Is the problem saturated fat or sugar?

bacon&sugarWhich food component is the true nutritional evil: saturated fat or sugar?  In a recent opinion piece in the British Medical Journal, cardiologist Aseem Malhotra argues that our obsession with saturated fat as the cause of heart disease is way off base and needs to be scrapped.  He argues that while saturated fat intake may be linked to high total cholesterol, association does not equal causation.  A low saturated fat diet only affects one type of “bad” LDL cholesterol: the large fluffy particles.  Unfortunately, it’s the small dense LDL particles that are linked to atherosclerosis, and diet has no effect on those.

He also argues that removing fat from food removes taste.  Solution: food manufacturers add more sugar and sweeteners to perk up the flavor.  Result: sugar intake went up.  And high sugar intake is now linked to a cluster of chronic diseases: Type 2 diabetes, metabolic syndrome, hypertension, high triglyceride a, inflammation and kidney disease.  Not to mention obesity, from excess calorie intake.

The continued hysteria about saturated fat and blood cholesterol reinforces the belief that high total cholesterol must be attacked on all fronts.  Which makes statin drugs very attractive.  Millions of people now take statin drugs, simply because their total cholesterol is higher than recommended.  But as Dr. Malhotra notes, statins don’t affect those small dense LDL particles.  Plus statins cause a variety of adverse side effects.

Meanwhile the saturated fat supporters point to studies showing that refined carbohydrate intake is the real culprit in chronic disease.  They claim saturated fat has no effect and intake doesn’t have to be limited.  Some even suggest saturated fat is healthy, and that a low sugar high saturated fat diet is just fine.

So now we’ve got two camps, armed with “proof” that their nutritional belief system is the right one:

  1. The saturated fat defenders, who claim all problems come from sugar.
  2. The saturated fat haters, who advocate low fat diets as a cure all.

Food manufacturers are mostly stuck in “low fat” mode, judging from food labels.  There aren’t any products being touted as “high in saturated fat” on the label, although it’s pretty easy to recognize those foods.  Bacon is the most iconic example, along with butter.

Can you go back to eating bacon, butter and rib eye steaks every day (or just continue eating those, minus the guilt)?  Is it just a matter of avoiding sugar?  Here are some take away points:

  • A diet full of added sugar is a really bad idea.  You’re eating lots of empty calorie sugar, which crowds out healthy, nutrient-dense foods.  Plus it’s easy to overeat calories and gain weight.  And if the evidence of a link between excess sugar and chronic disease holds up, your health will suffer.
  • The diet that is always linked to better health is the low sugar/low saturated fat Mediterranean Diet.  It’s not low fat though; the focus is on plant-based unsaturated fats.  Nuts, olive oil, avocados and other vegetable oils are healthy alternatives to butter and bacon.
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