from the University of Alberta suggests that the beneficial effects of cheese might not be related to fat but to some other component, such as protein or calcium.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Mmmm, cheese – a food as nutritious as it is delicious. Or is it? </p>
<p>On the one hand, cheese is an excellent source of minerals like calcium and magnesium, vitamins A, B2 and B12, not to mention being a complete protein. </p>
<p>On the other hand, cheese is also a significant source of saturated fat and sodium in our diets. To lower saturated fat intake, consuming reduced-fat cheese is sometimes recommended to lower cardiovascular disease risk. </p>
<p>Paradoxically, however, there is now a growing body of evidence that <a href="https://doi.org/10.1017/S0007114515005000">people who eat lots of cheese do not have a higher risk of cardiovascular diseases</a>, including Type 2 diabetes. </p>
<p>Our research team at the University of Alberta examined the impact of <a href="https://doi.org/10.1016/j.jnutbio.2018.10.018">both reduced- and regular-fat cheese on insulin resistance</a> in the bodies of pre-diabetic rats. We found that both types of cheese reduced insulin resistance, which is important to maintain normal blood sugars.</p>
<h2>Why we used rats</h2>
<p>Many of the studies previously conducted into the impact of cheese on cardiovascular disease (CVD) have been observational. In other words, researchers have studied the usual eating behaviour of large numbers of people, usually for years, and then correlated the amount of cheese (and other dairy foods) eaten with the development of CVD risks, such as high cholesterol or coronary artery disease.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/272360/original/file-20190502-103053-109t14b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Observational studies of human eating patterns cannot be used to determine causation.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>A 2016 survey of published observational studies found that cheese had either a <a href="https://doi.org/10.3945/an.115.011403">neutral or beneficial effect on several CVD risk factors</a></p>
<p>These studies are very useful to establish trends associated with usual eating patterns but they can’t definitively say that a particular food causes or prevents a particular disease. </p>
<p>To understand causation better, studies that examine the effects of foods in a controlled setting are useful. These studies can be conducted in humans but there are limitations. Thus, studies in laboratory animals can also be useful, particularly in understanding biochemical mechanisms.</p>
<h2>Cheese and insulin resistance</h2>
<p>Insulin resistance is a condition that commonly develops with ageing and obesity, leading to high blood glucose, and risk factor of CVD and Type 2 diabetes. </p>
<p>Our objective was to <a href="https://doi.org/10.1016/j.jnutbio.2018.10.018">compare how consuming reduced- versus regular-fat cheese affected insulin resistance, and to explore biochemical mechanisms that might explain any observed effects</a>.</p>
<p>We used a rat model of insulin resistance that shares many characteristics with humans. We created the model by feeding the rats high amounts of lard. After four weeks, the rats were divided into three groups: 1) lard diet, 2) lard diet and reduced-fat cheddar cheese, 3) lard diet and regular fat cheddar cheese. </p>
<p>All the diets had the same total amount of fat, only the source of it varied (lard versus cheese). The rats ate these diets for eight more weeks.</p>
<p>The most interesting finding in our research was that both reduced- and regular-fat cheddar cheese reduced insulin resistance in the rats. This suggests that the beneficial effects of cheese might not be related to the amount of fat but to some other component, such as the protein or the calcium.</p>
<h2>Butter versus cheese</h2>
<p>A few new studies in humans have appeared in the literature since we began our study. A group from Laval University and the University of Manitoba <a href="https://doi.org/10.3945/ajcn.116.150300">compared the effects of eating fats from different sources in men and women with abdominal obesity</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=316&fit=crop&dpr=1 600w, https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=316&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=316&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=398&fit=crop&dpr=1 754w, https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=398&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/272361/original/file-20190502-103060-12xwz2h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=398&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Another study tested butter, cheese, olive oil and corn oil diets and found no impact on insulin levels.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The diet duration was four weeks and each diet was assessed in all the participants. Butter, cheese, olive oil and corn oil diets (32 per cent calories from fat) were compared with a higher carbohydrate diet (25 per cent calories from fat). </p>
<p>The researchers examined blood glucose and insulin levels (which are indirect indicators of insulin resistance) and found no effect from any of the fats. However, the blood samples were collected after fasting, so the information about blood sugar was incomplete.</p>
<p>Another <a href="https://doi.org/10.1186/s12986-018-0300-0">study that compared reduced- to regular-fat cheese</a> found no overall differences on LDL-cholesterol characteristics in people with cardiovascular disease risk factors, but did not examine blood sugar-related outcomes.</p>
<h2>Changing blood metabolites</h2>
<p>In our study, we also examined how metabolites in the blood changed after cheese feeding and found similar effects in reduced- and regular-fat cheese. </p>
<p>The changes are related to a specific type of molecule called phospholipids, which have many functions in the body. Interestingly, low-circulating phospholipids are linked with diabetes and insulin resistance in humans. </p>
<p>The rats fed on a lard diet had lower phospholipid levels. These were normalized in the rats that ate cheese. </p>
<p>We are pursuing this line of research now — to understand how cheese regulates phospholipid metabolism and how this relates to insulin resistance.</p><img src="https://counter.theconversation.com/content/116057/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This study was funded by the Dairy Farmers of Canada and the Natural Sciences and Engineering Research Council. A representative of Dairy Farmers of Canada reviewed the manuscript prior to submission but had no role with respect to study design, data collection, analysis or interpretation, writing of the manuscript and its final content, or the decision to submit the manuscript for publication.
Catherine Chan receives funding from Dairy Farmers of Canada, Alberta Agriculture Funding Consortium, Danone Institute, Canadian Institutes for Health Research, Lawson Foundation, Natural Sciences and Engineering Research Council, Canadian Foundation for Dietetics Research, Egg Farmers of Canada, Alberta Health Services </span></em></p>A recent research study found that cheese reduced insulin resistance in prediabetic rat models.Catherine Chan, Professor, Agricultural Life and Environmental Sciences, University of AlbertaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1150952019-04-17T10:56:12Z2019-04-17T10:56:12ZNew cholesterol study may lead you to ask: Pass the eggs, or pass on the eggs?<figure><img src="https://images.theconversation.com/files/269655/original/file-20190416-147480-1q9s78f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">What is brunch with eggs of some sort? </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/carzy-moment-funny-group-middle-age-1054135829?src=vRiBY-WHdCjws9C8nzOVIA-2-5">simona pilolla 2/Shutterstock.com</a></span></figcaption></figure><p>The <a href="https://www.nytimes.com/2019/03/15/well/eat/eggs-cholesterol-heart-health.html">recent news</a> that eating three to four eggs a week is linked to a slight increase in risk for developing heart disease was a bummer for egg lovers. Should you stop eating eggs because of this new finding?</p>
<p>The study, published in March in the <a href="https://jamanetwork.com/journals/jama/fullarticle/2728487">Journal of the American Medical Association</a>, examined the association between dietary cholesterol or egg consumption with cardiovascular disease and all causes of mortality. </p>
<p>The analysis pooled the data of over 29,000 participants from six major U.S. studies conducted between 1985 and 2016. The authors reported that when 300 mg of dietary cholesterol were consumed per day (<a href="https://ndb.nal.usda.gov/ndb/foods/show/01132?fgcd=&manu=&format=&count=&max=25&offset=25&sort=default&order=asc&qlookup=egg&ds=&qt=&qp=&qa=&qn=&q=&ing=">one large egg</a> contains about 180 mg of dietary cholesterol), there was a 17% higher risk of a cardiovascular disease incident, including stroke, heart attack, coronary heart disease or heart failure. There was also an 18% higher risk of mortality from all causes when compared to not consuming dietary cholesterol. </p>
<p>When the most recent version of the <a href="https://health.gov/dietaryguidelines/2015/guidelines/">Dietary Guidelines for Americans</a> did not include a recommendation to limit consumption of dietary cholesterol, it left many consumers confused. Since the initial release of the Dietary Guidelines in 1980 and in the six following editions, there has always been a recommendation to limit total fat, saturated fat and dietary cholesterol. </p>
<p>The 2015-2020 Dietary Guidelines’ <a href="https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/key-recommendations/">key recommendation</a> instead focused on consuming less than 10% of daily calories from saturated fats with no mention of dietary cholesterol. Many consumers concluded that dietary cholesterol must no longer matter. </p>
<p>I am a registered dietitian nutritionist and will try to explain the study and previous findings.</p>
<h2>What is cholesterol anyway?</h2>
<p>Cholesterol is a waxy, yellowish fat that is produced in our liver and intestines. It is found in every cell of the body. It is a necessary component for many of our bodies’ physiological and structural functions, including cell membrane construction, hormone production and other vital functions. All the cholesterol we need can be produced by our bodies, so it is not essential that we consume dietary sources of cholesterol for our well-being. </p>
<p>While our bodies make cholesterol, we can also consume cholesterol from the foods we eat. These “dietary” sources of cholesterol are found in animal sources that produce cholesterol. So foods, such as beef, pork, lamb, chicken, eggs, fish and shellfish all contain cholesterol in various amounts. Small amounts of dietary cholesterol can also be found in items produced from animals, such as milk.</p>
<p>One reason the 2015-2020 Dietary Guidelines Advisory Committee gave for not focusing on dietary cholesterol is because dietary cholesterol and saturated fats are found in similar foods. So, when one consumes foods with low amounts of saturated fats, they are generally consuming low amounts of dietary cholesterol. </p>
<p>Of course individual animal foods will differ, with some containing high amounts of cholesterol and low amounts of saturated fat, low amounts of cholesterol and high amounts of saturated fat, or anywhere in between. <a href="https://ndb.nal.usda.gov/ndb/search/list?home=true">For example</a>, a 2-ounce large egg contains 180 mg of dietary cholesterol and 1.5 g of saturated fat, while a 2-ounce top sirloin contains 60 mg of cholesterol and 3.5 g of saturated fat. </p>
<p><a href="https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/">Plant sources, including vegetables, fruits, grains, nuts and seeds</a> do not contain cholesterol. However, some plant sources naturally contain saturated fats, and through processing and preparation can have saturated fats or trans fats added to the final product. The 2015-2020 Dietary Guidelines recommended limiting saturated fats from all sources to less than 10% of total calories (that would equal about 22 g of saturated fat in a 2,000 kcal/day eating pattern). </p>
<h2>In the end, the guidelines faced fat, not cholesterol</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/269640/original/file-20190416-147518-u76qy9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A meal of high-cholesterol and high fat such as this is not healthy for most people if eaten on a regular basis.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/baked-eggs-sausage-vegetables-pan-close-472671814?src=vRiBY-WHdCjws9C8nzOVIA-2-14">Sloniki/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>The 2015-2020 committee decided not to provide a daily limit of dietary cholesterol intake, which had been included in previous versions of the Dietary Guidelines. This was due in part to a lack of evidence regarding just how much of an effect dietary cholesterol had on an individual’s blood cholesterol level. </p>
<p>The advisory committee also noted that the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024549/">average daily intake</a> of dietary cholesterol in the United States was already below the 300 mg recommended threshold.</p>
<p>The omission of any definitive recommendation combined with the increasing popularity of low carbohydrate-high fat diets almost seemed an endorsement of dietary cholesterol . However, this was not the <a href="https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/">2015-2020 DGA committee’s intent.</a></p>
<h2>What about those with high blood cholesterol?</h2>
<p>Less than optimal levels of blood cholesterol continues to be a critical risk factor for cardiovascular disease. </p>
<p>The body produces several types of <a href="https://health.gov/dietaryguidelines/2015/guidelines/appendix-6/">cholesterol</a>, but two are of primary concern, HDL, “good cholesterol” which removes cholesterol from the body, and LDL, “bad cholesterol,” which carries cholesterol to arteries and tissues. Over time high LDL levels of cholesterol can lead to a buildup of cholesterol in the arteries.</p>
<p>According to the <a href="https://www.cdc.gov/cholesterol/facts.htm">Centers for Disease Control and Prevention,</a> more than 125 million adults have a total cholesterol above the recommended 200 mg/dL.</p>
<p>High blood cholesterol has no symptoms but raises a person’s risk for heart disease, the leading cause of death, and for stroke, the fifth leading cause of death in the U.S.</p>
<p>For those where high cholesterol is not a current concern, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18195171">consuming eggs</a> three to four times per week appears to pose little risk to their overall health, especially if they are following other aspects of a heart-healthy diet. </p>
<p>However, people who have high cholesterol should continue to pay close attention to sources of saturated fat and dietary cholesterol.</p>
<h2>What can we learn from this egg study?</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/269642/original/file-20190416-147514-6p1oiv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Eggs are a versatile and popular dish.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/various-ways-cooking-chicken-eggs-omelette-714691903?src=g4n0IzmpPLw-DmTghV_WxA-1-68">Lenasirena/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>It is always difficult to draw a definitive conclusion based on the result of a single study. In fact, most scientists discourage doing so. It is also very important to consider the study’s design.</p>
<p>Regarding the JAMA article, this was not a single study with over 29,000 participants. Instead, it was a collection of six large studies conducted over a long period of time and then combined into one study. </p>
<p>Considering methods differed between the studies, it can be difficult to align the studies and participants exactly. While the authors worked hard to correct for this, it will still remain a limitation. </p>
<p>Second, the initial studies used <a href="https://jamanetwork.com/journals/jama/fullarticle/2728487">self-reported dietary data</a> which can result in inaccurate data and relied on a single measurement of both egg and dietary cholesterol intake, which may not reflect habitual intake. </p>
<p>Finally, while many additional heart disease risk factors were considered in this study, there is still a risk of <a href="https://jamanetwork.com/journals/jama/fullarticle/2728487">“residual confounding,”</a> which results when some other variable may actually be responsible for an outcome instead of the main variable investigated. </p>
<p>So, where does such a study combined with our current knowledge of the subject leave the public? </p>
<p>People who have normal blood cholesterol levels can continue to eat foods such as eggs and shellfish, which contain high levels of dietary cholesterol but low levels of saturated fat. These individuals should also consider following the Dietary Guidelines key recommendations. Currently, there isn’t sufficient evidence to conclude how much is too much for this segment of the population. And as previously noted, <a href="https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/">ongoing concern</a> continues to be placed on the effect of saturated fat from all sources.</p>
<p>However, for those with high cholesterol, there remains strong <a href="https://www.ncbi.nlm.nih.gov/pubmed/12975030">evidence</a> that a heart-healthy eating pattern that focuses on limiting daily intake of saturated fat, trans fatty acids and dietary cholesterol while consuming a variety of fiber-rich vegetables, fruits, whole grains, low-fat and fat-free dairy, nuts, seeds and legumes is still very important. </p>
<p>Since determining to what degree each factor plays in every individual’s blood cholesterol is impractical, the prevailing logic for those who have high blood cholesterol is to continue care with their primary health care provider and adopt an eating pattern that supports their cardiovascular health.</p><img src="https://counter.theconversation.com/content/115095/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brent Fountain is affiliated with The Dairy Alliance</span></em></p>A recent study revisited the issue about eating foods high in cholesterol, such as eggs. The findings are nuanced but suggest that those with high cholesterol may want to limit food with cholesterol.Brent Fountain, Associate Extension Professor of Human Nutrition, Mississippi State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1064092019-01-08T11:40:10Z2019-01-08T11:40:10ZLet them eat more fat? Researcher argues that a balance of types of fat is the key<figure><img src="https://images.theconversation.com/files/252690/original/file-20190107-32124-vlzf8b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"> A mix of fats, such as those found in nuts, avocados, salmon and olives, could be healthy and more satisfying.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/selection-healthy-fat-sources-on-wooden-396446890?src=ekSdGUl72cn3WGKgPd-dZQ-1-2">Craevschii Family/Shutterstock.com</a></span></figcaption></figure><p>Public health guidelines, such as the <a href="https://health.gov/dietaryguidelines/2010/">Dietary Guidelines for Americans</a>, have long emphasized reducing dietary fat intake, but nutritionists and other health scientists now have more recent evidence that not all fats have adverse effects. Dietary fats differ with regard to their effects on health and risk for chronic diseases, particularly in regard to effects on risk for heart disease. </p>
<p>Indeed, <a href="https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/dietary-fat-and-disease/">some nutrition experts</a> now believe that certain types of dietary fat may even reduce cardiovascular risk. Some dietary fats may lower fats in the blood called <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186">triglycerides</a>. They may also increase levels of HDL, or what is known as the “good” cholesterol, and <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/the-facts-on-fats">reduce LDL-cholesterol</a>, or the less healthy type of cholesterol, thus improving the HDL to <a href="https://www.sciencedirect.com/science/article/pii/S0735109707032597?via%3Dihub">total cholesterol ratio</a>. </p>
<p>Also, many diet plans that do not strictly limit the total amount of dietary fat a person consumes have been associated with <a href="https://onlinelibrary.wiley.com/doi/full/10.1177/0884533611405791">better diet satisfaction</a>, weight loss, and preservation of muscle mass. </p>
<p>As a research professor in the field of nutrition and dietetics, I am convinced that findings <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306330/">from our work</a>, along with other published current evidence, show that the concept that dietary fat is “toxic” is very much outdated and misguided. </p>
<p>Although there is conclusive evidence that one type of fat, trans fat, has no place in a healthy diet, it’s important to learn how to balance the other types of fats in the diet.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/ro4UObvPpdo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Prof. Heidi Silver discusses the role of dietary fat.</span></figcaption>
</figure>
<h2>A balancing act</h2>
<p>While not all fats are alike, they do share some things in common. They provide energy with approximately <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/monounsaturated-fats">nine calories per each gram of fat</a>, they are all broken down during digestion by enzymes in the gastrointestinal tract, and they are well absorbed as fatty acids, or <a href="https://www.britannica.com/science/hydrocarbon">chains of hydrogen and carbon</a>. </p>
<p>But these carbon chains vary in length and their degree of saturation. As a result, dietary fats vary in their effects on the body.</p>
<p>In some instances, the carbon molecules bind to other carbon molecules. In others, they bind to hydrogen molecules. You likely have heard names for these two types of fats – unsaturated and saturated. Unsaturated fats are those in which carbon molecules bind to other carbon molecules. <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats">Saturated fats</a> are those in which carbon molecules bind to hydrogen molecules. Within the two broad types of fat, there are differences still.</p>
<p>Among the unsaturated fats, there are those that are <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/monounsaturated-fats">mono-unsaturated</a>, or those that have one unsaturated carbon bond, which are found in olive oil and certain kinds of nuts, and there are those that are <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/polyunsaturated-fats">poly-unsaturated</a> and are found in such foods as walnuts, plant oils, salmon and sardines. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=260&fit=crop&dpr=1 600w, https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=260&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=260&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=327&fit=crop&dpr=1 754w, https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=327&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/252693/original/file-20190107-32127-7th6aw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=327&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This illustration of stearic acid shows the 18 carbon molecules binding to 36 hydrogen molecules and to two oxygen molecules.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/stearic-acid-molecular-formula-c18h36o2-saturated-1085497997?src=14tXPwxJ0chL73lBWd85aw-1-15">Orange Deer Studios/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>We also have learned that different kinds of saturated fats affect the body in different ways. For example, the 12-carbon lauric acid, 14-carbon myristic acid, 16-carbon palmitic acid and 18-carbon stearic acid are all saturated fats. But, <a href="https://www.nejm.org/doi/full/10.1056/NEJM198805123181905?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed">stearic acid</a> does not increase LDL-cholesterol levels like the other saturated fats. </p>
<p>While these differences are not new, the understanding of their effects is new, mostly due to findings from more recent studies like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306330/">my own</a>. </p>
<p>Thus, the amount of total fat in the diet no longer is the sole measure of the health effects of dietary fat. It’s also about the type of fatty acid, how long the carbon chain is, and whether the fat is saturated, mono-unsaturated or poly-unsaturated. </p>
<h2>The link to heart health</h2>
<p>The scientific discourse about the potentially toxic role of dietary fat and cholesterol on human health started in the late 1950s and early 1960s, when scientists discovered how to analyze fats in the lab. They also discovered the link between <a href="https://www.ncbi.nlm.nih.gov/pubmed/13376806">dietary fat intake</a>, serum levels of total and LDL-cholesterol, and risk for cardiovascular diseases in animals. </p>
<p>Because heart disease has been the leading cause of death in the U.S. since the 1930s, the Nutrition Committee of the American Heart Association in 1968 recommended <a href="https://www.heart.org/-/media/files/healthy-living/company-collaboration/inap/dietary-fat-recommendations-timeline-pdf-ucm_474998.pdf">reducing total and saturated fat intake</a>. The emphasis on <a href="https://health.gov/dietaryguidelines/dga95/12DIETAP.HTM">lowering dietary fat</a> intake was advanced further in 1977 with the publication of the first Dietary Guidelines for Americans by the Senate Select Committee on Nutrition and Human Needs. </p>
<p>Health care professionals in turn shifted their nutrition counseling efforts toward encouraging a low-fat diet. And, the food industry began to develop and produce of a wide-ranging assortment of “low-fat,” “reduced-fat,” “light” and “fat-free” items. </p>
<p>In the mid-1980s, advice to consume a low-fat diet also became a strategy for weight control. Evidence from the landmark <a href="https://www.framinghamheartstudy.org">Framingham Heart Study</a> uncovered that obesity increased risk for heart disease, and national data showed that the entire population was getting heavier. </p>
<p>Americans responded with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598942/">substantial reduction</a> in the percentage of calories consumed as fat. But humans have a <a href="https://www.ncbi.nlm.nih.gov/books/NBK53528/">biological preference</a> for the taste of fat. And with fat off the table, millions increased their consumption of dietary carbohydrates to compensate for the loss in flavor and appeal of foods. As a result, there has been a substantial increase in the waistlines of Americans. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/252709/original/file-20190107-32145-gp9s07.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Studies have shown that humans have a preference for foods that contain fat, such as this slab of steak.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/against-sliced-raw-steak-344404673?src=ph6BufMyu5FU49Nb8xZ90A-1-20">Paolo Santos/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>An alternative approach</h2>
<p>Given the mixed scientific evidence on fat, and the diverse roles of dietary fatty acids in health and disease, about four years ago I designed a diet that is moderately high in fat but the types of fat are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306330/">proportionally balanced</a>, that is, one-third of total fat comes from saturated fats; one-third comes from monounsaturated fats; and one-third comes from polyunsaturated fats. </p>
<p>Based on this balanced moderately-high fat diet approach, my research team developed a 14-day cycle of menus comprised of three meals and two snacks per day that increases intake of foods high in the 18-carbon monounsaturated fat, oleic acid, and the 18-carbon and longer chain polyunsaturated fats (more commonly known as omega-3 and omega-6 fatty acids). To do this, we replaced high simple carbohydrate snacks with nuts, we replaced croutons in salads with avocado slices, and we used salad dressings high in safflower oil, canola oil and olive oil. </p>
<p>We have been studying the effects of this balanced moderately high fat diet in adults who are overweight or obese. In a study with 144 women over a period lasting 16 weeks, we found that study participants had <a href="https://www.ncbi.nlm.nih.gov/pubmed/24559846">significant reductions</a> in abdominal fat and waist circumference; a 6 percent improvement in blood pressure; reduced blood levels of markers of inflammation; and overall a 6 percent reduction in their five- and 10-year cardiovascular risk. </p>
<p>Study participants reported that they found our diet to be highly palatable, satisfying and economically feasible to adhere to. The firm adherence to our balanced moderately high fat diet in the four-month study was reflected by significant changes in participants’ plasma fatty acid profiles (the array of saturated and unsaturated fats in the blood) that reflected the fatty acid composition of the diet menus.</p>
<p>In a follow-up study using more in-depth analysis of the lipid response to the balanced moderately high fat diet, we found a difference in response between Caucasian females and African-American females. While the Caucasian females had improvements in serum triglyceride and LDL-cholesterol levels, African-American females had the <a href="https://www.ncbi.nlm.nih.gov/pubmed/29382504">most significant improvement</a> in HDL-cholesterol levels. These data support the concept that not all people respond to a dietary approach in the same way and there is no one optimal diet for all people. </p>
<p>In another follow-up study of the response to a higher fat diet, we also found that people with a specific genotype had a stronger response, and that response differed by sex, particularly with regard to improvements in HDL-cholesterol being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306330/">stronger in females versus males</a>. </p>
<p>Thus, I believe the choice of an effective dietary approach must be determined based on an individual’s goals and an individual’s clinical and metabolic response to the interaction between genes and environment. </p>
<p>There are limited studies on the strategy of balancing the type of dietary fat. While current scientific consensus is that extremes of dietary fat intake, too high or too low, are unhealthy, I believe that a paradigm shift focusing on the types of dietary fats consumed may offer the opportunity to modify our cardiometabolic risk factors without requiring major changes in the amount of fat or calories we consume.</p><img src="https://counter.theconversation.com/content/106409/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heidi J. Silver received funding to study dietary fat from the Atkins Foundation. </span></em></p>When did eating become so confusing? In the 1960s, studies began to show a link between heart disease and dietary fat, and fat was demonized. As it turns out, fat is nuanced and may not be so bad.Heidi Silver, Associate Professor of Medicine, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1047332018-10-12T12:23:51Z2018-10-12T12:23:51ZCould cheese help prevent type 2 diabetes?<figure><img src="https://images.theconversation.com/files/240303/original/file-20181011-154577-19jnawm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">No need to feel guilty.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/679621210?src=nZVQUm1jqC85ra13g-gqog-1-27&size=medium_jpg">hlphoto/Shutterstock.com</a></span></figcaption></figure><p>Many people believe that low-fat dairy products are healthier than high-fat dairy products. Indeed, many public health guidelines recommend low-fat dairy over high-fat dairy. However, our <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002670">latest research</a>, published in PLOS Medicine, found that people who had higher levels of biomarkers of dairy fat had a lower risk of developing type 2 diabetes. </p>
<p>Dairy products contain calcium and other nutrients that are important for our health, but they are often high in saturated fat – which is considered to be bad for cardiovascular health. Although food manufacturers have created many low-fat dairy products, such as yogurts and flavoured-milk drinks, they often have lots of added sugar. Sugar, of course, is also bad for our health. So which dairy products should we choose: high-fat or low-fat?</p>
<p>Studies on dairy consumption have reported mixed results. The recent evidence shows no clear differences between high-fat and low-fat dairy in terms of the risk of developing <a href="https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.123216">type 2 diabetes</a> or <a href="https://academic.oup.com/advances/article/7/6/1041/4568638">cardiovascular diseases</a>. </p>
<p>However, most studies have relied on self-reports of dietary consumption by study participants. And self-reports are notoriously unreliable as people often misjudge how much they have eaten. With dairy consumption, for example, participants may fail to report baked goods, such as cakes and savoury pies, that contain dairy.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/240403/original/file-20181012-119114-1xmh5yt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many low-fat dairy products are high in added sugar.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1074814925?src=8dfReOdZDslSCooi8TWDtA-1-24&size=medium_jpg">Madele/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>An objective measure</h2>
<p>Some <a href="https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/68.2.291">scientists</a> have shown that certain types of fat in our body tissue reflect dairy fat consumption. These biomarkers are more reliable than self-reports of dairy consumption.</p>
<p>Using this method, a <a href="https://www.ahajournals.org/doi/10.1161/JAHA.113.000092">couple</a> of <a href="https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqy117">studies</a> and one <a href="http://annals.org/aim/article-abstract/1846638/association-dietary-circulating-supplement-fatty-acids-coronary-risk-systematic-review">systematic review</a> have found no link between dairy fat consumption and a higher risk of heart disease. </p>
<p>And <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(14)70146-9/fulltext">summary evidence</a> from our group, published in 2014, found an inverse association between dairy fat biomarkers and type 2 diabetes risk. In other words, the more dairy fat biomarkers found in a person’s blood, the lower their risk of getting type 2 diabetes.</p>
<p>To produce more definitive evidence, we conducted a global study which included data on nearly 64,000 adults from 16 countries. We evaluated the biomarkers we previously examined, but we also included <a href="https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehv595">additional dairy-fat biomarkers</a>.</p>
<p>The results of our study further support the evidence that higher concentrations of the dairy-fat biomarkers are associated with a lower risk of developing type 2 diabetes. </p>
<h2>Limitations</h2>
<p>As with all studies, there are limitations. Biomarkers do not distinguish different types of dairy products, such as milk, cheese and yogurt. Also, our findings were mostly from white populations in the US and Europe – evidence for other populations remains limited.</p>
<p>Dairy products are one of the main sources of saturated fat, but we can’t draw conclusions about other sources of saturated fat, such as meat and oil, and the risk of type 2 diabetes and cardiovascular disease. This complexity should also be discussed in different contexts such as how dairy products are consumed with different foods in different cultures and populations, and how dairy fat consumption is linked to other health outcomes, such as cancer and bone health. </p>
<p>Despite the limitations, our new research highlights how objective assessment using biomarkers can help to increase understanding between dairy consumption and health risks. This research indicates that dairy fat may not be harmful, indeed, it may be beneficial. But more work needs to be done to understand the overall effects of dairy, over and above its fat content. </p>
<p>There isn’t enough evidence, yet, to change dietary guidelines, which in the UK recommend that saturated fats should make up less than 11% of all calories consumed from food. We hope that our research will further stimulate clinical and public health research and a dialogue to promote an optimal diet, focusing more on foods than nutrients, including dairy.</p><img src="https://counter.theconversation.com/content/104733/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Fumiaki Imamura and Nita G Forouhi receive funding from Medical Research Council Epidemiology Unit Core Grant (MC_UU_12015/5). Nita G Forouhi is an invited member (unpaid) of ILSI-Europe Qualitative Fat Intake Task Force Expert Group on update on health effects of different saturated fats. </span></em></p>Recent research suggests that biomarkers for dairy fat are inversely associated with the risk of developing type 2 diabetes.Fumiaki Imamura, Senior Investigator Scientist, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1021302018-08-31T14:00:24Z2018-08-31T14:00:24ZCoconut oil: not quite poisonous, but best treated with caution<figure><img src="https://images.theconversation.com/files/234232/original/file-20180830-195298-kb0wja.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/coconut-oil-fresh-coconuts-on-old-257285275?src=aW4T-jCpdoIsbKg_-tqM_A-1-4">Shutterstock</a></span></figcaption></figure><p>Coconut oil is under attack. Once hailed as a miraculous superfood, its reputation has been more than a little bruised after a Harvard professor <a href="https://news.sky.com/story/coconut-oil-pure-poison-says-harvard-professor-11478886">described the substance</a> as “pure poison”. To remove any doubt about her feelings, Karin Michels, an epidemiologist, added that coconut oil is “one of the worst things you can eat”.</p>
<p>Pure poison? Well it won’t kill you instantly, eyes popping, foaming at the mouth, gasping for breath – nothing quite as dramatic as that. But it’s true that coconut oil could, for avid and devoted fans, contribute to potentially fatal heart disease. </p>
<p>So how can such a natural plant product be regarded as being so dangerous? After all, it looks so innocent, with its white flesh and refreshing liquid centre providing an exotic taste of tropical beaches, as well as minor amounts of minerals (potassium and iron), some fibre and fat. </p>
<p>It has also been a long standing and popular ingredient in sun cream and shampoo and skin products. But it is edible coconut oil that has grabbed centre stage recently for its supposed health benefits. Products containing coconut oil and recipes using it are becoming ever more popular. A quick web search will provide numerous suggestions for including more coconut oil in your diet by using it in cooking and baking and even mixing it into tea, coffee and smoothies. </p>
<p>With claims of health benefits including weight loss, increased “good” cholesterol, improved immune function and even prevention of Alzheimers disease, it is easy to see why the public would be swayed to swap their usual household oils and fats for this incredible sounding product. </p>
<p>Not even the high price tag seems to deter buyers (one British supermarket is currently selling it at £1.36 per 100ml compared to vegetable (rapeseed) oil at 11p per 100ml and olive oil at 30p per 100ml). </p>
<h2>The fats of the matter</h2>
<p>But <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/nbu.12188">looking more closely</a> at these apparent health benefits, we can see that most claims derive from studies, which to date, are based on animal or in-vitro (laboratory) studies. </p>
<p>By far the biggest negative for coconut oil is the fact that it is so very high in saturated fat. As much as 86% of it is made up of the type of fat that we have been urging people to cut down on in their diets due to its proven association with raised “bad” cholesterol and heart disease. </p>
<p>Even butter, that long standing enemy of heart health fanatics, looks healthy compared to the fatty acid profile of coconut oil, at 52% saturated fat. Olive oil comes in at 14% and rapeseed is 7%.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/234243/original/file-20180830-195331-11q7s7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A taste of the exotic?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/coconut-palm-tree-on-sandy-beach-144219664?src=Fu3VC3SqHPnMxBrrv1Zpaw-2-0">Shutterstock</a></span>
</figcaption>
</figure>
<p>So why, after decades of promoting the evidence-based health benefits of replacing saturated fats with unsaturated fats, such as olive, rapeseed and sunflower oils, has this product soared in popularity? Perhaps it is the taste that people like (though I’m not convinced it’s that good). Or the fact that it seems like an exotic and trendy ingredient, and people are still unconvinced about the risks of saturated fat (despite professional advice not changing for years).</p>
<h2>Coconut fall</h2>
<p>Whatever the reason, timely <a href="https://onlinelibrary.wiley.com/doi/10.1111/nbu.12333">draft reports</a> currently being finalised from the UK’s Scientific Advisory Committee on Nutrition and the World Health Organisation continue to endorse the dietary guidelines of restricting intake of saturated fat to less than 10% of total energy intake (around 20g for women and 30g for men per day).</p>
<p>Using as little as two tablespoons of coconut oil in the daily diet will smash this target to pieces, providing 26g of saturated fat as well as around 200 calories. </p>
<p>Do I use coconut oil in my kitchen? Definitely not. But the odd can of (reduced fat) coconut milk for a Thai curry or bag of desiccated coconut for home baking can be found lurking in my larder.</p>
<p>No single food is a “superfood”. It is the overall balance of our intake that matters. As with any high fat product, coconut oil should be used sparingly, only occasionally and as a minor ingredient, rather than as a replacement for staple oils such as rapeseed, olive and sunflower oils. Coconut oil is not strictly speaking a poison – but nor is it something which should pass our lips without caution.</p><img src="https://counter.theconversation.com/content/102130/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma Kinrade does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It’s been trendy for some time – but these nuts are filled with saturated fat.Emma Kinrade, Lecturer in Nutrition and Dietetics, Glasgow Caledonian UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/847642017-11-05T23:37:07Z2017-11-05T23:37:07ZThese foods will lower your risk of heart disease<figure><img src="https://images.theconversation.com/files/192856/original/file-20171101-19867-1unjwzx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The evidence shows that both low and high fat diets can reduce your risks of cardiovascular disease -- if they are plant-based. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Low-fat or low-carb? Butter or margarine? Avocado oil or coconut oil? Bombarded with contradictory media reports on the ever-changing landscape of nutrition research, it’s difficult for anyone to know which fats and other foods they should eat, and in what quantities. </p>
<p>We know that cardiovascular diseases (CVD) are the <a href="http://www.who.int/mediacentre/factsheets/fs317/en/">No. 1 cause of death globally</a> and a <a href="http://www5.statcan.gc.ca/cansim/a26?lang=eng&id=1020529">leading cause of death in Canada</a>. We also know that <a href="https://www.ncbi.nlm.nih.gov/pubmed/19667296">80 per cent of chronic disease could be alleviated</a> by following a healthy diet, avoiding tobacco, maintaining a healthy weight and getting regular exercise. </p>
<p>In an effort to follow a healthy diet, it’s easy to focus on individual nutrients. This serves us well for preventing nutrient deficiencies (<a href="https://www.medicalnewstoday.com/articles/155758.php">think Vitamin C and scurvy</a>). It doesn’t work so well as a strategy for avoiding chronic disease. </p>
<p>We eat food — ideally three to six times per day — not individual nutrients. So, when it comes to fats, we really need to <a href="https://jamanetwork.com/journals/jama/article-abstract/186365">focus on dietary patterns</a>.</p>
<h2>Fats and cardiovascular disease</h2>
<p>There have been many studies looking at diet and its impact on the heart. When the scientific community has examined the link between saturated fat (in butter, meat fat, chicken skin and high-fat dairy products) and risk for cardiovascular disease, conflicting findings have emerged. </p>
<p>One review of the evidence showed that saturated fat has <a href="http://dx.doi.org/10.3945/ajcn.2009.27725">no relationship with CVD</a>. However, this research didn’t consider what nutrient replaced saturated fat. Another review of the evidence demonstrated that the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593072/">risk for CVD varies depending on what nutrient replaces the saturated fat.</a></p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/192854/original/file-20171101-19853-1rs0t1i.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The best fats for our body come from fish, nuts, healthy oils and seeds.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>When you eat trans fat — found in donuts and other store-bought baked goods, deep-fried foods, partially hydrogenated oils and vegetable oil shortening — instead of saturated fat, your risks of CVD increase. However, if you eat unsaturated fats — oils that are liquid at room temperature, especially polyunsaturated fats such as vegetable oils, nuts, seeds and fish, and carbohydrates from whole grains —instead of saturated fats, your risk of CVD decreases. </p>
<p>Whether you eat mostly saturated fats or sugar and refined starches (such as white rice, white bread and processed cereal) doesn’t appear to matter when it comes to heart disease. According to this research, the risks are about equal. </p>
<h2>Coconut oil or olive oil?</h2>
<p>The effects of coconut oil as a replacement for other dietary fats, such as butter, olive oil and canola oil, <a href="https://www.nutritionaction.com/daily/fat-in-food/fat-in-food-the-truth-about-coconut-oil/">have not been studied for the effects on CVD</a>. The impact of coconut oil on heart disease risk remains unknown. </p>
<p>We do know, however, that <a href="https://academic.oup.com/nutritionreviews/article-lookup/doi/10.1093/nutrit/nuw002">coconut oil raises some risk <em>factors</em> for CVD</a> — it increases cholesterol compared to polyunsaturated fats (in vegetable oils, nuts, seeds and fish) that lower cholesterol.</p>
<p>Olive oil, on the other hand, when consumed as part of the high-fat “predimed diet pattern” (PDP) referenced below, has been shown to reduce cardiovascular disease. It’s important, then, to look at dietary patterns rather than individual fats.</p>
<h2>Plant-based diets are best</h2>
<p>Our <a href="http://www.cnn.com/2015/07/07/health/western-diet-health/index.html">western diet pattern</a> includes sugar-sweetened beverages (pop, flavoured juice and coffee drinks), refined carbohydrates (commercially baked goods like muffins and doughnuts which are sources of trans fat), processed meats (salami, pepperoni and bacon) and combination foods (for instance pepperoni pizza and bacon cheese burgers). </p>
<p>Unfortunately, Canadians are consuming <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042566/">sugar</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/19916364">trans fat</a> and <a href="https://globalnews.ca/news/2238025/cut-the-crap-heart-and-stroke-foundations-advice-to-canadians/">processed foods</a> in quantities that have been shown <a href="https://jamanetwork.com/journals/jama/fullarticle/2608221?utm_campaign=articlePDFlink&utm_source=articlePDF&utm_content=jama.2017.0947">to increase CVD risk</a>.</p>
<p>There is substantial evidence that a <a href="https://oldwayspt.org/traditional-diets/mediterranean-diet">Mediterranean diet</a> pattern (MDP) reduces cardiovascular disease. This involves eating plant foods — vegetables, fruit, whole grains, legumes and olive oil — plus fish and a moderate amount of wine. Meat, butter, cream, sugar-sweetened beverages and commercial baked goods are eaten in limited quantities. </p>
<p>Men with heart disease in the <a href="http://circ.ahajournals.org/content/circulationaha/99/6/779.full.pdf">Lyon Diet Heart Study</a> following the Mediterranean diet had a 30 per cent reduction in secondary heart events. Participants following the pridimed diet had a <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1200303#t=article">30 per cent reduction</a> in the primary prevention of CVD. The diet plans are similar and are high in fat from additional nuts or olive oil. </p>
<p>Vegetarian diet patterns are mostly plant-based, but can include small amounts of animal foods, such as dairy products, eggs and fish. Communities known for their longevity and low incidence of heart disease include Sardinia in Italy, Icaria in Greece, Okinawa in Japan and Loma Linda in California. These so-called “<a href="https://en.wikipedia.org/wiki/Blue_Zone">blue zones</a>” all follow healthy lifestyles including vegetarian diets. Their staples are vegetables and fruit, whole grains, legumes and nuts and may include fish. Meat is consumed only on special occasions. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/192861/original/file-20171101-19867-1sb1g34.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Traditional fish market stall full of fresh red gurnard fish and orata — at Mercato di San Benedetto in Cagliari, Sardinia in March 2017.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>When combined with intensive exercise, another plant-based diet followed in the <a href="https://jamanetwork.com/journals/jama/fullarticle/188274">Lifestyle Heart Trial</a> demonstrated reversal of heart disease. This was a very low-fat vegetarian diet (with fat accounting for only 10 per cent of total calories) that consisted of vegetables, fruit, whole grains and legumes with small amounts of non-fat dairy products.</p>
<p>In these diet patterns, fat content ranges from 10 per cent to 40 per cent of total calories. This shows that both low-fat and high-fat diets lower risks of CVD — if they are plant-based.</p>
<h2>Eat cruciferous veg and citrus fruits</h2>
<p>We should all be eating five to 10 servings of fruits and vegetables daily. Research shows that <a href="https://doi.org/10.1093/ije/dyw319">five servings of vegetables and fruit per day are protective against CVD, but 10 servings of vegetables and fruit per day lower heart disease risk by 24 per cent</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/192851/original/file-20171101-19883-1ojo22z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">shutterstock.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>One serving is equivalent to a medium-sized fruit, a half-cup of chopped fruit or berries, a quarter-cup of dried fruit, a half-cup of cooked or raw vegetables and one cup of salad greens. About <a href="https://www.statcan.gc.ca/pub/82-625-x/2012001/article/11661-eng.htm">40 per cent of Canadians over the age of 12 consume at least five servings of vegetables and fruit per day</a>.</p>
<p>Cruciferous vegetables — such as broccoli, cabbage, green leafy vegetables, spinach and kale — along with beta-carotene-rich fruits and veggies like tomatoes, carrots and squash demonstrate the most benefit. As do apples, pears, berries and citrus fruit like oranges.</p>
<h2>Serve up whole grains and legumes</h2>
<p>We should also be eating at least three servings per day of whole grains. The research shows this <a href="https://www.ncbi.nlm.nih.gov/pubmed/27301975">lowers CVD risk by 19 per cent</a>. </p>
<p>What’s a serving? It can be one slice of whole grain bread, half a slice of whole grain pita bread, one bowl of cereal, one third of a cup of cooked grains like barley, bulgur, brown rice and quinoa or half a cup of cooked whole grain pasta or corn.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/192849/original/file-20171101-19845-1ffd841.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">shutterstock.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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</figure>
<p>Legumes also reduce our risk of heart disease. The research shows that four servings of legumes per week <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144102/">lower CVD risk by 14 per cent</a>.</p>
<p>We should be eating three to four servings per week — of black beans, garbanzo beans, kidney beans, navy beans, soy beans, lentils or dried peas. One serving is measured as three quarters of a cup of cooked legumes.</p>
<h2>Healthy fats in fish, nuts, seeds and oils</h2>
<p>Finally, back to the fats. We can obtain the good fats our body needs by eating fish, nuts, oils and seeds. </p>
<p>Eating fish at least two to four times per week <a href="https://doi.org/10.1017/S1368980011002254">reduces CVD risk by 17 per cent</a>, according to research. One serving of fish is defined as three ounces of cooked salmon, mackerel, herring, sardines, tuna, halibut and other fish.</p>
<p>Eating at least three servings of nuts per week is a good idea. Just one quarter cup of nuts consumed four times weekly <a href="http://ajcn.nutrition.org/content/100/1/278.long">reduces CVD by a whopping 24 per cent</a>, according to research. One serving of nuts is defined as one quarter cup of walnuts, almonds, hazelnuts, pecans, cashews, peanuts or pistachios. Or two tablespoons of natural almond, cashew or peanut butter. </p>
<p>Seeds — such as pumpkin, flax, chia, sunflower and sesame seeds — and butters made from sesame and sunflower seeds <a href="http://dx.doi.org/10.1161/CIRCULATIONAHA.112.001119">also lower CVD risk</a>. Olive oil, canola oil, peanut oil, avocado oil and soybean oils <a href="http://dx.doi.org/10.1016/j.jacc.2015.07.055">all lower CVD risk</a> as do avocados, which <a href="http://www.fasebj.org/content/31/1_Supplement/789.13.short">improve your cholesterol profile</a>.</p>
<p>Enjoy minimally processed plant foods from nature most of the time. They are better for us. And, as a bonus - eating them is <a href="http://www.onegreenplanet.org/environment/how-eating-more-plant-based-foods-benefits-the-environment/">better for the planet</a> too.</p><img src="https://counter.theconversation.com/content/84764/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karen Mornin received funding from St. Paul's Hospital research challenge fund. </span></em></p>From donuts to avocados, food impacts your heart health. Here we delve into the science of how to eat – to reduce your chances of cardiovascular disease.Karen Mornin, Clinical Instructor of Land and Food Systems, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/853202017-10-26T19:12:16Z2017-10-26T19:12:16Z5 claims about coconut oil debunked<figure><img src="https://images.theconversation.com/files/189868/original/file-20171011-28044-1nefo1c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Is coconut oil all it's really cracked up to be, or is it just another fad?</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/eTU7o_K4LBI">Sebastien Gabriel/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Coconuts have been a valued food in tropical areas for thousands of years, traditionally enjoyed as coconut water from the centre of the coconut, coconut flesh, or coconut “milk” (made by steeping the flesh in hot water).</p>
<p>Solid white coconut oil (I’ll use this popular term, although technically it’s a fat not an oil) is now the darling of <a href="https://www.thehealthyhomeeconomist.com/top-10-celebrities-who-use-virgin-coconut-oil/">celebrities</a> and <a href="http://www.harpersbazaar.com/beauty/skin-care/advice/a2377/benefits-and-uses-coconut-oil-0614/">bloggers</a>, paleo enthusiasts and sellers of so-called <a href="https://www.naturalnews.com/040903_coconut_oil_healthy_fats_oils.html">superfoods</a>. Claims for its supposed medical value reverberate around the internet, but how well do they stand up to scientific scrutiny?</p>
<h2>1. It helps you lose weight</h2>
<p>No study has found coconut oil <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531289/">helps weight loss</a>. The claim made on hundreds of <a href="http://bembu.com/coconut-oil-for-weight-loss/">internet sites</a> that it has some special ability to get rid of body fat is based on the erroneous idea that coconut oil is synonymous with a semi-synthetic laboratory product known as MCT oil. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-are-saturated-fats-good-or-bad-21524">Health Check: are saturated fats good or bad?</a>
</strong>
</em>
</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/189876/original/file-20171012-9833-1hljx7r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Claims that coconut oil can get rid of body fat are based on false premises.</span>
<span class="attribution"><span class="source">From www.shutterstock.com</span></span>
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</figure>
<p>Unlike regular edible oils, MCT oil is soluble in water and was <a href="https://www.nestlehealthscience.us/brands/mct-oil/mct-oil-hcp">originally designed</a> for use in tube feeding or for people who were malnourished because they lacked normal enzymes that split fat. Unlike most fats that are absorbed into the bloodstream, MCT oil is absorbed directly into the liver. This means it can be used more rapidly for fuel than other fats.</p>
<p>There is <a href="http://www.jlr.org/content/37/4/708.long">some evidence</a> MCT oil may help with weight loss, although the dose required and its side effects – at least initially – can include nausea, stomach cramps and diarrhoea. Even so, <a href="https://www.healthline.com/nutrition/coconut-oil-and-weight-loss#section3">internet sites</a> that assume the effects of MCT oil also apply to coconut oil are wrong. The two products are not equivalent and you can’t switch the findings of one to the other.</p>
<p>MCT is made up of two fatty acids - caprylic and capric acids. Coconut oil has small amounts of <a href="https://ndb.nal.usda.gov/ndb/foods/show/659?n1=%7BQv%3D1%7D&fgcd=&man=&lfacet=&count=&max=50&sort=default&qlookup=04047&offset=&format=Full&new=&measureby=&Qv=1&ds=&qt=&qp=&qa=&qn=&q=&ing=">these acids</a>, but its dominant fatty acid is lauric acid. Lauric acid is not digested in the liver but is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892314/">digested and metabolised</a> in the body like the fatty acids in other edible oils.</p>
<p>If munching on a piece of coconut flesh (which is a reasonable source of dietary fibre) helps you eat less overall, that could be useful. However, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/20451538">study of different fats</a>, including coconut oil, found no beneficial effect on hunger, fullness, satisfaction or current thoughts of food.</p>
<h2>2. It reduces heart disease risk</h2>
<p>Careful studies show the overall effect of coconut oil on increasing LDL cholesterol (which increases the risk of heart disease) is greater than with <a href="http://www.jlr.org/content/24/8/1039.long">corn</a>, <a href="http://www.jlr.org/content/36/8/1787.long">safflower</a> or a mixture of <a href="https://www.ncbi.nlm.nih.gov/pubmed/11348573">soybean and sesame</a> oils. It is, however, slightly better than <a href="http://www.jlr.org/content/36/8/1787.long">butter</a>. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-healthier-butter-or-margarine-19777">Health Check: what's healthier, butter or margarine?</a>
</strong>
</em>
</p>
<hr>
<p>Plenty of evidence from studies of people living traditional lifestyles with coconut (as flesh or the creamy liquid squeezed from the flesh) as their major source of fat show low levels of heart disease. They include <a href="https://www.ncbi.nlm.nih.gov/pubmed/7270479">1960s studies</a> of lean and active Pacific Islanders whose diets consisted mainly of fish, octopus, taro, breadfruit, bananas and coconuts. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/189887/original/file-20171012-9787-jadkrp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Pacific Islanders use coconut as a major source of fat.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/2zFna5RUGyU">Eddie Kopp/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The same applies to the very lean people of <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.1994.tb00804.x/abstract">Kitava</a> (a small island of Papua New Guinea), with their traditional diet of yams, cassava, sweet potato, taro, banana and other tropical fruits, fish and coconut. Their diet is not only low in fat, but also has little alcohol, salt, sugar, dairy or processed foods.</p>
<p>In contrast to these restricted diets of past times, coconut has not been able to protect against big changes in diet and activity. In Samoa, for example, coconut <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323707/">consumption hasn’t changed</a>, but the total daily diet contributed 3,800 kilojoules (900 calories) more in 2007 compared with the 1960s. Pacific Islanders now top the world <a href="https://www.ncbi.nlm.nih.gov/pubmed/20360794">obesity tables</a>, heart disease rates are high, and type 2 diabetes is <a href="https://www.ncbi.nlm.nih.gov/pubmed/18797481">three times</a> more common than in Australia - all in spite of consuming coconut.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">Got high cholesterol? Here are five foods to eat and avoid</a>
</strong>
</em>
</p>
<hr>
<p>As one recent review of 21 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892314/">research papers</a> and a <a href="http://onlinelibrary.wiley.com/doi/10.1111/nbu.12188/full">further review</a> have shown, coconut oil cannot be relied on to reduce blood cholesterol or protect against heart disease.</p>
<h2>3. It kills bacteria and viruses</h2>
<p>Some <a href="http://www.prnewswire.com/news-releases/monolaurin-a-wonder-immune-boosting-component-207501061.html">internet sites</a> claim coconut oil can <a href="http://coconutresearchcenter.org/hwnl_5-5.htm">kill viruses</a>, fungi and bacteria due to its content of <a href="http://www.ppt-health.com/hiv-and-aids/coconut-oil-and-monolaurin/">monolaurin</a>, a compound derived from lauric acid. </p>
<p>Studies in mice show monolaurin can <a href="http://online.liebertpub.com/doi/abs/10.1089/jmf.2012.0066">provide some protection</a> against the bacteria <em>Staphylococcus aureus</em> (responsible for some staph infections), but researchers doing this study found no effect with either refined or virgin coconut oil. </p>
<p>In particular types of infection, there is some possibility monolaurin might be of use, but it’s not valid to extrapolate from this to make claims about coconut oil when there’s no evidence the body can make monolaurin from coconut oil.</p>
<p>Instead, a manufactured form of monolaurin (glycerol monolaurate) is found in coconut oil and is popular for its emulsifying and moisturising properties in cosmetics, detergents and soaps. These properties in coconut oil could support its benefits as a surface <a href="http://www.naturallivingideas.com/coconut-oil-face/">moisturiser</a> or <a href="http://www.youbeauty.com/beauty/diy-coconut-oil-makeup-remover/">make-up remover</a>. </p>
<h2>4. It repairs your hair</h2>
<p>Several papers published in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/11413497">Journal of Cosmetic Science</a> claim that coconut oil applied to hair is better at penetrating the hair shaft than mineral oil. </p>
<p>This could be useful and it’s unlikely that coconut oil massaged into hair will have any adverse effect on human health, so if it appeals, it may be worthwhile to use it for this reason.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=393&fit=crop&dpr=1 600w, https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=393&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=393&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=494&fit=crop&dpr=1 754w, https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=494&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/189877/original/file-20171012-9833-10syk8h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=494&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There are claims coconut oil will repair damaged hair.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/oil-hair-treatment-woman-580189900">From shutterstock.com</a></span>
</figcaption>
</figure>
<h2>5. It whitens your teeth</h2>
<p>This claim is another extrapolation of the idea that coconut oil can kill harmful organisms. The practice of swishing oil in the mouth (called “<a href="https://www.healthline.com/nutrition/oil-pulling-coconut-oil#section1">oil pulling</a>”) for 10-30 minutes before spitting hails from <a href="https://www.mindbodygreen.com/0-4896/The-Single-Most-Effective-Ayurvedic-Practice-for-Your-Mouth.html">Ayurvedic practices</a> in India and supposedly draws out toxins. </p>
<p>If it makes you feel sick or headachy, that’s meant to be proof you are extracting toxins.</p>
<p>There’s no scientific evidence to support this practice and it should not replace proper dental care.</p><img src="https://counter.theconversation.com/content/85320/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rosemary Stanton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Coconut oil is being hailed as the new “superfood”, helping us lose weight and kill harmful bugs. But how do the claims stand up to scientific scrutiny?Rosemary Stanton, Visiting Fellow, School of Medical Sciences, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/774232017-05-12T14:57:11Z2017-05-12T14:57:11ZDairy got the all-clear this week - but was it justified?<figure><img src="https://images.theconversation.com/files/168991/original/file-20170511-32610-fq0lan.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/520248970?src=RBiSCEgJ9nig4tHbGI50fg-1-63&size=medium_jpg">margouillat photo/Shutterstock</a></span></figcaption></figure><p>A new study, published recently in <a href="https://link.springer.com/article/10.1007/s10654-017-0243-1">the European Journal of Epidemiology</a>, appeared to give dairy products a clean bill of health. The researchers found no evidence for an increased risk of cardiovascular disease or death from consuming dairy products – even full-fat dairy products. </p>
<p>These findings were widely covered in the media – headlines <a href="https://www.thesun.co.uk/living/3514406/cheese-milk-cream-and-yoghurt-are-not-bad-for-your-health-boffins-now-claim/">mostly</a> <a href="http://metro.co.uk/2017/05/09/full-fat-cheese-does-not-increase-risk-of-heart-attacks-or-strokes-6625129/">singled out</a> <a href="http://www.dailymail.co.uk/health/article-4487242/Cheese-does-NOT-increase-risk-heart-attack.html">cheese</a>, saying it does not increase the risk of heart attack or stroke. Some of the reports claimed that saturated fats do not increase the risk of cardiovascular disease, but the study didn’t examine saturated fat consumption itself. </p>
<p>It’s worth taking a closer look at the science behind the headlines.</p>
<h2>Key findings</h2>
<p>This new study is a type of study known as a meta-analysis because it pools data from earlier studies and analyses the combined data. In this instance, there were 29 studies that the researchers felt were of sufficiently high quality to include in their analysis. There were 783,989 participants in all, with an average age of 57 years. Each of the studies had asked healthy people about their usual diet and then followed them up over five to 25 years. Over the course of the follow up, 93,158 participants died (from any cause), 28,419 developed coronary heart disease and 25,416 developed cardiovascular disease (heart attack and stroke).</p>
<p>The international team of researchers who conducted the meta-analysis found no statistically significant link between any of total dairy consumption (high- and low-fat combined), high-fat dairy consumption, low-fat dairy consumption, and risk of death, risk of coronary heart disease or risk of cardiovascular disease.</p>
<p>Among individual dairy products, milk consumption was not associated with cardiovascular disease or death, and neither was yoghurt consumption. For cheese and fermented dairy products (including sour milk products, cheese or yoghurt), there was a minor reduction in the risk of cardiovascular disease, but it seemed to be because of one large study. When this study – which showed an extreme result – was removed from the analysis, the link disappeared.</p>
<h2>Strengths and weaknesses</h2>
<p>Although not new, this research included the largest sample of participants to date on this topic and investigated both total and individual types of dairy products. The researchers applied sound meta-analysis methods and were careful to use extra analyses (called sensitivity analyses) to check their initial findings. However, there are some limitations of the individual studies, and meta-analysis, which are worth mentioning.</p>
<p>Although up to 29 studies were identified for the meta-analysis, the actual number available for each analysis was considerably less than 29. For example, for high-fat there were five studies for looking at death, nine for heart disease and seven for cardiovascular disease. And for yoghurt consumption, there were only three studies. This can compromise the confidence we can place in some of the results. For example, we can’t be certain that the association of yoghurt intake with cardiovascular disease is indeed null, as fermented dairy products – especially yoghurt – have been associated with reductions in <a href="http://ajcn.nutrition.org/content/99/5/1235S.short">cardiovascular risk</a>, <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157461">weight gain</a> and <a href="http://ajcn.nutrition.org/content/early/2016/02/24/ajcn.115.123216.short">type 2 diabetes</a> in other research.</p>
<p>Another weakness is that the meta-analysis combined data from observational studies. Observational studies are not as robust as clinical trials. But this is a common limitation of studies of diet as it’s often not possible to keep people under close scrutiny – as required in clinical trials – for many years while comparing one type of diet with another. </p>
<p>With observational studies, there is always a risk that some other factor – one not being investigated – is the actual reason for the observed associations. To get around this, researchers take “confounding factors” into account when analysing the data. In this instance, the studies took into account such factors to very different degrees – some only including a very limited number of factors such as age, sex, smoking, or social status (such as education), while there are also other important factors such as obesity, physical activity, alcohol intake, ethnicity and other foods consumed that were missed in some studies. It is possible such health and lifestyle factors not taken into account by the researchers may have influenced the results.</p>
<p>Inconsistency in the definitions of groups of dairy products might also obscure interpretation. For example, some studies might include full-fat yoghurt in high-fat dairy products, whereas other studies might include both types of yoghurt in low-fat dairy products. Some dairy products such as cream and butter were not individually assessed in the meta-analysis. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/169123/original/file-20170512-3664-1wucg3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Food surveys can be unreliable as memory is fallible.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/540133312?src=r_tz1fp12PcxGAqEy3qSag-1-7&size=medium_jpg">Mangostar/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Wider context</h2>
<p>There is emerging evidence from other research, that not all foods that are rich in saturated fats have the same impact on health. This is probably because foods rich in saturated fat also contain many other ingredients. For instance <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483430/">processed red meat</a> is associated with an increased risk of type 2 diabetes, whereas<br>
<a href="http://ajcn.nutrition.org/content/early/2016/02/24/ajcn.115.123216.short">dairy products</a>, particularly yoghurt, are associated with a decrease in risk of type 2 diabetes, as we have also shown in two studies (<a href="http://ajcn.nutrition.org/content/96/2/382.short">EPIC InterAct</a> and <a href="https://link.springer.com/article/10.1007/s00125-014-3176-1">EPIC-Norfolk</a>).</p>
<p>Most dietary research relies on people reporting their dietary habits, and this can be prone to error and inaccuracies, which can mask the detection of links between diet and health. <a href="http://www.sciencedirect.com/science/article/pii/S2213858714701469">Our own research</a> has shown that measuring biomarkers of food intake in blood or urine can open up new possibilities for understanding links with disease and bypass errors due to self-reporting in questionnaires. </p>
<p>New evidence suggests that saturated fat in dairy may not be as bad for us as we once thought, but there isn’t enough evidence, just yet, to change dietary guidelines which, in the UK, recommend that saturated fats should make up fewer than 11% of all calories consumed from food.</p><img src="https://counter.theconversation.com/content/77423/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eirini Trichia declares no conflict of interest. She receives PhD funding from MRC Epidemiology Unit and the Cambridge Trust. </span></em></p><p class="fine-print"><em><span>Nita Forouhi receives funding from the Medical Research Council (MRC) Epidemiology Unit (MC_UU_12015/5)</span></em></p>A number of media reports claimed that saturated fats are safe to consume. Here’s why you should treat those reports with caution.Eirini Trichia, PhD student, MRC Epidemiology Unit, University of CambridgeNita Forouhi, Programme Leader, MRC Epidemiology Unit, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/766982017-05-08T19:46:03Z2017-05-08T19:46:03ZViewpoints: is saturated fat really the killer it’s made out to be?<figure><img src="https://images.theconversation.com/files/167121/original/file-20170428-15112-137ejx9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A controversial editorial has questioned whether saturated fats really clog up your arteries and put you at risk of heart disease. But can it really overturn decades of research?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/99621002?src=jxTPXTYXmpHsEfNjNB44hA-2-42&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>A recent editorial in the <a href="http://bjsm.bmj.com/content/early/2017/03/31/bjsports-2016-097285">British Journal of Sports Medicine</a> dismissed the widely held belief that a diet rich in saturated fats increases our risk of heart disease as “just plain wrong”.</p>
<p>The authors concluded we have been concentrating on reducing one type of fat in our diet when instead we should be promoting a <a href="https://theconversation.com/what-is-the-mediterranean-diet-and-why-is-it-good-for-you-12656">Mediterranean diet</a>, exercise and reducing stress to reduce our chances of heart disease.</p>
<p>So, is saturated fat really the killer it’s made out to be. Or, as the editorial suggests, have we really got it all wrong?</p>
<hr>
<h2>The case for saturated fat’s role in heart disease</h2>
<p><strong>David Sullivan, Clinical Associate Professor, University of Sydney</strong></p>
<p>According to evidence collected over more than five decades, the level of saturated fat in our diet is one of the most powerful environmental risk factors for the inflammatory process in the artery wall that leads to <a href="http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2530902">heart attack and stroke</a>. </p>
<p>Science and medicine have never suggested saturated fat <em>itself</em>, for instance from a diet rich in fatty meat or processed foods, blocks your arteries (vessels that carries blood from the heart to other organs).</p>
<p>What we know is eating too much saturated fat raises levels of blood cholesterol, in particular the type commonly called “bad” cholesterol, <a href="https://www.heartfoundation.org.au/your-heart/know-your-risks/blood-cholesterol">low-density lipoprotein cholesterol</a> or LDL.</p>
<p>LDL and related particles enter the artery wall where they are chemically modified, triggering a vicious cycle of inflammation and cholesterol accumulation. It is this cycle of inflammation and cholesterol accumulation that leads to heart disease and stroke.</p>
<p>That’s why doctors like to keep an eye on your blood cholesterol levels, as part of assessing your risk of heart disease.</p>
<p>But it’s not just LDL particles that contribute to the inflammatory process; other related particles do so too. So doctors look beyond simple measures of LDL cholesterol to measure your risk. It’s <a href="http://www.sciencedirect.com/science/article/pii/S1933287408002742">better</a> to start with your total level of blood cholesterol, then take away levels of so-called “good” cholesterol – the high-density lipoprotein or HDL cholesterol. This gives you an idea of the level of damaging particles (or non-HDL cholesterol).</p>
<p>If we understand that raised blood cholesterol levels (in particular, raised LDL) increase your risk of heart disease and stroke, then it stands to reason that reducing their levels might decrease your chances.</p>
<p>This is exactly what two <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1410489#t=article">recent</a> <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1615664#t=article">studies</a> showed. These provided the highest form of evidence in over 40,000 patients; they looked at how two cholesterol-lowering drugs significantly reduced cardiovascular events, like heart attacks and stroke.</p>
<p>Neither drug has anti-inflammatory effects. Instead, their success is attributed to reduced levels of harmful cholesterol-carrying particles, including LDL cholesterol.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/167125/original/file-20170428-15091-h7013r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In one study, participants swapped butter for polyunsaturated margarine as a way of reducing their saturated fat intake.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/514088740?src=Ju6y5EkxtXFJhD6TABFPOw-1-57&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>So, what role does diet play in all this? Two <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1200303#t=article">landmark</a> <a href="http://circ.ahajournals.org/content/103/13/1823">studies</a> in people who ate Mediterranean-style diets show what happens when you eat less saturated fat. Replacing saturated fat in the diet with foods containing healthier unsaturated fat, like the fats in nuts, extra virgin olive oil, polyunsaturated margarine – but not processed carbohydrates – reduced levels of heart attacks and premature death.</p>
<p>Downplaying the role of dietary saturated fat in heart disease prevents health care workers from managing cardiovascular risk using diet. Any recommendation to not be so focused on saturated fat will therefore increase population levels of blood cholesterol, increasing the need for statins and other cholesterol-lowering drugs.</p>
<hr>
<p><em><a href="https://theconversation.com/some-things-you-should-know-about-statins-and-heart-disease-19655">Some things you should know about statins and heart disease</a></em></p>
<hr>
<p>The implication, that one of the most thoroughly researched areas of medical science – that excess saturated fat puts you at risk of heart disease and stroke – is a hoax, misrepresents the evidence.</p>
<hr>
<h2>The case against labelling saturated fat ‘bad’</h2>
<p><strong>Yutang Wang, Senior Lecture at Federation University Australia</strong></p>
<p>Saturated fat (for instance high in fatty meat or full-fat dairy) is thought to clog the arteries and increase the risk of heart disease. But currently available evidence does not support these common beliefs.</p>
<p>First, let’s look at whether saturated fat really clogs the heart’s arteries leading to coronary <a href="https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis">atherosclerosis</a> (when plaque builds up inside your arteries, in time hardening and narrowing them). In a surprise finding, one study in women who had been through the menopause found a diet richer in saturated fat was linked with <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1270002">less, not more</a>, progression of coronary atherosclerosis.</p>
<p>Second, whether eating saturated fat increases your chances of dying from heart disease. When researchers combined the results from 41 research papers published from 1981 to 2014, eating saturated fat <a href="http://www.ncbi.nlm.nih.gov/pubmed/26268692">was not linked</a> with dying from heart related diseases, like heart attack, stroke or type 2 diabetes.</p>
<hr>
<p><em><a href="https://theconversation.com/health-check-are-saturated-fats-good-or-bad-21524">Health Check: are saturated fats good or bad?</a></em></p>
<hr>
<p>Many of us think saturated fat is bad for us because it increases levels of low-density lipoprotein cholesterol or LDL in our blood. But is LDL-cholesterol really that bad?</p>
<p>When researchers studied all the research papers written in English that investigated the effects of LDL-cholesterol on the deaths in people over 60, they had some surprising results. In most of the papers (representing 92% of participants), LDL-cholesterol was linked with a <a href="http://bmjopen.bmj.com/content/6/6/e010401">lower death rate, and there was no link</a> in the remaining 8% of participants.</p>
<p>It is not the level of LDL <em>itself</em> that predicts people’s risk of heart disease, but the ratio of total cholesterol and another type of cholesterol, high-density lipoprotein (HDL) cholesterol, that’s the key.</p>
<p>While LDL is largely responsible for delivering cholesterol to cells around the body, HDL cholesterol transports extra cholesterol back to the liver for recycling. So LDL and HDL work together to ensure cells in our body maintain the right levels of cholesterol.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/167307/original/file-20170501-12987-asrrpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Eating three eggs a day increased levels of HDL cholesterol in the short term.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/596694929?src=xlRooFpchhtbJK_CxPPEMw-1-0&size=medium_jpg">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>A higher ratio of total cholesterol against HDL-cholesterol is commonly associated with <a href="http://www.ncbi.nlm.nih.gov/pubmed/7944071">higher incidence</a> of heart disease because a higher ratio reflects that more cholesterol will be deposited into the blood vessel and less will be removed from it.</p>
<p>But when we eat saturated fat, both LDL and HDL cholesterol levels increase. So, eating normal amounts of saturated fat <em>will not</em> tip the balance. We need saturated fat in our diet to form the building blocks for the cells in our body and to help our cells communicate with each other.</p>
<p>The long-term effect of eating too much cholesterol on the ratio of total against HDL cholesterol is not clear. A short-term study <a href="https://www.ncbi.nlm.nih.gov/pubmed/18203890">suggests</a> eating moderately high levels of cholesterol may not be bad. Researchers found that eating three eggs a day (containing 640 mg cholesterol) for 12 weeks did not increase LDL-cholesterol. </p>
<p>Instead it significantly increased HDL-cholesterol by 20% compared to those who ate an egg substitute without cholesterol.</p>
<p>So, we may need to stop thinking about “bad” saturated fat and “bad” cholesterol. Rather, we should enjoy our meals containing moderate amounts of saturated fat and be physically active. That will be more effective in keeping us healthy.</p>
<hr>
<p><strong>David Sullivan:</strong></p>
<p>The author mentions the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1270002/">study of progression of artery disease in women who have gone through the menopause</a>. This shows women with the highest saturated fat intake had the lowest LDL cholesterol levels (despite taking less lipid-lowering treatment). This might be explained, <a href="https://doi.org/10.1016/j.cell.2012.03.001">as some researchers suggest</a>, by genetic factors that allow some people to tolerate saturated fat better, leading to a lower LDL and a reduced risk of heart disease.</p>
<p>And rather than eating moderate amounts of saturated fat, as the author suggests, there is ample evidence for <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2012.02553.x/abstract">avoiding saturated and trans fats, replacing them</a> with healthier ones and <a href="https://www.heartfoundation.org.au/images/uploads/publications/CON-084.v3-HealthyEating-LR-secure.pdf">reserving saturated fats as treats</a>.</p>
<p>We also differ in our opinions of the best marker of heart-disease risk that your doctor might consider when analysing blood test results.</p>
<p>Use of the total cholesterol to HDL ratio, as the author proposes, has declined because levels of HDL cholesterol itself may not be a marker of <a href="https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2011-1846">heart disease protection</a>. And raising HDL <a href="https://www.ncbi.nlm.nih.gov/pubmed/28099220">has not reduced the risk</a> of heart disease. Instead, non-HDL cholesterol has been introduced as a superior measure to LDL, as I have mentioned.</p>
<p>Finally, there’s confusion over how the terms cholesterol and saturated fat are used. Saturated fat is chain-shaped and consumed in much greater amounts than the ring-like <a href="https://www.nhlbi.nih.gov/health/health-topics/topics/hbc">cholesterol</a>. And it’s saturated fat in the diet that’s the main determinant of cholesterol levels in the blood.</p>
<hr>
<p><strong>Yutang Wang:</strong></p>
<p>Despite decades of research on whether eating saturated fat increases our chances of dying from heart disease, the results are not consistent. Some show eating high <a href="http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2530902">saturated fat is bad</a>, whereas others <a href="http://www.ncbi.nlm.nih.gov/pubmed/26268692">do not</a>. </p>
<p>For instance, as recently as 2016, a study showed higher total saturated fat intake was linked to <a href="http://ajcn.nutrition.org/content/early/2016/01/20/ajcn.115.122671">lower levels of heart disease</a>. </p>
<p>Yes, LDL cholesterol can be chemically modified and involved in the inflammation process. However, this does not mean non-modified LDL cholesterol in the blood <a href="http://bmjopen.bmj.com/content/6/6/e010401">is bad</a>.</p>
<p>There is no doubt that cholesterol-lowering drugs <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1615664#t=article">can lower</a> your risk of a heart attack or stroke. These drugs can decrease LDL-cholesterol. However, the beneficial effect of cholesterol-lowering drugs may be largely because of the favourable change in the balance between total cholesterol and HDL-cholesterol, rather than lowering “harmful” LDL-cholesterol alone.</p><img src="https://counter.theconversation.com/content/76698/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Richmond Sullivan received funding to support diet studies involving chocolate, plant sterols and pork. </span></em></p><p class="fine-print"><em><span>Yutang Wang does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We need to eat a healthy diet, do some exercise and avoid stress rather than blame saturated fat for heart disease, says a recent editorial. But does the evidence stack up?David Richmond Sullivan, Clinical Associate Professor, University of SydneyYutang Wang, Senior Lecturer, Federation University AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/736572017-03-06T11:25:53Z2017-03-06T11:25:53ZHow diets high in sugar and saturated fat could be harming your brain<figure><img src="https://images.theconversation.com/files/159112/original/image-20170302-14690-73xl84.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Forgotten something?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/question-178026500?src=_yh_0OsmKl5CIU1Ss2ktdg-1-20">Shutterstock</a></span></figcaption></figure><p>A lot of research has been conducted to establish the risks that a high energy diet – high in saturated fat and sugar – poses to our health. The most common known results of such diets include obesity, heart disease and diabetes, but research suggests that a diet high in fat and sugar can also have a significant impact on our cognition – the way we learn, remember, and think. </p>
<p>Back in 2010, Scott Kanoski, assistant professor of biological sciences at Perdue University in the US, showed that as little as three days of a diet that is high in <a href="https://www.bhf.org.uk/heart-health/preventing-heart-disease/healthy-eating/fats-explained">saturated fat</a> and sugar was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409296/">enough to change cognition in rats</a>. </p>
<p>During the research, rats were fed either a high energy diet or one that was nutritionally balanced, and had to learn where to find the food while inside a maze. After only three days, the rats on the high energy diet <a href="http://psycnet.apa.org/journals/xan/36/2/313/">were less able to find the food rewards</a> than those that had been given the nutrient-balanced diet. They didn’t gain any weight, which suggests the damaging effects of a high energy diet are more than the production of excess body fat – it also affected their brains. </p>
<p>Further research by Kanoski indicated that the <a href="http://psycheducation.org/brain-tours/memory-learning-and-emotion-the-hippocampus/">hippocampus</a>, the area of the brain that is important for learning and memory, is <a href="https://www.ncbi.nlm.nih.gov/pubmed/20413889">especially vulnerable to the effects of a high energy diet</a>. The fact that this brain region appears to be affected earlier than others is worrying, as it proves that the earliest detrimental effects of a high energy diet are on cognition. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=341&fit=crop&dpr=1 600w, https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=341&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=341&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=429&fit=crop&dpr=1 754w, https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=429&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/159134/original/image-20170302-14695-zmzpik.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=429&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The hippocampus.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/235282123?src=N4gVoCaLVzQTTsuIhhYnbg-1-0&size=medium_jpg">Shutterstock</a></span>
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<p>This effect on memory could be explained by <a href="http://www.diabetes.co.uk/insulin-resistance.html">insulin resistance</a> which happens on an energy rich diet. Insulin is used as a signalling chemical that tells the body to remove glucose from the blood to use as energy. So, when the body becomes insulin resistant, it can’t do this as effectively, which leads to high blood sugar levels. Insulin resistance has been mostly associated with obesity, as these people typically have had high energy diets over a long time period, and can sometimes progress into <a href="http://www.nhs.uk/Conditions/Diabetes-type2/Pages/Introduction.aspx">type 2 diabetes</a>. </p>
<p>In fact, researchers at the University of Mexico found that rats showed evidence of <a href="https://www.ncbi.nlm.nih.gov/pubmed/24667917">insulin resistance after only seven days</a> on a high energy diet. In this case the hippocampus’ response to insulin changed and it appeared to alter the structure of nerve cells in that region. It meant that the nerve cells were less able make new connections with other nerve cells, which is required to make new memories, and suggests that a high energy diet can impact the way we learn through this developed insulin resistance.</p>
<p>Cognitive decline has also been previously linked to <a href="https://www.researchgate.net/profile/Carol_Greenwood/publication/7510443_High-fat_diets_insulin_resistance_and_declining_cognitive_function/links/56378d2008ae30cbeff4d15a.pdf">insulin resistance in humans</a>. One study, in 2011, showed that <a href="https://www.ncbi.nlm.nih.gov/pubmed/21270386">after five days of a high fat, low sugar diet, people performed worse on cognitive tasks</a> such as focusing their attention and such diets have also been linked to the <a href="http://www.biochemsoctrans.org/content/33/5/1041">development of Alzheimer’s Disease</a>. However, further research into the very short-term effects of high energy diet in humans is currently lacking. </p>
<h2>A vicious circle?</h2>
<p>Terry Davidson, professor of psychology at Perdue University, suggested that changes of this kind to the hippocampus <a href="http://linkinghub.elsevier.com/retrieve/pii/S030645221300732X">could even affect the way we eat and even lead to obesity</a>. The hippocampus is responsible for learning and perhaps also for us associating the feeling of hunger with pleasure when we eat. But, when there is damage to the hippocampus, this could be disrupted and it might cause you to eat even when you don’t feel hungry. And if you turn to food which is high in fat and sugar in this instance, it could create a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2223183/">vicious circle</a> of further hippocampus damage – and more overeating.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/159115/original/image-20170302-14690-1flxhao.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Overeating sugar and saturated fat.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fat-man-eating-unhealthy-food-on-188620154?src=5qDoRA_19nrsIv50U1gJLQ-1-10">Shutterstock</a></span>
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<p>Although our knowledge regarding the short-term effects of a high energy diet on our brains is limited, we should still be encouraged to make <a href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801">healthier choices</a> when it comes to food and it’s especially important when the food we eat could impact our minds as well as our bodies. It’s unfortunate that a bad diet can affect the way we think and learn – and long before most of us would be concerned about having a few too many treats.</p><img src="https://counter.theconversation.com/content/73657/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Boyd works for The University of Sussex. </span></em></p>Rats were less able to find food after only three days on a diet high in sugar and saturated fat. So could a bad diet also be affect the human brain?Katie Boyd, PhD Candidate in Neuroscience, University of SussexLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/598852016-11-14T04:36:03Z2016-11-14T04:36:03ZHealth Check: is cheese good for you?<figure><img src="https://images.theconversation.com/files/145005/original/image-20161108-29124-8ae9vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">We need protein and calcium, but shouldn't have too much fat and salt. So what's the verdict on cheese?</span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>It’s no wonder people are confused about whether it’s good to eat cheese, when even food experts are divided. Some argue that we’re not eating enough of this important source of protein and calcium, while others say the high levels of salt and saturated fat mean we should be eating less.</p>
<p>Whatever your position, it’s becoming increasingly hard to avoid cheese. Whether its grilled halloumi with poached eggs for breakfast, pumpkin and feta salad for lunch, or pepperoni pizza for dinner, cheese is a key ingredient in many regular meals. It’s a popular snack food, with many health professionals promoting crackers and cheese as a high-protein snack. A cheese platter is also the favourite way to kick off afternoon drinks or a barbeque.</p>
<p>So just how much cheese are Australians eating, and is it good for us?</p>
<p>The <a href="https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5">Australian Dietary Guidelines</a> recommend that adults eat about 2.5 serves of dairy (including milk, yoghurt and cheese) a day. They also say this should preferably be low-fat to ensure that nutrient needs are met without exceeding energy requirements.</p>
<p><a href="http://www.dairyinfo.gc.ca/index_e.php?s1=dff-fcil&s2=cons&s3=consglo&s4=tc-ft">Available sales data for cheese</a> suggest that Australians are eating 13.6kg of cheese per person per year, which works out at 37g per person per day, or just less than one Australian portion (Australian portion sizes are 25% bigger than European Union ones, at 40g compared with 30g).</p>
<h2>Fat</h2>
<p>It seems that the advice to limit full-fat cheeses to two or three serves per week is being ignored. Low-fat products <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.012main+features12011-12">only made up 29%</a> of dairy products consumed in the last dietary survey while cheese accounted for 99% of the high-fat dairy products consumed. </p>
<p>Full-fat cheese products contain high levels of saturated fat, which can <a href="https://www.heartfoundation.org.au/healthy-eating/food-and-nutrition/fats-and-cholesterol/saturated-and-trans-fat">increase the risk of heart disease</a>. A 40g portion of cheese <a href="http://www.legendairy.com.au/%7E/media/Legendairy/Documents/Health/Fact%20sheets/2012%20Proximate%20Composition%20Booklet.ashx">can contain between</a> 2.24g (reduced-fat ricotta) and 9.5g (Danish creamy cheese Havarti) of saturated fat.</p>
<p>This is 11% and 40%, respectively, of the amount used as the <a href="http://www.mydailyintake.net/daily-intake-levels">reference guide for daily intake labelling</a>. So even though actual recommendations depend on individual energy requirements, it is still clear that we need to limit our consumption of full-fat cheese to avoid excessive amounts of saturated fat.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/145006/original/image-20161108-29136-224lor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Saturated fats are bad for heart health.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<h2>Salt</h2>
<p>The levels of sodium in cheese are also something to watch out for as too much salt increases blood pressure, which increases the risk of heart disease and stroke.</p>
<p>Sodium levels in one 40g portion of cheese range from 74mg (<a href="http://www.who.int/nutrition/publications/guidelines/sodium_intake/en/">4% of the World Health Organisation’s (WHO)</a> recommended daily amount) in reduced-fat ricotta, to a scary 1,160mg (<a href="http://www.legendairy.com.au/%7E/media/Legendairy/Documents/Health/Fact%20sheets/2012%20Proximate%20Composition%20Booklet.ashx">58% of the WHO’s</a> recommended daily amount) in halloumi.</p>
<p>Interestingly, processed cheddar contains twice as much sodium as unprocessed cheddar, at 532mg per portion (26% of WHO recommended amount), so it would seem better to opt for the unprocessed version on that basis (although this may have higher levels of saturated fat and less calcium).</p>
<h2>Processed cheeses</h2>
<p>The <a href="https://www.foodstandards.gov.au/code/code-revision/Documents/35%20-%20Standard%202.5.4%20.pdf">definition of a processed cheese</a> is a product manufactured from cheese and products obtained from milk, which is heated and melted, with or without added emulsifying salts, to form a homogeneous mass. </p>
<p>Such products can be produced more cheaply, last longer and are more convenient to use and so are a popular product for kids’ school lunchboxes. Current concerns over increasing childhood obesity in Australia means its important to keep an eye on fat and energy contents of children’s foods.</p>
<p>Kraft singles and Bega Stringers both contain a little less energy, substantially less saturated fat, and about the same amount of sodium and calcium per portion as regular cheddar cheese. Meanwhile, Philadelphia cream cheese contains even less energy and much less sodium but is higher in saturated fat.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=389&fit=crop&dpr=1 600w, https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=389&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=389&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=489&fit=crop&dpr=1 754w, https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=489&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/145007/original/image-20161108-29136-1hut6qb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=489&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Are we getting any nutrition from highly processed cheeses?</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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</figure>
<h2>Health benefits?</h2>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/27517544">recent meta-analysis</a> of 15 studies, that suggested moderate cheese consumption (up to 40g per day) was associated with reduced heart disease risk, didn’t differentiate between low and full fat cheeses. </p>
<p>The authors (two of whom incidentally work for a leading dairy company in Asia) suggested the calcium, protein, vitamins or minerals (not specified) in cheese might explain the apparent protective health benefits.</p>
<p>Cheese is a <a href="https://www.nrv.gov.au/nutrients/calcium">good source of calcium</a> and we need calcium for bones and teeth as well as regulating muscle and heart functions. </p>
<p>The recommendations are for most adults and children aged nine and above to eat 1,000-1,300mg of calcium a day. A 40g serving of cheddar cheese contains around 320mg. So you would need to eat at least three portions if you were to get your calcium requirements just from cheese.</p>
<h2>So what’s the verdict?</h2>
<p>For maximum health outcomes I’d stick to the advice to eat two to three serves of dairy (mainly low fat) per day. This may include one serve of low-fat cheese, with maybe one serve each of low-fat milk and yoghurt to ensure you get enough calcium. I’d also stick with the recommendations to limit full-fat cheeses to two to three serves per week. </p>
<ul>
<li><p>Enjoy sparingly (two to three times a week): full-fat cheeses, hard cheeses, feta, halloumi, blue cheese. </p></li>
<li><p>Eat moderate amounts (one portion a day): low-fat cheeses, cottage cheese, reduced fat ricotta, reduced fat mozarella.</p></li>
</ul><img src="https://counter.theconversation.com/content/59885/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqui Webster is supported by a National Health and Medical Research Council Career Development Fellowship and a National Heart Foundation Future Leaders Award and receives additional project funding from The National Health and Medical Research Council, The World Health Organization and The Victorian Health Promotion Foundation. </span></em></p>It’s no wonder people are confused about whether it’s good to eat cheese, when even food experts are divided.Jacqui Webster, Senior Research Fellow, Food Policy. Director of World Health Organization Collaborating Centre on Population Salt Reduction, George Institute for Global HealthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/675432016-10-27T19:12:05Z2016-10-27T19:12:05ZWhy Australian dietary recommendations on fat need to change<figure><img src="https://images.theconversation.com/files/143401/original/image-20161027-11278-1fmcyb5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Evidence supports a review of dietary guidelines around the ideal balance of omega 6 to omega 3 dietary fats. </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-153246482/stock-photo-mediterranean-omega-3-diet-fish-steak-olives-nuts-and-herbs-isolated-on-black-background-with-reflection.html?src=UFDjfQ0fea4AEdcf1-_oqg-1-6">Shutterstock/Uber Images</a></span></figcaption></figure><p>A recent <a href="http://openheart.bmj.com/content/3/2/e000385.full?sid=acd05aa3-4e5f-4680-83bb-63aef173896f">editorial</a> in the journal Open Heart suggests many of us have it all wrong when it comes to the balance of fats we eat. </p>
<p>The authors urge a return to equal amounts of specific types of fats known as <a href="http://ebm.sagepub.com/content/233/6/674.short">omega-6 and omega-3 polyunsaturated fatty acids</a> in order to help combat global obesity. </p>
<p>The paper reflects a recent wave of evidence supporting a revision of guidelines around dietary fat, including in Australia. </p>
<h2>What are dietary fats?</h2>
<p><a href="http://www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good">Fats</a> - more correctly referred to as fatty acids - are a major dietary source of energy, along with carbohydrate and protein. Fats can be saturated or unsaturated, terms that refer to the makeup and structure of the fat molecules. </p>
<p><a href="http://ebm.sagepub.com/content/233/6/674.short">Polyunsaturated fatty acids</a> include the groups of omega-6 and omega-3 fats. The omega-6 linoleic acid and omega-3 alpha-linolenic acid are called <a href="https://www.ncbi.nlm.nih.gov/pubmed/12442909">essential fats</a>, as humans cannot produce them: we need to obtain these from dietary sources. </p>
<p>Major sources of <a href="http://link.springer.com/article/10.1007/s11745-003-1074-0">omega-6 polyunsaturated fatty acids</a> are seeds that are used abundantly in vegetable oils like safflower and sunflower oil. These oils are commonly used to make margarines. Processed foods such as cakes, biscuits, burgers, pizza and chips are therefore high in omega-6.</p>
<p>Plant sources of <a href="http://ajcn.nutrition.org/content/83/6/S1526.short">omega-3 alpha-linolenic acid</a> are nuts (such as walnuts), seeds (such as linseeds) and green leafy vegetables. The longer chain, more highly unsaturated omega-3s known as <a href="http://link.springer.com/article/10.1007/s11745-003-1074-0">eicosapentaenoic acid and docosahexaenoic acid </a> come from algae and oily fish like salmon, tuna, mackerel and sardines.</p>
<p>There is good evidence for the health benefits of <a href="http://link.springer.com/article/10.1007/s11745-010-3524-y">monounsaturated fatty acids</a>: these are found in olive oil, macadamia oil, avocado, and selected nuts like almonds and peanuts. </p>
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<p>Excess amounts of saturated fatty acids in the diet have been associated with increased risk of clogged arteries and heart disease (although this is <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-10-50">complicated</a> and may depend on their source). <a href="https://www-ncbi-nlm-nih-gov.ezproxy.uow.edu.au/pmc/articles/PMC3966685/pdf/AJPH.2013.301492.pdf">Saturated fatty acids</a> come primarily from red meat and processed foods, but dairy products, coconut and palm oil also contain them. </p>
<p>Highly processed food also contains <a href="http://www.nejm.org/doi/full/10.1056/NEJMra054035">trans fatty acids</a> which occur as a result of the hydrogenation of vegetable oils for margarine, commercial cooking and manufacturing. This process alters the structure of the fat, and these are associated with increased risk of heart disease.</p>
<h2>How do fats contribute to our health?</h2>
<p>Apart from contributing energy that our bodies need to work properly, <a href="https://medlineplus.gov/ency/patientinstructions/000104.htm">fats</a> have numerous important health benefits including healthy skin and hair, absorbing fat-soluble vitamins (A, D, E and K), and insulation to keep us warm.</p>
<p>Omega-3 and omega-6 polyunsaturated fatty acids are important for brain development. Docosahexaenoic acid is particularly concentrated in our brains, where it has multiple important roles in healthy <a href="https://www.ncbi.nlm.nih.gov/pubmed/23517914">brain function</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/23517914">cognition and mental health</a>. </p>
<p><a href="http://ebm.sagepub.com/content/233/6/674.short">Furthermore</a>, omega-3 polyunsaturated fatty acids produce important chemicals that reduce inflammation and blood clotting, and improve blood vessel dilation. Conversely, omega-6 polyunsaturated fatty acids promote inflammation, clotting and constriction of blood vessels. </p>
<p>A diet low in omega-3 and rich in omega-6 can therefore create a range of problems, including chronic inflammation and poor blood flow. These changes are associated with <a href="https://www.ncbi.nlm.nih.gov/pubmed/18408140">chronic diseases</a> such as obesity, heart disease, stroke, mental illness and dementia. </p>
<h2>What sorts of fats do Australians eat?</h2>
<p>In traditional societies, humans consumed a <a href="http://ebm.sagepub.com/content/233/6/674.short">ratio</a> of roughly 2-1:1 of omega-6 to omega-3 polyunsaturated fatty acids. This came about due to diets rich in fish, plant foods and free grazing animals, and eggs from chickens that ate plants high in omega-3 fats. </p>
<p>In industrialised regions such as Europe and the United States, the dietary ratio of omega-6 to omega-3 is very different, being closer to <a href="http://ebm.sagepub.com/content/233/6/674.short">16:1</a>. In <a href="https://www.ncbi.nlm.nih.gov/pubmed/12848284">Australia</a> it is estimated to be 8:1. </p>
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<img alt="" src="https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=707&fit=crop&dpr=1 600w, https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=707&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=707&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=889&fit=crop&dpr=1 754w, https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=889&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/143410/original/image-20161027-11239-f7an3o.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=889&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p>Therefore Australians are not meeting recommended guidelines for <a href="http://www.mdpi.com/2072-6643/8/3/111">omega-3 intake</a>, eating high levels of processed and takeaway foods, a lot of fatty red meat and not enough fish or vegetables. </p>
<p>This diet is associated with high levels of obesity and chronic disease in adult <a href="http://www.aihw.gov.au/food-and-nutrition/in-brief/">Australians</a>. </p>
<p>Furthermore, <a href="http://www.aihw.gov.au/food-and-nutrition/in-brief/">one in four Australian children</a> is overweight or obese. This age group also consumes excess saturated fat – largely through processed foods – and not enough <a href="http://onlinelibrary.wiley.com/doi/10.1002/lite.201400067/pdf">omega-3 fats</a>.</p>
<p>The recent <a href="http://openheart.bmj.com/content/3/2/e000385.full">Open Heart editorial</a> suggests such statistics may be reflective of poor dietary policy: </p>
<blockquote>
<p>It is the responsibility of the governments and international organisations to establish nutrition policies based on science and not continue along the same path of focusing exclusively on calories and energy expenditure, which have failed miserably over the past 30 years.</p>
</blockquote>
<h2>Confusion around dietary fat: low-fat diets</h2>
<p>Since the 1960s there has been a focus on low-fat diets to improve health. However recently recovered documents implicate a role for <a href="http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2548255">sugar industry</a> fraud in this focus. A sponsored program of research cast doubt on links between sugar and heart disease, and pointed the finger at fat instead. </p>
<p>There is now increasing high quality evidence that a Mediterranean-style diet high in monounsaturated fat from extra virgin olive oil is <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1200303#t=article">superior to a low-fat diet</a> in preventing heart disease and reversing <a href="http://www.sciencedirect.com/science/article/pii/S0168827813001347">fatty liver</a>, which is associated with metabolic syndrome and risk of type 2 diabetes. </p>
<p>Not only that, but a high fat Mediterranean diet is superior to a low-fat diet for <a href="http://www.nejm.org/doi/full/10.1056/nejmc1204792#t=article">weight loss</a>, and particularly for long term maintenance of weight loss.</p>
<p>This may be at least partly because <a href="https://theconversation.com/why-most-food-labels-are-wrong-about-calories-35081">all calories are not equal</a>: processed foods are thought to provide energy in a form that is more accessible to our bodies compared with raw or unrefined foods. </p>
<p>Fat is also more satiating, which may explain why a Mediterranean-style diet is more sustainable. Extra virgin olive oil is not only highly palatable, but its antioxidant properties have been associated with <a href="http://www.nature.com/ejcn/journal/v63/n12/abs/ejcn2009106a.html">weight loss</a>. </p>
<h2>Confusion around dietary fat: polyunsaturated fatty acids</h2>
<p>Guidelines in <a href="http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Polyunsaturated-Fats_UCM_301461_Article.jsp#.WA_muS195hE">America</a> and <a href="https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_book.pdf">Australia</a> recommend replacing saturated fat with polyunsaturated fat. In practice, this translates to recommending vegetable oils and margarines instead of butter, and thus replacing saturated fat with omega-6 polyunsaturated fatty acids. Little heed is paid to dietary content of omega-3 in this approach. </p>
<p>However, omega-3 and omega-6 polyunsaturated fatty acids are not the same. Recently <a href="http://healthland.time.com/2013/02/06/omega-6-fats-linked-to-increased-risk-of-heart-disease/">uncovered data</a> from a study conducted in Sydney in the 1960s showed that margarine containing linoleic acid (omega-6 fat) was associated with increased risk of early death.</p>
<p>When data across a range of studies investigating polyunsaturated fats and heart disease were re-analysed, study outcomes changed when omega-3 and omega-6 were separated rather than treated as a single factor. When <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/n-6-fatty-acid-specific-and-mixed-polyunsaturate-dietary-interventions-have-different-effects-on-chd-risk-a-meta-analysis-of-randomised-controlled-trials/938F3F74E18033ED061F7D8CEAB0A24A">separated</a>, omega-6 was found to be a risk factor for mortality, while omega-3 was protective. </p>
<p>This supports <a href="http://circ.ahajournals.org/content/106/21/2747.short">good evidence</a> linking omega-3s with heart health. Although some recently published research <a href="http://www.bmj.com/content/332/7544/752?query=rft.genre%25253Darticle%2526rft_val_fmt%25253Dinfo%25253Aofi%25252Ffmt%25253Akev%25253Amtx%25253Ajournal%2526ctx_ver%25253DZ39.88-2004%2526url_ver%25253DZ39.88-2004%2526url_ctx_fmt%25253Dinfo%25253Aofi%25252Ffmt%25253Akev%25253Amtx%25253Actx">questions</a> the importance of omega-3s in fish oil for prevention of heart disease, this interpretation has been <a href="https://www.ncbi.nlm.nih.gov/pubmed/24933212">professionally critiqued</a> due to <a href="http://www.issfal.org/statements/hooper-rebuttable">methodological flaws</a>. </p>
<h2>So where are we now?</h2>
<p>Australian dietary guidelines continue to recommend low-fat diets, polyunsaturated fats in place of saturated fats (without segregating omega-6 and omega-3), and no longer specifically recommend omega-3s for preventing heart disease. </p>
<p>Encouragingly, the recent <a href="http://www.nutritionaustralia.org/national/resource/healthy-eating-pyramid">Nutrition Australia</a> food pyramid has incorporated some significant changes reflecting evidence around the health benefits of a Mediterranean-style diet. </p>
<p>These changes include the placement of vegetables, fruit and legumes at the base of the pyramid, indicating the importance of high intake of plant foods, and extra virgin olive oil is depicted as a healthy fat.</p>
<p>In light of current evidence and consistent with the recent <a href="http://openheart.bmj.com/content/3/2/e000385.full?sid=acd05aa3-4e5f-4680-83bb-63aef173896f">editorial</a>, Australians can <a href="http://link.springer.com/article/10.1007/s11745-010-3524-y">improve their health and maintain a healthy weight</a> by aiming for an equal balance of omega-6 to omega-3 intake. </p>
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<hr><img src="https://counter.theconversation.com/content/67543/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Natalie Parletta (formerly Sinn) has received funding from Australian Research Council Linkage grants and is employed by NHMRC Program Grant funding. </span></em></p><p class="fine-print"><em><span>Barbara Meyer receives funding from the National Health & Medical Research Council, the Australian Research Council and is an independent scientific advisor for the Omega-3 Centre.</span></em></p><p class="fine-print"><em><span>Catherine Itsiopoulos receives funding and/or support from the National Health and Medical Research Council and primary food industries.</span></em></p><p class="fine-print"><em><span>Karen Murphy receives funding from the National Health & Medical Research Council, the food industry and a co-operative research centre; an Australian government funded initiative and is an independent scientific advisor for the Omega-3 Centre.. </span></em></p>A prominent new paper reflects growing global sentiment amongst scientists and dieticians to review advice relating to the types of dietary fats we should consume for optimal health.Natalie Parletta, Senior Research Fellow and Dietitian/Nutritionist, University of South AustraliaBarbara Meyer, Associate Professor in School of Medicine, University of WollongongCatherine Itsiopoulos, Head of School of Allied Health and Professor of Human Nutrition and Dietetics, La Trobe UniversityKaren Murphy, Senior Research Fellow in Nutrition and Cardiovascular Disease and Accredited Practicing Dietitian, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/649212016-09-13T10:32:04Z2016-09-13T10:32:04ZStop making health and well-being a moral issue<figure><img src="https://images.theconversation.com/files/137198/original/image-20160909-13359-shu18y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Virtue and vice? Or just food?</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-346420046/stock-photo-choosing-between-apple-and-donut.html?src=xvhTIuGbyrZ19f0os-Vs1Q-1-43">Ana D/Shutterstock.com</a></span></figcaption></figure><p>Applying a human moral construct to nature by dividing foods and lifestyles into good and bad is misleading. In reality, nothing in nature is either good or bad. For instance, our bodies need cholesterol for a variety of important purposes, while <a href="https://theconversation.com/four-things-you-should-know-before-starting-that-exercise-regime-63850">exercise</a> and <a href="http://news.bbc.co.uk/1/hi/uk/7876425.stm">sports</a> can be dangerous and even capable of ending our lives prematurely.</p>
<p>A recent study <a href="http://www.bmj.com/content/353/bmj.i1246">published in the BMJ</a> concluded that replacing saturated with polyunsaturated fat in diet may not prolong life, contradicting decades of received medical wisdom. Curiously, this conclusion was not based on new data, but rather on a new interpretation of old data. At the same time, we are witnessing a growing trend towards the <a href="http://www.independent.co.uk/life-style/health-and-families/health-news/is-sugar-the-new-evil-arguments-for-and-against-the-grain-9171543.html">demonisation of sugar</a>, with calls for a tax on sugary drinks.</p>
<p>The empirical evidence supporting the health benefits of <a href="http://circ.ahajournals.org/content/105/24/2836.short">drinking alcohol in moderation</a> was largely ignored by the chief medical officer, Sally Davies, when she recently cut down the <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/489795/summary.pdf">recommended daily limit</a>. The press later revealed that the committee that had drafted the guidelines had close links with the modern <a href="http://health.spectator.co.uk/no-wonder-britains-alcohol-guidelines-are-so-extreme-just-look-at-who-drafted-them/">temperance movement</a>.</p>
<p>“<a href="https://www.nationaleatingdisorders.org/orthorexia-nervosa">Orthorexia nervosa</a>”, an excessive preoccupation with “healthy” eating, has become a recognised clinical entity. Orthorexic patients apply moral qualities to their diet, developing in the process an affinity towards foods that are thought to improve health, and strong – even pathological – aversions against those foods that are believed to damage it. The emotions involved are so strong that patients will sometimes paradoxically compromise their nutrition in their quest for “the perfect diet”.</p>
<p>Product information in the supermarket shelves often includes moral claims, with labels such as “fair trade”, “be good to yourself” or “drink responsibly”.</p>
<p>We tend to attribute moral characteristics to food and lifestyle choices according to a perceived inverse correlation between pleasure and health. In this perverse “pleasure economy”, life can only be extended by renouncing and containing hedonism, just like the virtuous renounced all the pleasures of the flesh in order to access paradise in more religious times than ours. </p>
<p>In this way, a wholesome and unpleasurable diet, in conjunction with daily, and equally unpleasurable and strenuous exercise, will earn us the right to prolong our lives, while indulging in unearned and therefore illicit pleasure (such as alcohol, fats and sugar) will be punished with an early death.</p>
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<span class="caption">French temperance poster.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/w/index.php?curid=3238678">Frédéric Christol</a></span>
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<h2>Nature doesn’t care about good and bad</h2>
<p>Underpinning this moralistic approach is the idea of nature as a person with a moral code and a plan. It seems we have not fully accepted the mechanistic randomness of evolution and continue to attach a personal will to nature, as the successor of God in our secular society. In this context, we also see all things natural as good and man-made artifice as bad, ignoring the fact that illness and death are the most natural of events, often prevented by very artificial medical interventions.</p>
<p>In fact, nature (if it were a person) is only concerned with survival and reproduction. Indeed, we like fats and sugar precisely because the scarcity of high-calorie nutrition was the <a href="http://www.ncbi.nlm.nih.gov/pubmed/18257754">main threat to survival in pre-industrial societies</a>. So it is nature that has programmed us to desire them, for the same reason it programmed us to like sex: having a desire for fats and sex helps with survival and reproduction. Good things are associated with pleasure precisely because they are good for us, while we associate bad and dangerous things with fear and pain.</p>
<p>Unfortunately, pleasure can also be problematic for survival when it can be experienced without any constraints or limits. When pleasure can be had constantly, the benefit that was originally associated with it and facilitated survival – in this case, the energy contained in fats and sugar – is cancelled.</p>
<p>Just as we feel the need to tame our sexual desires with moral rules in order to avoid social chaos, we also seem to have developed the need to moralise other pleasurable choices, now that our access to them has become too easy.</p>
<p>The fact is that, ultimately, nature does not really care much about our moral choices. Even the nutritionally virtuous will die one day, just like the rest of us.</p><img src="https://counter.theconversation.com/content/64921/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rafael Euba does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sugar and saturated fat aren’t ‘evil’ and kale and avocado aren’t ‘good’.Rafael Euba, Consultant and Senior Lecturer in Old Age Psychiatry, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/578542016-06-08T03:54:45Z2016-06-08T03:54:45ZSaturated fats make some cells lose track of time – and that’s bad<figure><img src="https://images.theconversation.com/files/124207/original/image-20160526-22068-i24ret.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Out of sync.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-98154296/stock-photo-three-wall-clocks-showing-time-in-different-parts-of-the-world-in-office.html?src=WgZzNTrKTL_nL1-uZOMLpQ-2-36">Clocks via www.shutterstock.com.</a></span></figcaption></figure><p>Foods high in fat, especially saturated fat, are bad for you. A high-fat diet is a risk factor for cardiovascular disease as well as metabolic disorders like <a href="http://www.ncbi.nlm.nih.gov/pubmed/9225171">obesity</a> and <a href="http://care.diabetesjournals.org/content/25/3/620.full">type 2 diabetes</a>. So why does saturated fat have these effects on the body? What’s going on in your body when you eat a fatty meal? </p>
<p>I’ve been studying circadian clocks – internal biological clocks – and how they affect human health and disease for about 30 years. </p>
<p>These clocks exist in all cells throughout the brain and body. They regulate the timing of processes, such as keeping important metabolic and inflammatory responses in check in fat and immune cells. And if the clocks in our cells can no longer tell accurate time, those cell processes won’t occur at the “right” time of day or night. </p>
<p>My previous research demonstrated that genetic and environmental alterations of internal body clocks produce <a href="http://dx.doi.org/10.1074/jbc.M113.539601">metabolic disease</a>, like diabetes and obesity. </p>
<p>What we didn’t know until recently is that not only can saturated fat actually cause “jet lag” in the internal circadian clocks in some types of cells in the body, but this effect is accompanied by strong inflammation. This suggests why consuming saturated fat can lead to metabolic disorders and heart disease. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/125585/original/image-20160607-15052-c3gb7f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Palmitate is often found in fast food.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-305776586/stock-photo-group-of-burgers-plate-and-fries-beef-isolated-on-white.html?src=pp-same_artist-305801747-AY6F4i7ApCOCTybUatpcMg-5">Burgers via www.shutterstock.com.</a></span>
</figcaption>
</figure>
<h2>Testing ‘good’ fats and ‘bad’</h2>
<p>Our <a href="http://dx.doi.org/10.1016/j.ebiom.2016.03.037">study compared the effects</a> of a saturated fat, called palmitate, and an omega-3 polyunsaturated fat, called DHA, on body clocks and the induction of inflammation in cells. </p>
<p>We studied palmitate because it is commonly found in processed and fast foods and is known to trigger chronic inflammation, which is regarded as a causal factor in obesity and type 2 diabetes. DHA is a polyunsaturated fat (a “good” fat) and has anti-inflammatory properties, so we wanted to see if it could prevent or reduce the effect that palmitate had on cells.</p>
<p>We experimented on cultured mouse cells. Some cells were treated with either DHA or palmitate alone and other cells received palmitate and DHA at the same time so we could find out if healthy fat could protect cells from the effects of saturated fat.</p>
<p>After treating cells with palmitate and DHA at different times of the day, we analyzed the cells’ inflammatory markers. To read the cells’ “internal clocks” we measured how much their “molecular gears” luminesced or “glowed” in real time. This tells us where the cell is in its circadian cycle and if its processes are happening in sync with the cells around it.</p>
<h2>Saturated fat ‘jet lags’ circadian clocks</h2>
<p>We found that palmitate resets circadian clocks in some cells, but not all. If all clocks throughout the body were reset, then palmitate probably wouldn’t impose any noticeable changes. The time zone might shift, but all of the cells would in the same one, and would still work in sync.</p>
<p>Having some cells functioning in different “time zones” has consequences for our health.</p>
<p>For cells, functioning in a different time zone than the other cells around them is confusing. Think for a moment of how muddled you feel when you travel to a time zone that’s even just a few hours off from where you normally live. It takes a while to adjust, and until you do, you might get hungry, get sleepy or wake up at weird times. Now imagine the utter confusion for your body in trying to adjust internally to multiple time zones simultaneously so that many cells in your body feel that way, while other don’t.</p>
<p>“Jet lag” isn’t the only problem that palmitate causes for cells. It also induces inflammation in several different cell types. These two effects fluctuate in sync. For instance, in fat cells, both the inflammatory and jet lagging effects appear to peak at night. While there is no good time to eat saturated fat, it’s probably not a great idea to eat a meal rich in these “bad” fats late at night. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/122148/original/image-20160511-18140-mokrg5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There’s no good time to eat saturated fat, but nighttime is especially bad.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-246715423/stock-photo-portrait-of-a-man-taking-food-from-refrigerator.html?src=pu3SEXznqbFkzAhAvKo3Pg-2-7">Man and fridge via www.shutterstock.com.</a></span>
</figcaption>
</figure>
<p>We also tried to find out whether specific polyunsaturated “good” fats had protective effects on cells, and could counteract palmitate’s jet lagging and inflammatory effects.</p>
<p>We found that DHA, a common omega-3 polyunsaturated fatty acid, is anti-inflammatory. Besides inhibiting the inflammatory response to palmitate, this omega-3 also prevented cell clocks from being reset. </p>
<h2>Turning inflammatory responses on and off</h2>
<p>I think this work has significant implications in the management or prevention of metabolic and other inflammation-related disorders such as cardiovascular disease, stroke and arthritis. </p>
<p>Further studies with animal models will help us understand how saturated fats exacerbate inflammation. In terms of prevention, we can start looking at timed administration of omega-3 fatty acids or other anti-inflammatory treatments to prevent this jet lag and chronic inflammation.</p>
<p>There could be some benefit, for example, in figuring out how to use saturated fats like palmitate to turn on the body’s inflammatory responses. If we can figure out how to do that in specific tissues at specific times, we can use saturated fats to help the body respond to infection or injury. </p>
<p>Learning more about these cell-specific circadian clock changes and why they amplify inflammation will give us a better understanding of why high-fat diets, and saturated fat in particular, lead to metabolic disorders, like obesity.</p><img src="https://counter.theconversation.com/content/57854/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David J. Earnest receives funding from American Heart Association. </span></em></p>Saturated fats are linked to metabolic disorders and heart disease. That may be because thes fats make some cells lose track of time, causing inflammation.David J. Earnest, Professor of Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/598502016-06-01T12:21:28Z2016-06-01T12:21:28ZForget about fats – it’s processed food we should be worried about<figure><img src="https://images.theconversation.com/files/124346/original/image-20160527-869-153bkdu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=&searchterm=food%20factory&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=174437342">Yuangeng Zhang/Shutterstock</a></span></figcaption></figure><p>Last week, the National Obesity Forum caused a <a href="http://www.bbc.co.uk/news/health-36345768">furore</a> by claiming that eating fat, including saturated fat, will help cut rates of obesity and type 2 diabetes. Public Health England hit back, calling NOF’s advice “irresponsible”.</p>
<p>There’s wide agreement that modern diets have led to a rise in illnesses such as coronary heart disease and type 2 diabetes. Like most research, the recent controversy focuses on whether specific nutrients are the cause. </p>
<p>I’m not qualified to decide whether fat is good for you or will help you lose weight. But as a philosopher, and someone who has studied diet and health-related behaviours, I am curious about the question. What we ask determines what sorts of answer make sense. Does it make sense to focus on nutrients such as fat or carbohydrates, for example, or should we reframe the question?</p>
<p>There are many ways to think about the <a href="http://www.cpc.unc.edu/projects/nutrans/whatis">dietary changes</a> in Western societies over the past century or so. Of course, we can think in terms of nutrients: more sugar, more refined carbohydrates, more animal fats, more oils. Another change is in terms of agriculture and animal husbandry: new fertilisers and pesticides, new ways to feed and breed animals, new ways to hasten their growth. A third sort of change starts with an organisational revolution: <a href="https://twitter.com/garrathwilliams/status/735478021352787968">large corporations</a> now dominate our food supplies. </p>
<p>These corporations are armed with factories and laboratories, with brands and trademarks and marketing departments. And they have created a new sort of food: <a href="https://www.researchgate.net/publication/235627891_Profits_And_Pandemics_Prevention_Of_Harmful_Effects_Of_Tobacco_Alcohol_And_Ultra-Processed_Food_And_Drink_Industries">the ultra-processed variety</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=567&fit=crop&dpr=1 600w, https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=567&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=567&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=713&fit=crop&dpr=1 754w, https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=713&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/124021/original/image-20160525-25202-g70zp8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=713&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Why don’t we see cabbages advertised by modern food companies?</span>
</figcaption>
</figure>
<p>Raw ingredients are reduced to pulps and powders and concentrates and extracts. Chemicals are used to emulsify and enhance flavours (some of these familiar, such as salt, others unknown before modern chemistry). New technologies pound and process and bleach and coat, change liquids into pastes or solids, extract the last scraps from animal carcasses, and “fortify” with vitamins lost in earlier stages of processing. </p>
<p>We see appealing pictures of farms and crops on the packaging, but <a href="http://www.4thestate.co.uk/author/joanna-blythman/">we’ve no idea</a> how the products inside came from the baffling lists of ingredients.</p>
<p>Given these enormous changes, how can we discover which aspects of modern diets are damaging to health? I’ve just sketched out three major changes. But each of them involves many factors. So it is enormously difficult to establish which aspects of modern diets have increased rates of some illnesses.</p>
<p>This isn’t to say that conventional questions about different nutrients are unanswerable. Some answers are becoming clear: <a href="https://theconversation.com/sweet-enough-separating-fact-from-fiction-in-the-sugar-debate-21796">lots of sugar</a> isn’t good for us; <a href="http://www.sciencedirect.com.ezproxy.lancs.ac.uk/science/article/pii/S0149291814000538">trans-fats</a> are definitely bad for us. But just focusing on nutrients is a mistake. In particular, there are good reasons to think that modern food processing itself poses health risks.</p>
<p>Some of these problems overlap with concerns about specific nutrients. Adding salt, sugar or fat (sometimes all three) is a good way to make cheap ingredients palatable. Processing foods tends to remove the many micronutrients found in whole foods, and crops from modern industrial agriculture tend to be <a href="http://hortsci.ashspublications.org/content/44/1/15.full">poorer in micronutrients</a> anyhow. </p>
<p>Some problems overlap with concerns about energy intake. Processed foods tend to contain <a href="http://www.wphna.org/htdocs/downloadsdec2012/12-12_WN3_The_Food_System_PDF_SENT.pdf">less water and fibre</a>, so they are more calorie-dense and easier to consume in large quantities. </p>
<p>Alongside convenience, processed foods are carefully engineered for immediate appeal. They are also marketed with every trick in the book (unlike whole foods). All these factors encourage over-consumption. And then we can add suspicions that some aspects of modern food processing – various additives or <a href="http://shelflifeadvice.com/content/whats-our-food-maybe-processing-aids-maybe-not">“processing aids”</a> or chemicals in packaging – pose health risks of their own.</p>
<h2>Don’t focus on specific nutrients</h2>
<p>Focusing on specific nutrients such as fat or cholesterol has often damaged the reputation of whole foods. Many people limit their consumption of eggs, butter or red meat, for example. Processed food companies are in a better position to defend their products, though. Packaging can easily make or insinuate health claims. Margarine might be made who-knows-how with industrial trans-fats, but it can be formulated to be low in cholesterol to reassure us of its health value. The breakfast cereal might be over a quarter sugar, but the packaging emphasises the fibre or vitamin or iron content.</p>
<p>No one can see or taste nutrients themselves. To focus on them means trusting labels and mistrusting your senses. Confused, we pick up a low-calorie fizzy drink, then choose a low-fat yoghurt that contains all the sugar we just tried to avoid. When healthy eating guidelines focus on nutrients, we become more susceptible to the processed food and drink industry. </p>
<p>Claims that “fat won’t make you fat” <a href="http://www.dailymail.co.uk/news/article-3603951/Now-experts-say-eat-fat-combat-obesity-Damning-report-calls-major-overhaul-dietary-guidelines-advises-people-stop-counting-calories.html">make headlines</a>. I think they hide a more important idea also hinted at in the new report. On top of modern industrial agriculture, industrial food processing represents the <a href="http://www.journals.cambridge.org/abstract_S0029665110003903">biggest change to human diets</a> since people began farming. Major food and drink companies compete with one another. But as Carlos Monteiro, a professor of nutrition and public health at the University of São Paulo, <a href="http://www.wphna.org/htdocs/downloadsnovember2010/10-11%20WN%20Comm%20Food%20processing.pdf">remarks</a>, “they all have the same overall policy” – promoting ultra-processed foods. </p>
<p>Instead of asking about specific nutrients, we might also ask whether the rise of processed foods has contributed to the rise in diet-related diseases. And perhaps the best health advice is not to obsess about the latest demon nutrient, but to prepare whole foods for ourselves, adapting the old adage: everything in moderation, especially ultra-processed foods.</p><img src="https://counter.theconversation.com/content/59850/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Garrath Williams receives funding from the European Union’s Seventh Framework Programme (as part of the I.Family Study), and has previously received funding from the EU's Sixth Framework Programme (as part of the IDEFICS Study).</span></em></p>Arguing about the pros and cons of fat in our diet takes the focus away from the real nutritional demon: processed foods.Garrath Williams, Senior Lecturer in Philosophy, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/439092015-11-30T06:17:54Z2015-11-30T06:17:54ZHealth Check: the low-down on trans fats<figure><img src="https://images.theconversation.com/files/103602/original/image-20151130-23045-widwlm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Trans fats increase the shelf life of bakery goods and fast foods.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/castorgirl/3957442626/">skepticalview/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>When you buy commercially baked goods such as pies, pastries, cakes and biscuits, there’s a good likelihood they’ll contain one of the nastier types of fatty acids: trans fats. These unsaturated fats have been chemically altered to give them a longer shelf life and withstand repeated re-heating. </p>
<p>Trans fats are produced through hydrogenation, a manufacturing process where hydrogen is added into the fatty acid structure of fats. This stabilises the oil, allowing it to remain solid at room temperature and to be turned into margarine and cooking fat. </p>
<p>Small amounts of trans fatty acids (trans fats) are also found naturally in dairy and meat products. </p>
<h2>How big a problem are trans fats?</h2>
<p>The first artificially produced trans fats <a href="http://cspinet.org/transfat/timeline.html">date back to</a> the early 1900s, when a German chemist found a way to turn liquid oils into solid fats. </p>
<p>Trans fats were initially thought to be a healthy alternative to saturated fat, particularly <a href="https://www.washingtonpost.com/news/morning-mix/wp/2015/06/17/how-trans-fats-just-banned-were-once-touted-as-the-healthy-alternative/">after the 1950s</a>, when alarms were raised about saturated fats. </p>
<p>But by the 1990s the evidence indicated otherwise. Trans fats were linked with elevated LDL (bad cholesterol) and reduced HDL (good cholesterol), leading to an <a href="http://www.heartfoundation.org.au/SiteCollectionDocuments/Dietary-fats-transfat.pdf">increased risk</a> of heart disease. </p>
<p>The World Health Organisation <a href="http://www.who.int/nutrition/topics/trans_fatty_acids/en/">recommends</a> less than 1% of a person’s total energy intake be derived from trans fats. </p>
<p>Australia <a href="http://www.foodstandards.gov.au/consumer/nutrition/transfat/Documents/AE%202009%20Vol%2016%20-%20trans_fats%20Issue%2011.pdf">first measured</a> dietary intake of trans fats in 2005 and found it accounted for an average of 0.6% of our total energy intake. A 2015 update <a href="http://www.foodstandards.gov.au/consumer/nutrition/transfat/Pages/default.aspx">clocked</a> 0.5%.</p>
<p>The United States Food and Drug Administration (FDA) <a href="https://www.federalregister.gov/articles/2015/06/17/2015-14883/final-determination-regarding-partially-hydrogenated-oils#h-15">estimated</a> Americans’ intake of trans fats in 2012 was an average of 1g per person per day, or 0.5% total energy. </p>
<h2>Phase-out in the US</h2>
<p>The United States <a href="http://cspinet.org/transfat/timeline.html">introduced mandatory labelling</a> of trans fat content in foods in 2006. In June 2015, the FDA <a href="http://www.fda.gov/Food/IngredientsPackagingLabeling/GRAS/ucm2006850.htm">determined that</a> partially hydrogenated oils were not “generally regarded as safe” for use in human food.</p>
<p>The evidence for the determination came from four large population-based studies that found trans fat increases the risk of heart disease.</p>
<p>The US FDA <a href="https://www.federalregister.gov/articles/2015/06/17/2015-14883/final-determination-regarding-partially-hydrogenated-oils#h-15">expert panel concluded</a> the evidence demonstrated a linear, or proportional, relationship with no threshold effect. In other words, there is no safe level of consumption of partially hydrogenated oils.</p>
<p>The FDA has set a compliance period of three years for industry to reformulate products without trans fats or request special exemption for specific products. </p>
<h2>Voluntary reductions in Australia</h2>
<p>Around half of the trans-fats in Australian diets comes from dairy and meat products. </p>
<p>Australia’s food standards regulator, Food Standards Australia New Zealand (FSANZ), has <a href="http://www.foodstandards.gov.au/science/monitoringnutrients/Pages/Monitoring-of-trans-fatty-acids.aspx">taken the view</a> that public education and voluntary industry codes are the best approach to manage trans fats in the Australian context. Then, if needed, further regulations can be introduced. </p>
<p>Manufacturers have been encouraged to voluntarily reduce levels of trans fats in their products. FSANZ reports this is working; manufacturers have <a href="http://www.foodstandards.gov.au/publications/documents/TFAs_roundtable_2009.pdf">taken steps to reduce</a> levels. </p>
<p>Food manufacturers are not required to disclose on packs when their products contain trans fats, or in what quantities. Current regulations require only that manufacturers label trans-fats if they make a nutritional claim about cholesterol or saturated, trans or other fatty acid.</p>
<p>So it’s difficult for Australian consumers to make informed decisions about their trans fat intake. </p>
<h2>What can you do?</h2>
<p>You can reduce the amount of trans fats in your diet by making some <a href="https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5">simple dietary adjustments</a> that are also in line with the Australian dietary guidelines: </p>
<ul>
<li>Use oils and spreads made with canola, sunflower and olive oil</li>
<li>Choose to steam, stir fry, poach, bake or grill your meat or meat products</li>
<li>Reduce the amount of shallow- or deep-fried food you consume</li>
<li>Select lean meat and trim visible fat</li>
<li>Choose reduced-fat dairy products</li>
<li>Limit your consumption of commercially baked products, takeaways and fast foods.</li>
</ul><img src="https://counter.theconversation.com/content/43909/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lesley MacDonald-Wicks does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When you buy commercially baked goods such as pies, pastries, cakes and biscuits, there’s a good likelihood they’ll contain one of the nastier types of fatty acids: trans fats.Lesley MacDonald-Wicks, Senior Lecturer , University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/480072015-09-24T20:15:42Z2015-09-24T20:15:42ZExpert is as expert does: in defence of US dietary guidelines<figure><img src="https://images.theconversation.com/files/96033/original/image-20150924-17074-xcuzy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The main thrust of the advisory committee’s report is that diets should be focused on whole foods, not specific nutrients.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/usdagov/8263905087/">U.S. Department of Agriculture/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>National dietary guidelines have become an easy target for those looking for a scapegoat for bad diets in prosperous countries. And an article just <a href="http://www.bmj.com/content/351/bmj.h4962">published in the BMJ</a> about the scientific evidence for the US dietary guidelines provides further needless fuel for the fire.</p>
<p>In February 2015, an advisory committee of 14 experts appointed to review research evidence and inform the government of the relevant science underpinning the US dietary guidelines issued a <a href="http://health.gov/dietaryguidelines/2015-scientific-report/">570-page report</a>. Among its conclusions, the report recommended guiding the population to dietary patterns that are:</p>
<ul>
<li>rich in vegetables, fruit, whole grains, seafood, legumes and nuts </li>
<li>moderate in low-fat and non-fat dairy products and alcohol (among adults) </li>
<li>lower in red and processed meat, and </li>
<li>low in sugar-sweetened foods and beverages and refined grains.</li>
</ul>
<p>The report also recommended limiting marketing of unhealthy foods to children, clearer food labelling, and greater consideration of sustainability issues. </p>
<p>The report generated much angst. This was not unexpected – because so many people feel they’re experts in nutrition, and because it upset many <a href="http://www.usda.gov/factbook/chapter2.pdf">groups with vested interests</a> in maintaining the current US diet with its high levels of meat, junk foods and drinks. </p>
<p>The advisory committee received more than 29,000 written responses to its recommendations. <a href="http://www.sugar.org">The Sugar Association</a>, the National Pork Producers Council, the National Cattlemen’s Beef Association and the National Chicken Council <a href="http://union-bulletin.com/news/2015/mar/14/meat-industry-wages-war-new-guidelines/">all challenged the report</a>. </p>
<p>Senators <a href="http://www.grassley.senate.gov/news/news-releases/grassley-extension-public-comment-period-dietary-guidelines-advisory-committee">complained directly to Congress</a>, <a href="http://www.thune.senate.gov/public/index.cfm/press-releases?ID=2cbe42da-eac8-48c1-a820-44a392b57195">especially upset</a> that health and nutrition experts <a href="http://www.fcrn.org.uk/fcrn-blogs/samuel-lee-gammage/who-will-win-battle-over-sustainability-dietary-guidelines-americans">should consider sustainability</a>. <a href="http://www.futureoffood.ox.ac.uk/blog/us-dietary-guidelines-report-%E2%80%93-whats-fuss-over-sustainability">Others</a>, including <a href="http://www.hsph.harvard.edu/nutritionsource/2015/06/16/the-new-focus-on-sustainability-the-dietary-guidelines-for-americans-and-for-our-planet/">experts in the field</a>, were <a href="http://www.foodpolitics.com/2015/03/my-plate-my-planet-support-sustainability-in-dietary-guidelines/">supportive of its inclusion</a>. </p>
<p>A congressional hearing on the report has been scheduled for October 7.</p>
<h2>People in glass houses</h2>
<p>The recommendations also met with displeasure from those who promote high-fat, low-carbohydrate diets. And this week the BMJ has unfortunately given voice to one such person. US journalist and author of <a href="http://thebigfatsurprise.com/">The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet</a> Nina Teicholz has published an “investigation” into the report and its authors.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/96030/original/image-20150924-17087-1o9rtjz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A new advisory report on US dietary guidelines has upset many in the meat and junk food industries.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/brizzlebornandbred/9375507295/in/photolist-fhtVFv-ff52LL-ff52BN-4z5AkF-6CMYYq-6CMZ9s-7cXRW8-4z5D48-4z5vot-4z5yqD-4z9T2w-4z9TrA-4z5za8-y4gkiG-4z9TJL-a95RFU-4z5BKM-4z5DiH-e1iERv-5kk29W-aj1328-5B1sk7-sMsxA-e1NAEK-4z9RyY-czfSzC-h">Paul Townsend/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>In line with the arguments of her book, Teicholz criticises the scientific report for the 2015 guidelines. She claims the advisory committee didn’t conduct thorough reviews of recent evidence and failed to identify their conflicts of interest. </p>
<p>But, after a close look, I could find little evidence of conflict of interest among the committee members. Its members were carefully selected to provide balanced viewpoints on the scientific evidence, and to not represent the viewpoints of any specific group. They conducted public meetings and also invited various other experts to present data. </p>
<p>It’s hard to understand Teicholz’s criticism of such an extensive, systematic and practical report. The methodology <a href="http://health.gov/dietaryguidelines/2015-scientific-report/05-methodology.asp">the panel used</a> was thorough, clearly outlined and followed strict scientific guidelines.</p>
<p>Over a two-year period, the committee examined a vast amount of data in a detailed and scientifically rigorous way. Its answers to science-based research questions were published at the <a href="http://www.nel.gov/">USDA Nutrition Evidence Library</a> (NEL). The committee also used systematic reviews that pay great attention to sources and types of bias, and graded all this evidence according to strict and well-defined criteria. </p>
<p>Perhaps in keeping with her own conflict of interest in promoting the ideas in her book and the listed conflicts in the BMJ piece (honorariums from the restaurant, meat and dairy industries), Teicholz is especially critical of the advice concerning saturated fat. The US diet is high in saturated fat, with much of it coming from vegetable oils hydrogenated for use in commercial frying, pizzas, pastries, cakes and desserts, biscuits, savoury and sweet snack foods. Some of it comes from a high intake of processed and fatty meats, including burgers. And cheese is a major source. </p>
<h2>Saturated fat controversy</h2>
<p>The advisory committee’s report doesn’t ignore the recent controversy over saturated fat and heart disease. In fact, it <a href="http://health.gov/dietaryguidelines/2015-scientific-report/11-chapter-6/d6-2.asp">specifically discusses major studies</a> of randomised controlled trials and prospective cohort studies conducted between 2009 and 2014. The committee placed particular emphasis on reviews that looked at what <em>replaces</em> saturated fat in most diets, a move suggested by authors of recent research reviews that reported a lack of relationship between total intake of saturated fat and heart disease. </p>
<p>The <a href="http://www.cochrane.org/CD011737/VASC_effect-of-cutting-down-on-the-saturated-fat-we-eat-on-our-risk-of-heart-disease">best evidence</a> still points out that when saturated fats are replaced with polyunsaturated fats, cholesterol levels improve and the risk of cardiovascular disease declines. But the key is where these polyunsaturated fats come from; getting them from deep-fried foods or snack foods, for instance, won’t improve heart health.</p>
<p>The claim by some critics that the committee’s report advocates a low-fat or high-carb diet is wrong. Indeed, the report specifically notes that swapping saturated fat for sugar and refined grains is useless. Instead, it recommends foods high in unsaturated fats, echoes the recommendation from the <a href="http://www.who.int/mediacentre/factsheets/fs394/en/">World Health Organization</a> that added sugars be limited to no more than 10% of total daily calories, and recommends big reductions in refined grains.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/96031/original/image-20150924-17062-11jw54q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The US diet is high in saturated fat, with cheese being a major source.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/cogdog/8690615113/">Alan Levine/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Teicholz claims the committee ignored many studies of low-carbohydrate diets. But, as the report notes, most have been small, short-term, often pilot or case-control studies that rely on subjective recall of information (both of which rate poorly as evidence). When you look at <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0100652">published trials</a> of such diets being undertaken for six months, there’s little difference in weight-loss outcomes compared to more balanced approaches.</p>
<p>Teicholz accepts that effects of low-carb diets are not maintained in the long term but defends them with reference to only <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0056190/">one meta-analysis of stricter low-carb diets</a>. It’s an odd choice since the authors include “grey” literature, which is not peer reviewed, and comes from organisations outside of academic publishing channels. Her chosen study also concludes that, in the long term, and when compared with conventional therapy, results of even strict low-carb diets appear to be of little clinical significance. </p>
<p>Had the advisory report made recommendations on this basis, Teicholz would have a valid complaint.</p>
<h2>Eat food, not nutrients</h2>
<p>The <a href="https://theconversation.com/eat-food-not-nutrients-why-healthy-diets-need-a-broad-approach-45823">food sources</a> for fats or carbohydrates matter; talking in broad terms of these macronutrients fails to distinguish between healthy foods and junk foods. The main thrust of the advisory committee’s report is that diets <a href="http://www.ncbi.nlm.nih.gov/pubmed/24572039">should be focused on whole foods</a>, not specific nutrients. And that makes a lot of sense.</p>
<p>Consider this: bacon, lard, olive oil and nuts all contain saturated fat to some extent. Dietary patterns containing plenty of the latter two are linked to health benefits. As for the first two, back slowly away from the bookshop when anyone is trying to sell you on these being the keys to good health and weight loss. The report notes evidence showing benefits for dietary patterns that favour olive oil and nuts.</p>
<p>Teicholz is not the only one to complain about the committee’s report. Nor is this anything new. Dietary guidelines produced in other countries, <a href="https://www.nhmrc.gov.au/guidelines-publications/n55">including Australia</a>, also attract mud-slinging. Sadly, this serves to confuse the public and leads some to abandon advice because “experts are always changing their minds”.</p>
<p>So it’s not surprising that lobbyists for the sugar and meat industries as well as companies marketing junk foods <a href="http://blog.aicr.org/2015/06/25/lobbyists-move-to-weaken-the-dietary-guidelines-help-us-protect-them/">have been vocal</a> about the US report. It’s just a pity that a reputable journal such as the BMJ decided to publish such an article from a journalist rather than an expert scientific appraisal.</p><img src="https://counter.theconversation.com/content/48007/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>National dietary guidelines have become an easy target for those looking for a scapegoat for bad diets in rich countries. And a BMJ article about draft US guidelines adds further fuel for the fire.Rosemary Stanton, Nutritionist & Visiting Fellow, UNSW SydneyTim Crowe, Associate Professor in Nutrition, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/458232015-08-13T20:30:36Z2015-08-13T20:30:36ZEat food, not nutrients: why healthy diets need a broad approach<figure><img src="https://images.theconversation.com/files/91723/original/image-20150813-21401-1ix0h71.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">We need to stop fussing over macronutrients and think about foods.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/eugenia_loli/17459500360/">Eugenia Loli/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>There seems to be a shortening gap between studies about diet, nutrition and health. And each starts another conversation about trans vs saturated vs polyunsaturated fats, or this diet vs that, or, as is today’s case, fats vs carbohydrates.</p>
<p>In a paper published today in the <a href="http://www.cell.com/cell-metabolism/abstract/S1550-4131(15)00350-2">journal Cell Metabolism</a>, researchers found that when 30% of a day’s kilojoules were restricted by cutting fats (diets with a higher intake of carbohydrates), participants in their study lost more body fat compared to when the same amount of energy was restricted by cutting carbs (diets with a higher intake of fat).</p>
<p>This study used a type of meticulous metabolic research, which is expensive and unsuited to lengthy periods, but valuable for exploring the physiology of reducing equal dietary contributions from fat or carbohydrate. But like much dietary analysis, it may be shining a light on the wrong issues altogether.</p>
<h2>The good, the bad and the ugly</h2>
<p>The most important aspect of any diet is that it should be practical and healthy enough to follow for the rest of your life. There’s no magic bullet for weight loss. While some people claim they find it easier to cut out foods high in carbohydrates, others find it easier to avoid high-fat foods. </p>
<p>If you need to lose weight, <a href="http://jama.jamanetwork.com/article.aspx?articleid=1900510">cutting down is what helps</a>. But few people can stick to any extreme diet for life, so what you substitute is just as important as what you cut out – especially for long-term health.</p>
<p>Choices based only on macronutrients (foods required in large amounts in the diet, such as fats, carbohydrates and protein) miss important aspects of many foods and open the diet to imbalance. Carbohydrate foods, for instance, include nutritionally worthy choices – such as legumes, wholegrains, fruits, milk and yoghurt – but also a huge range of items high in sugar or refined starches with little or no nutritional attributes. “Cutting carbs” doesn’t distinguish between the good and bad foods in this category.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/91726/original/image-20150813-21387-vtzp7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This may not be the best way to get your daily ration of fruit.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/chodhound/7755540602/">Adrian Scottow/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>The same thing happens with fats. Sources of unsaturated fat – such as nuts, seeds, avocado or extra virgin olive oil – have proven health benefits. But there’s no evidence for any benefits of lard, dripping, cream, fast foods or any of the fatty snack foods that account for much of our saturated fat intake. And no long-term study shows sustained weight loss or other health benefits from a diet high in saturated fats.</p>
<p>Some foods are more even problematic. Most fast foods are high in saturated fat and salt, and lack dietary fibre. And they’re not only largely devoid of vegetables (apart from the odd gherkin), but often displace meals that would have contained vegetables. </p>
<p>Biscuits, cakes, pastries, many desserts and confectionery provide a double whammy with high levels of unhealthy fats as well as sugar and refined starches. Make that a triple whammy because most lack any nutritional virtue as well.</p>
<h2>From bad to worse</h2>
<p>Assumptions based on macronutrients are simply too gross to be meaningful. This is apparent in so-called meta-analyses based on a mixture of cohort and case-control studies that use different methods and time frames relating to what people eat, and fail to report all aspects of the diet.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/24723079">One review</a>, for instance, claimed that saturated fat was unrelated to cardiovascular disease. But it ignored the adverse impacts of the foods that had replaced saturated fats and provided no information about the foods that provided saturated fat in the first instance. </p>
<p>Worse still, such analyses are prone to many errors. A long <a href="https://www.mja.com.au/journal/2015/202/8/sceptics-undermine-effective-dietary-and-heart-health-advice?utm_source=MJA+news+alerts&utm_campaign=2313abfd38-MJA_news_vol_202_Issue_8_4_May_20155_1_2015&utm_medium=email&utm_term=0_8c7e70a099-2313abfd38-31315341">check of every reference</a> used in that meta-analysis showed that the conclusion would have differed if 25 studies had either not been omitted or had been reported correctly (sadly, it’s paywalled). </p>
<p><a href="http://www.bmj.com/content/351/bmj.h3978">Another recent review</a> also failed to show any clear association between higher saturated fat intake and all-cause mortality, heart disease, ischaemic stroke or type 2 diabetes, although the authors were unable to confidently rule out increased risk for heart disease deaths. They also noted that the certainty of associations between saturated fat and all outcomes was “very low”, which means we don’t yet understand the association between saturated fats and disease.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=479&fit=crop&dpr=1 600w, https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=479&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=479&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=602&fit=crop&dpr=1 754w, https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=602&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/91725/original/image-20150813-21387-123i532.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=602&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Not all dairy products are created equal.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/samir-rahamtalla/393729330/">Samir Rahamtalla/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Hopefully, further research will distinguish between food sources of saturated fats; they are not all equal. There’s already good evidence that processed meats can have more deleterious effects than fresh meat. And that fermented dairy products, such as <a href="http://ajcn.nutrition.org/content/71/3/674.full.pdf+html">yoghurt</a> and <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383488/">cheese</a>, may also have health benefits and are distinctly different for heart health risk <a href="http://ajcn.nutrition.org/content/94/6/1479.long">compared to butter</a>.</p>
<p>Swapping saturated fat for sugar or refined starches is worse than useless <a href="http://www.ncbi.nlm.nih.gov/pubmed/26185980">for preventing cardiovascular disease</a>. But please direct criticism of foods where fat has been replaced by sugar at the food industry. Dietary guidelines have always recommended limiting sugar as well as saturated fat. </p>
<h2>A sorry state of affairs</h2>
<p>Unfortunately, in most developed countries, sugar consumption remains high while intakes of vegetables, legumes, fruits, nuts and wholegrains are low. And while macronutrient intakes in countries such as Australia may look fine (31% of energy from fat and 44% from carbs), problems remain with the kinds and amounts of foods we consume.</p>
<p>Junk food and drinks were once consumed only as an occasional treat, but they now contribute significant portions of both adult and children’s diets – in Australia, 35% of adults’ and 41% of childrens’ energy intake. Confectionery and starchy, fatty, savoury snack food intake have also increased significantly. </p>
<p>It really is time to focus on foods instead of wasting time on macronutrients. <a href="http://www.eatforhealth.gov.au">Australia’s Dietary Guidelines</a> have made this change, as has the <a href="http://www.livsmedelsverket.se/globalassets/english/food-habits-health-environment/dietary-guidelines/kostrad-eng.pdf?id=8140">new simple Swedish equivalent</a>, which emphasises sustainable choices. <a href="http://www.fao.org/nutrition/education/food-based-dietary-guidelines/regions/countries/norway/en/">Norway</a> and <a href="http://www.fao.org/nutrition/education/food-dietary-guidelines/regions/europe/en/">20 European countries</a> also take a food focus and the number one point in <a href="http://189.28.128.100/dab/docs/portaldab/publicacoes/guia_alimentar_populacao_ingles.pdf">Brazil’s enlightened guidelines</a> is that diet is more than the intake of nutrients.</p>
<p>Consider the dozens of studies on Mediterranean diets, including randomised trials, where the fat and carbohydrate content vary but the health value depends on particular foods: extra virgin olive oil, nuts, vegetables, fruits, grains and legumes and a low intake of highly processed products. The take-home message from these is that we need to stop fussing over macronutrients and think about foods.</p><img src="https://counter.theconversation.com/content/45823/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rosemary Stanton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>By focusing on micro- or macronutrients, most nutrition research fails to recognise the most important truth about food: diet is more than the intake of nutrients.Rosemary Stanton, Nutritionist & Visiting Fellow, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/377302015-04-03T19:47:05Z2015-04-03T19:47:05ZWhat’s your Easter bunny made of? Could it have palm oil in it?<figure><img src="https://images.theconversation.com/files/76936/original/image-20150402-9328-vj0exp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/11561957@N06/8623422288/in/photolist-e92i1C-e92iew-6ejWke-e92iiw-e8VDtM-6fXa22-9LTX6D-7NwJkD-e84aca-9CPM6r-bwNurU-e84ag4-7QkqJs-bssTLC-9mpMuE-6ejWkz-9DsLgt-9xRmDf-9BGLfS-9AxPWX-9nxAgR-bLaoft-9BVcTi-dYRSKh-e8943V-ed4rRi-7RoGUV-e7bk3k-byW44i-btDaGF-byW48T-bm2b9s-bxjiwB-bxjixH-bxjizz-bxjiyK-bxjiAD-btDaJF-HaNY-ngZZbz-bm2b6m-bm2b2S-bm2b7f-byW45R-6cNbmi-EMqYz-9zJxFm-btDaKM-6oZ2q5-6oUTsg">Spirit of Easter</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>It may come as no surprise that fats and oils are part of any piece of chocolate we eat. But the push to cut trans fats from food for health reasons has created demand for palm oil, an ingredient with significant environmental impacts. </p>
<p>The rapid expansion of palm oil production for food and biofuels in the past 25 years in Indonesia and Malaysia has been blamed for <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1755-263X.2008.00011.x/full">loss of biodiversity</a> and land-use changes that <a href="http://www.worldwatch.org/node/6059">increase carbon emissions</a>. About <a href="http://www.palmoilworld.org/nutrition.html">80% of palm oil production goes into food</a>, according to a web site sponsored by the Malaysian Palm Oil Board.</p>
<p>Palm oil is used in many candies with chocolate, although a number of confectionery producers do not use it or have started to use <a href="http://wwf.panda.org/what_we_do/footprint/agriculture/palm_oil/solutions/responsible_purchasing/palm_oil_buyers_scorecard_2013/conclusions_04112013_0920/">certified sustainable palm oil</a>. The El Paso Zoo is just one of the organizations that lists candy products with palm oil, including goodies for a <a href="http://www.elpasozoo.org/docs/Palmoil-candy.pdf">palm oil-free Easter basket filler</a>.</p>
<p>The conversation around palm oil clearly illustrates the conundrum often created by single-issue activism and why we must think holistically about the food system. </p>
<h2>Before you bite that chocolate bunny</h2>
<p>Fats and oils can be of animal origin, such as butter fat, tallow and lard, or of vegetable origin, such as soy bean oil, canola oil or palm oil. Natural fats are generally processed to remove gums, colors and odors. Their solid and liquid components may be separated into their component fats <a href="http://en.wikipedia.org/wiki/Stearin">stearins</a> and <a href="http://www.merriam-webster.com/dictionary/olein">oleins</a>, and oils may be hydrogenated to render them more solid.</p>
<p>The US standard of <a href="http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=163">identity for chocolate</a> permits only two fats: cocoa butter, the natural fat of the tree <em>Theobroma cacao</em>, and milk fat, which is also known as butter oil.</p>
<p>If any other “safe and suitable” vegetable fat, oil or stearin is added, the product may no longer be labeled “chocolate.” Instead, it legally becomes “sweet cocoa and vegetable fat coating,” “sweet chocolate and vegetable fat coating,” “milk chocolate and vegetable fat coating,” or more commonly known as chocolate-flavored confectioners’ coatings. Alternatively, the common or usual name of the vegetable-derived fat ingredient may be used in the name of the food, such as “sweet cocoa and palm oil coating.” </p>
<p>Most chocolate confections are not made of solid chocolate, and other vegetable fats and oils find their way into the fillings, centers or inclusions. For example, a truffle center might contain hazelnut paste, which is about 60% hazelnut oil, and a peanut butter cup obviously contains peanut oil. In these composite “candy bars” the technical properties of the fat, notably its melting point, are extremely important. </p>
<p>The melting point of liquid oils can be increased through hydrogenation of unsaturated fatty acids. Unfortunately, trans fatty acids may be created in this process and they have been shown to increase LDL cholesterol and decrease HDL cholesterol and, therefore, may increase the risk of coronary heart disease.</p>
<h2>Enter palm oil</h2>
<p>Consumers have expressed a desire for products with fewer ingredients and “cleaner,” simpler labels. As of January 2006, the Food & Drug Administration has required labels to include the trans fat content. In response, the food industry has sought means of reducing the trans fats, including the use of natural fats that have properties similar to hydrogenated oils and improvements in the hydrogenation process that avoid the formation of trans fatty acids. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/76938/original/image-20150402-9309-w6wpc1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The spread of palm oil plantations has led to destruction of rainforests.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/cifor/5640293162/in/photolist-9ApYDQ-9FRCoF-cZy8H5-cZy93C-bnL1NN-cZy8Qm-9ApY1h-cZy9ed-9GsUwi-gRgLVv-9EpmFv-cZyaU7-9BP9gx-e3hbRB-e3nSHG-pfKEyr-ohhUjQ-e3nSzq-cSD4aN-9FUzru-9FUB7m-cZy9qS-bYXp5C-9dsnMt-9dsqtK-e3nT8q-e3ha8g-e3nQJJ-bYYgQh-9FT6u5-e3nRSQ-cZyaCq-cZyaJ9-e3nRmh-e3hbea-e3haHR-nZZh3q-ohhTVd-9EsiaQ-cZy9yQ-9GsZ8p-cSD427-nZZg3Q-7xRtF-ohhSAj-ohtDp8-9dsnBt-9c9ro6-q5HkFt-9ccwDG">Yayan Indriatmoko for Center for International Forestry Research (CIFOR)</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>Palm oil is obtained from the pulp of the fruit of one or more species of oil palm, principally <em>Elaeis guineensis</em>. It is a common cooking oil in tropical regions of Africa, Asia and South America. It is naturally reddish in color due to high levels of beta-carotene. It is not the same as palm kernel oil, derived from the same plant, or coconut oil obtained from the coconut palm, <em>Cocos nucifera</em>. Palm oil is a moderately saturated fat (about 40%) making it semi-solid at room temperature and a good technical substitute for hydrogenated oils. </p>
<h2>Real health benefit?</h2>
<p>There is some concern that substituting palm oil for trans fatty acid containing fats, including hydrogenated soy bean oil, may not reduce the risk of coronary heart disease. A recent <a href="http://www.oeaie.org/content/uploads/2014/08/Fattore2014_Palm-oil-and-blood-lipid%E2%80%93related-markers-of-cardiovascular-disease.pdf">meta-analysis</a> of dietary intervention trials incorporating palm oil concluded that both favorable and unfavorable changes in risk occurred when palm oil was substituted for other dietary fats. </p>
<p>Yet the growing consumer demand for trans fat-free products has stimulated the rapid expansion of palm oil plantations, often at the expense of native forests. This has been particularly acute in Indonesia, where habitat destruction has <a href="http://www.orangutan.com/threats-to-orangutans/">threatened the orangutan</a>. </p>
<p>In response, the Roundtable on Sustainable Palm Oil (RSPO), an industry-led organization, promulgated the Certified Sustainable Palm Oil standards. According to RSPO’s website, only <a href="http://www.rspo.org/about/impacts">18% of global palm oil is certified</a>. </p>
<p>It seems straightforward to demand that food manufacturers simply remove trans fats from the diet, but in doing so we need to consider what they will be replaced by. Similarly, we can avoid eating palm oil, but what will we eat instead and what effect will that have on our health and the health of our environment?</p><img src="https://counter.theconversation.com/content/37730/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gregory R. Ziegler is affiliated with PMCA.</span></em></p>Why do chocolate makers and other food producers use unsustainably grown palm oil? You can blame health-conscious consumers looking for alternatives to trans fats.Gregory R Ziegler, Professor of Food Science, Penn StateLicensed as Creative Commons – attribution, no derivatives.