The Food Shaman Speaks (STHU): The AHA, 2018, and the F Word

Hey American Heart Association, It’s 2018.

What immediately comes to mind in the New Year as I assess your latest recommendation are the ageless lyrics of wisdom from John Lennon. Like the ghost of Christmas past, the words grip like the bite of the nutcracker on our proverbial, collective nutsack; It is now 2018:

And what have you done

Another year over

And a new one just begun.

Forty-one years ago the US government, at your behest, brought us the national fat and saturated fat guidelines:

No more than 30% of our diet from fat
Absolutely no more than 10% of that from saturated fat.

Forty-one years is a long time for you to collect irrefutable data to convince us that this aberration of nature will yield us some benefit. Forty-one years is a long enough time to acknowledge any error of your ways that newer science might have illuminated.

Forty-one years is long enough to get a grip on the F* Guidelines.

Yes, I mean the F Word; Fat.

The flavor of food, as every chef and foodie knows, is in the fat. It’s a universal law: fatty goodness equals deliciousness. But what you have failed to appreciate, AHA, is personality. You see, fats, like people, are a diverse bunch; some short, some long, and some that fall somewhere in between. Some are saturated, some unsaturated to multiple degrees, and some singularly so.

And like people, each one of these has a personality, a character. As Jules Winnfield reminded us, “Personality goes a long way.” And that’s not just opinion; that’s what science has shown us over the four decades since these F* Guidelines were put in place. Fats do a helluva lot more than presumptively raise cholesterol levels in some detached laboratory test tubes. When it comes to people, they are…complicated. And every fat’s personality goes a long way to determining its ultimate physiological effect. Except for man-made trans-fatty acids (TFAs). They’re like manufactured boy bands; universally, ubiquitously, annoying.

So, not only have you refused to recognize what the science has shown, you’ve doubled down by telling us we must consume even less than the previously ill-advised 10% saturated fat. You’ve slammed plant-based sources of medium chain fatty acids like coconut oil simply because they are saturated. And you based it on a handful of studies, the most recent of which was over 30 years old.

Forget the fact that we now know the body handles short, medium, and long chain fatty acids in completely different ways. Forget the fact that short chain fatty acids (SCFAs), are saturated fatty acids produced by a healthy gut microbiome when we eat things like plants and fiber. Forget that these saturated fats seem to be a key to a healthy gut, and thus a healthy body with less obesity, diabetes, heart disease and all the other attendant disabilities and diseases associated with the modern Western diet. A diet of convenience where the problem lies in the quality of the food, not the fat content.

So, perhaps it is time for a little fat shaming.

Here’s the gist of yet another meta-analysis dispelling the fat, particularly saturated fat, causes cardiovascular disease fairy tale you’ve been peddling to us like Willy Loman. And just like Willy, you seem unable to “just to walk away… [And] if you can’t walk away? I guess that’s when it’s tough… [when the] only thing you’ve got in this world is what you can sell.”

So before we serve dessert, here’s the meat of previous studies:

The original recommendations (1973 in the US, 1983 in the UK) had no basis in any scientific evidence derived from randomized, controlled clinical trials –the recognized gold standard in such matters. The analysis examining the approval of these guidelines concluded that “The dietary fat guidelines were not supported by RCT [randomized controlled trials] or epidemiological evidence available at the time of their introduction.” (Harcombe Z. , et al., 2015)
A study which systematically reviewed saturated, not just total, fat had mortality as the end point. They found that “Saturated fats are not associated with all cause mortality, CVD [cardiovascular disease], CHD [coronary heart disease], ischemic stroke, or type 2 diabetes” (de Souza, et al., 2015)
Another meta-analysis also looked at saturated, not just total fat, with disease as the end point. The researchers concluded that “Meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.” (Siri-Tarino, Sun, Hu, & Krauss, 2010 )
Yet another group of scientists examined the saturated fat question, concentrating on saturated, not total fat, and its relationship with the risk for CAD. They looked in detail at saturated, monounsaturated, polyunsaturated, and trans-fatty acids (TFAs). They also examined the specific long chain saturated fatty acids, palmitic (C16:0) and margaric (C17:0); because even among classes of fats (like long chain saturated fatty acids), the body is built to utilize many fats uniquely according to their individual characteristics. The conclusion of their analysis was that “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.” (Chowdhury, et al., 2014)
A 2009 meta-analysis conducted a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies looking at total and saturated fat and the risk of CHD and mortality. The take-away was that “Intake of total fat was not significantly associated with CHD mortality. Intake of total fat was also unrelated to CHD events.” (Skeaff & Miller, 2009)
The most recent investigation “Finds that the epidemiological evidence currently available does not support the dietary fat guidelines. …The conclusion of the four systematic reviews and three meta-analyses is that there was no evidence to support the dietary fat guidelines being introduced and there is no evidence currently available to support them. Not one review has found evidence to support [current] public health dietary fat guidelines ” (Harcombe, Baker, & Davies, Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review., 2017)

AHA, please note all these studies were done in years starting with 20, not 19.

AHA, it’s 2018.

Another year over, and you’ve done nothing but serve us up rehashed taradiddles. It’s time to stop trying to force feed us an outdated menu full of low-fat, no-fat, reduced fat, cholesterol free baloney. We’re no longer buying what you’re selling. It’s time to recognize that it is the quality of our comestibles; the freshness, authenticity, the wholesomeness of real food that really matters.

AHA, Shut The Hell Up.

References

Chowdhury, R., Warnakula, S., Kunutsor, S., Crowe, F., Ward, H. A., Johnson, L., . . . Di Angelantonio, E. (2014). Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis . Anal Int Med, 160(6):398-406. DOI: 10.7326/M13-1788.
de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., & Kishibe, T. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ, 351 :h3978 .
Fenster, M. (2014). The Fallacy of The Calorie: Why the Modern Western Diet is Killing Us and How to Stop It. New York: Koehler Publishing.
Harcombe, Z., Baker, J., & Davies, B. (2017). Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review. Br J Sports Med, 51:1737-1742.
Harcombe, Z., Baker, J., Cooper, S., Davies, B., Sculthorpe, N., DiNicolantonio, J., & Grace, F. (2015). Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart, http://dx.doi.org/10.1136/openhrt-2014-000196.
Harcombe, Z., Baker, J., DiNicolantonio, J., Grace, F., & Davies, B. (2016). Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis . BMJ Open Heart, 3:e000409. doi: 10.1136/openhrt-2016-000409 .
IMDb. (2017, January 4). Pulp Fiction Quotes. Retrieved from IMDb.com: http://www.imdb.com/title/tt0110912/quotes Miller, A. (2018, January 4). Death of a Salesman Quotes. Retrieved from goodreads.com: https://www.goodreads.com/work/quotes/2722054-death-of-a-salesman
Siri-Tarino, P. W., Sun, Q., Hu, F. B., & Krauss, R. M. (2010 ). Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr, 91(3): 535-546 .
Skeaff, C., & Miller, J. (2009). Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trials. Anal Nutr & Metab, 55:173–201 https://doi.org/10.1159/000229002.