Local experts explore the truth about fat

Many everyday foods contain healthy fats that lower cholesterol and prevent heart disease.
GOOD FAT BAD FAT: Many everyday foods contain healthy fats that lower cholesterol and prevent heart disease.

Here’s the first thing you need to know about fat: It’s complicated.

“Fat is confusing for everybody because we don’t agree,” says Taft Draper, a Hendersonville-based registered dietitian. “The body is very complex, and everyone is different.”

On the surface, it seems fairly simple. There are three main types of fat — unsaturated, saturated and trans fats. For years, the message has been that saturated and trans fats are bad and unsaturated fat is good. But dig a little deeper and you’ll find that it’s not so cut-and-dried. “How fat affects the body has been debatable for decades,” says Kendra Gaffney, a registered dietitian at Nutritious Thoughts in Asheville. What the scientific community is coming to terms with now, she says, “is that the body needs both saturated and unsaturated fats.”

But it’s hard to shake the ingrained belief that some fats are better for our bodies than others. Picture the comic strip where one avocado says to the other, “I said you were the good fat.” Still, even the notion of good and bad fat is being contested these days. “There are roles for fat and there are roles for saturated fat in our body,” says Denise Barratt, a registered dietitian in Asheville and owner of Vine Ripe Nutrition. In other words, the topic of fat isn’t as black and white as we used to believe it was.

Saturated fat

Saturated fats are found in animal products and tropical oils and are usually solid at room temperature. Think butter, lard and coconut oil.

Yes, coconut oil. Though it may be the new, trendy oil, according to the Journal of the American College of Cardiology, “solid fats, including coconut oil and palm oil, have deleterious effects on atherosclerotic cardiovascular disease risk factors. Current claims of documented health benefits of the tropical oils are unsubstantiated, and use of these oils should be discouraged.”

The Academy of Nutrition and Dietetics states that “virgin coconut oil is high in lauric acid, a medium-chain fatty acid that raises both good and bad cholesterol levels.” Draper explains that dietary medium-chain triglycerides have been shown to radically reduce the production of a variety of proinflammatory markers, increase the activity of the histamine-clearing enzyme, increase mucus production, and support gut-barrier healing. Draper adds that “coconut oil also has diverse antimicrobial properties and thus may be great for people with bacterial or yeast overgrowth.” But even with these benefits, the Academy of Nutrition and Dietetics still warns that coconut oil is a saturated fat, and one should “use coconut oil in moderation and buy the kind labeled ‘virgin.'”

So should we avoid all saturated fats? The American Heart Association says that “decades of sound science have proven that it can raise your bad cholesterol and put you at higher risk for heart disease.”

And yet, without some saturated fats our bodies will suffer. According to current dietary thinking, the human body uses some saturated fats for physiological and structural functions. The catch, however, is that the body itself makes more than enough saturated fats to meet those needs. Therefore, the guidelines state that individuals 2 years and older have no dietary requirements for saturated fats.

Yet other studies have shown that there is no scientific evidence linking saturated fats to coronary heart disease or cardiovascular disease. “They used to believe that because we had fats in our blood stream, that these fats must be the cause of clogged arteries,” says Gaffney. “What they’re actually finding now is that a large part of developing high cholesterol stems from a genetic predisposition. Saturated fats don’t necessarily cause harm; they’re just more of a neutral fat.”

Unsaturated fat

Unsaturated fats are the fats that have historically been considered healthy, and they come in two forms: monounsaturated and polyunsaturated.

Monounsaturated fats are found in olive oil, canola oil, peanut oil and peanut butter, avocados, nuts and seeds and are generally considered to benefit the body by reducing cholesterol and lowering the risk of heart disease.

Polyunsaturated fats come in two forms: omega-3 and omega-6. Salmon, trout and other fatty fish, walnuts and flax seed are all good sources of omega-3’s. Much like monounsaturated fats, omega-3’s are thought to provide health benefits.

But here’s where unsaturated fats get tricky. Omega-6 polyunsaturated fat is found in many grains and vegetable oils. “The problem with omega-6 is that, because of processed foods in our diet, we tend to get too many of those when compared to omega-3’s,” says Barratt. The implication, explains Draper, is that high omega-6 levels can lead to inflammation, which can lead to illnesses and diseases. “It leads to autoimmune conditions and a decrease in the quality of life. It can lead to cancer, diabetes and cardiovascular disease,” he says. Stated plainly, too many omega-6 fats, especially when combined with too little omega-3 fats, can throw your body out of whack.

Trans fats

There are two types of trans fat. The first is naturally occurring fat produced in the gut of some animals and found in some animal products that we eat. The second is artificial trans fat. Trans fat is primarily found in partially hydrogenated oils, which find their way into many of our processed foods.

“Another word for artificial trans fat is hydrogenated,” explains Barratt. “And that means that it was probably a healthier fat, but some of the double or single bonds in the fat were artificially removed in a factory and extra hydrogen was artificially added to make it thick and creamy and to extend shelf life.”

The American Heart Association claims that trans fat raises your bad cholesterol levels, lowers your good cholesterol levels and increases your risk of stroke, heart disease and developing Type 2 diabetes.

And yet, in 2015 a study in Germany claimed that trans fat might not be as bad for our health as we once feared.

With all of this conflicting information, what should we believe? “Part of the whole thing is, if there’s hype and sensationalism, it sells,” says Barratt. “A lot of things we see may not be based on hard research or clinical trials.” Barratt says that in her own life she tries to eat one-third of her diet as monounsaturated fats, one-third as polyunsaturated fats and one-third as saturated fats.

The days of low fat are over

In the 90s the low-fat craze swept our country. Fat made you fat, or so the story went. Has our thinking evolved?

The idea that fat makes you fat was always the message, says Gaffney. “There are three kinds of macronutrients, which are nutrients required in large amounts by living organisms — carbohydrates, proteins and fats. Fats got the bad rap because people assumed that if you ate fat you would automatically gain fat on your body, which isn’t the case.”

“Fat only makes you fat if you have too many calories in the day,” says Barratt.

Draper agrees: “Anything can make us fat. There’s more to it than that. In every cell in our body, trillions of cells, the membrane is made up of fat,” he explains. “So in order to absorb nutrients we have to have good integrity in our cell membrane. Fat is hugely important. We are not eating enough fat and especially healthy fat. Fat is good for sustainable energy, good for our brain and our immune system.”

Fat, in other words, is an essential part of our diet. Fats help with brain development, controlling inflammation, energy and blood clotting. They also help other nutrients be more efficient in the body.

“Fats help absorb certain vitamins in our body,” says Gaffney. That includes vitamin A, which helps with vision; vitamin E, which helps with skin and lubrication; vitamin D, which supports bone health and mental health; and vitamin K, which assists with blood clotting. “We use fats for all different types of purposes in our body, and they’re extremely important. In a balanced diet we need that variety,” she says.

Fats also help us feel satisfied. “When we don’t have fats in our diet, oftentimes there’s more frequent hunger,” says Gaffney.

So is there such a thing as too much fat? “It depends on the individual,” explains Gaffney. “Someone who follows a vegetarian diet may have a higher percentage of fat in their diet due to the need for increased intake of higher-fat foods such as oils, nut butters, nuts and seeds.”

 Balance is the key

According to current dietary guidelines, the recommended amount of total calories per day from fat is about 35 percent.

“But for some people it might be a little more and for some a little less,” says Gaffney.

Draper says that the most important thing to remember about fat is to include a healthy fat at each meal. “When we consume fat along with protein, it isn’t going to raise our blood sugar up as much, and it’s not going to digest quickly,” he says. “We should all work on becoming a fat burner, and to do that we should focus on vegetables, eating a good amount of healthy fat and getting a good amount of protein.”

Barratt adds that for the food we eat, “What it comes down to is to have a balance of fats.”





About Kim Dinan
Kim Dinan is a freelance writer and author of The Yellow Envelope. She lives in WNC with her husband and daughter. Follow me @kimdinan

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6 thoughts on “Local experts explore the truth about fat

  1. Connie Diekman

    Very easy to read article but one quote on saturated fats is not accurate. Saturated fats are not neutral in their impact on blood cholesterol and all scientific evidence continues to connect them to elevations in blood LDL levels. The body of evidence, as put forth by the American Heart Association, the National Lipid Association and the Academy of Nutrition and Dietetics, still supports limiting saturated fats to less than 10% of total calories. Connie Diekman, M.Ed., RD, CSSD, LD, FADA, FAND – Former President of the Academy of Nutrition and Dietetics and Former Chairman of the Board of the Missouri Affiliate of the American Heart Association.

  2. Geeta Sikand

    I agree with Connie Diekman that its a great article. However the quote on saturated fat is not correct.
    As an author and the Co-chair of the National Lipid Association Nutrition Expert Writing Group and Director of University of California Irvine Preventive Cardiology Program I have addressed it below in a question and answer format.

    Question: Are saturated fatty acids (SFA) associated with coronary artery disease (CAD)?

    Answer: Yes. While some early epidemiologic evidence (such as Siri-Tarino, 2010) reported no association between SFA and CAD, their methodologies were flawed These and other studies failed to consider the substitution of other nutrients for SFA, especially refined carbohydrates that in the United States are most commonly consumed as added sugars. Based on results and subsequent reports noting these flaws, the accurate conclusion drawn from these studies is that SFA and refined cholesterol (eg, added sugars) increase atherogenic cholesterol and coronary heart disease (CHD) risk. More recent studies report that when SFA is replaced with unsaturated fat (polyunsaturated fatty acids [PUFA], monounsaturated fatty acids [MUFA]), whole grains (Li, 2015), and even plant protein (Zong, 2016), risk of cardiovascular disease (CVD) decreases.The 2015-2020 Dietary Guidelines Advisory Committee and the authors of the American Heart Association/American College of Cardiology (AHA/ACC) Lifestyle Guideline to Reduce Cardiovascular Risk (Eckel, 2014) both rated the evidence for reducing SFA and replacing it with unsaturated fat to decrease CVD risk as strong. The totality of data from well designed and analyzed studies clearly support current dietary recommendations to decrease SFA intake to <7% of energy in order to decrease low-density lipoprotein cholesterol (LDL-C) and reduce CVD/CAD risk. Studies that contradict this message are likely based on outdated research and/or research with major methodological limitations. Geeta Sikand, MA,RDN,FAND, CDE,CLS,FNLA. Director of Nutrition University of California Irvine Preventive Cardiology Program.

    • Amy Deahl-Greenlaw, RDN

      The previous response, meant to say refined “carboyhydrates” not refined cholesterol. And to the authors of the article, the organization that you allude to is the Academy of Nutrition and Dietetics not Dietitians. Please check your facts and have someone review your piece before you publish.

      • Virginia Daffron

        Thank you for your comment and correction. I can assure you that we do review all articles multiple times prior to publication. Errors still sometimes make their way in, but the goal is to eliminate them entirely.

      • Geeta Sikand

        Thank you Amy for the correction on “refined cholesterol.” I agree it should be “refined carbohydrate.” Please excuse my typo.
        Geeta Sikand

    • Kevin Schwanz

      Here is my challenge: Can you cite a single randomized trial that shows decreasing saturated fat intake reduces MI, CVA, cardiovascular mortality, total mortality, or similar outcomes? Or a RCT that shows increasing saturated fat intake increases those outcomes? Relying on observational studies is very weak, especially given the significant healthy user bias seen in most observational trials on this topic. It would also be unwise to base recommendations on a change in a single risk factor such as cholesterol levels, as human physiology is very complex and the health impact of a food unfortunately cannot be represented with a single lab value. I could also argue that saying “saturated fats are……” is flawed because it assumes that all sources of saturated fat have the same impact on health, which is quite unlikely.

      Kevin Schwanz RD – Editor of Schwanz Nutrition Journal

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