Carbohydrates, fats, and proteins are the major nutrients your body needs for growth, repair, movement, and maintaining homeostasis. These macromolecules are broken down and absorbed into the body at different rates and into specific forms as they travel through the organs in your digestive system. Since there are only three of them, and since medical researchers have known about them and how they’re metabolized for over a century, you’d think they’d pretty much have them down by now. Unfortunately, not so much–especially when it comes to fats and carbohydrates. In fact, every few years they do wheelies and one-eighties on them flipping between which ones are healthy and which ones are dangerous.

Well today, we’re going to focus our attention on fats (and by extension carbohydrates) and how the medical community still doesn’t understand how they line up with health. To be sure, although what we’re going to talk about might be new information for many in the medical community–and especially for those in the American Heart Association (AHA)–it will merely be a review for longtime visitors to this website. As I’ve been saying for almost 50 years (yes, it really has been that long), the normal consumption of natural saturated fat is not a health problem–despite vociferous claims by the medical community to the contrary. In fact, when it comes to heart disease, the medical community is absolutely on the wrong side of reality. The problem is not saturated fat but, rather, the alternatives the medical community has encouraged consumers to turn to.

So exactly, what is the medical position on saturated fat?

What the American Heart Association Says About Saturated Fat

No need to invent anything here. Let’s just take our information directly from the AHA information page on saturated fat, last updated on March 24. 2017.¹ “Saturated Fats.” AHA. Last Updated: March 24, 2017. (Accessed 16 May 2017.)  http://healthyforgood.heart.org/Eat-smart/Articles/Saturated-Fats To quote:

From a chemical standpoint, saturated fats are simply fat molecules that have no double bonds between carbon molecules because they are saturated with hydrogen molecules. Saturated fats are typically solid at room temperature. Replacing foods that are high in saturated fat with healthier options can lower blood cholesterol levels and improve lipid profiles.

The American Heart Association recommends aiming for a dietary pattern that achieves 5% to 6% of calories from saturated fat. For example, if you need about 2,000 calories a day, no more than 120 of them should come from saturated fats. That’s about 13 grams of saturated fats a day. [Incidentally, that’s less than half an ounce a day. Ed.]

The American Heart Association recommends limiting saturated fats — which are found in butter, cheese, red meat and other animal-based foods. Decades of sound science has proven it can raise your “bad” cholesterol and put you at higher risk for heart disease. [Not even close as we’ll discuss in a bit. Ed.] The more important thing to remember is the overall dietary picture. Saturated fats are just one piece of the puzzle. In general, you can’t go wrong eating more fruits, vegetables, whole grains and fewer calories.

When you hear about the latest “diet of the day” or a new or odd-sounding theory about food, consider the source. The American Heart Association makes dietary recommendations only after carefully considering the latest scientific evidence. [But also after purposely ignoring other “latest scientific evidence.” Ed.]

Now let’s take a look at what two of the latest studies say and which point of view (mine or the AHA) they actually support. Then we’ll take a quick look at the how we got where we are today and how the misinformation being promoted has killed millions of people (no exaggeration) over the last half century. And finally, we’ll bring it full circle with a closer look at saturated fats and a recommendation as to what you should, in fact, be eating–a recommendation that will, in fact, promote better health and longer life.

So, let’s start with the first study.

Saturated Fat Does Not Clog the Arteries: Coronary Heart Disease Is a Chronic Inflammatory Condition

This is actually an editorial published in the British Journal of Sports Medicine. But more than that, it is a systematic review and meta-analysis of a number of observational studies.² Aseem Malhotra, Rita F Redberg, Pascal Meier. “Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions.” British Journal of Sports Medicine, April 2017. http://bjsm.bmj.com/content/early/2017/03/31/bjsports-2016-097285 Jumping right to its conclusion, the analysis showed no association, in healthy adults, between saturated fat consumption and:

• All-cause mortality
• Coronary heart disease (CHD)
• CHD mortality
• Ischemic stroke
• Type 2 diabetes

Essentially, the authors concluded that coronary artery disease pathogenesis and treatment “urgently require a paradigm shift.” Despite popular belief among doctors and the public, the study categorically concluded that the conceptual model of dietary saturated fat clogging a pipe is just plain wrong. As cardiologist, Dr. Aseem Malholtra, one of the study’s authors said in an interview, “One thing that’s very clear when you look at the totality of the evidence: saturated fat does not clog the heart arteries. And sadly, for many years — for decades, in fact — this has been the primary focus of treatment of heart disease and public health advice.”³ “Pass the butter: Cutting saturated fat does not reduce heart disease risk, cardiologists say.” CBS News. Apr 25, 2017. (Accessed 23 May 2017.) http://www.cbc.ca/news/health/pass-the-butter-cutting-saturated-fat-does-not-reduce-heart-disease-risk-cardiologists-say-1.4085453

Similarly, in the secondary prevention of CHD, the authors observed that their meta-analysis revealed that there is no benefit from reduced fat, including saturated fat, on myocardial infarction (heart attacks), cardiovascular mortality, or all-cause mortality. And finally, as the researchers stated, it is instructive to note that in an angiographic study of postmenopausal women with CHD (one of the studies that the meta-analysis looked at), a greater intake of saturated fat was actually associated with less progression of atherosclerosis, whereas carbohydrate and polyunsaturated fat intake were associated with greater progression.⁴ Mozaffarian D, Rimm EB, Herrington DM. “Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women.” Am J Clin Nutr. 2004 Nov;80(5):1175-84. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1270002/

According to the authors, the best predictor of heart disease risk involves a high total cholesterol (TC) to high-density lipoprotein (HDL) ratio, not low-density lipoprotein. You might want to read that sentence again. It’s pretty much the opposite of what your doctor has been telling you for years. Instead, the researchers explained that dietary changes, such as replacing refined carbohydrates with healthful high-fat foods including olive oil and nuts, can significantly reduce the high TC to HDL ratio. The reason for getting rid of the refined carbohydrates, as cardiologist Dr. Michael Farkouh said, is that when the body becomes resistant to insulin, an inflammatory response is triggered. “What this editorial really brought to light was that your diet, if it’s a diet rich in carbohydrates, can be associated with what’s called insulin resistance. That allows your innate inflammatory process in the body to attack the vessel wall and start the process of hardening of the arteries.”⁵ Pass the butter

The authors also stated that chronic stress is a risk factor for coronary heart disease that “should not be overlooked.” Chronic stress puts the body’s inflammatory response on a continuous state of high alert. As they state: research has shown that environmental stress, such as childhood trauma, can decrease life expectancy by up to 20 years.

On the other side of the equation, the research team found that exercise plays an essential role in preventing heart disease and may increase life expectancy by 3.4 to 4.5 years. Just 30 minutes of moderate activity per day on more than three occasions each week has been shown to make a difference to risk factors for inactive adults. Furthermore, the researchers point out that regular brisk walking may be more effective at preventing coronary disease than running.

The bottom line, according to the researchers, is that spending just 22 minutes per day walking and eating healthy food can prevent coronary artery disease. In the end, the authors concluded with what can only be considered as an astonishing statement, “There is no business model or market to help spread this simple yet powerful intervention.” Or as Deep Throat said, “Follow the money.”

And now, the second study.

Milk and Dairy Consumption and Risk of Cardiovascular Diseases

As I’ve expressed many times over the years, I’m not a great fan of commercial dairy for a number of reasons–but primarily because of its negative effect on bone health. But that said, a second meta-analysis, also published in April, in the European Journal of Epidemiology, concluded that the saturated fats in milk and dairy products have no negative impact on cardiovascular health.⁶ Jing Guo, Arne Astrup, Julie A. Lovegrove, et al. “Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose–response meta-analysis of prospective cohort studies.” European Journal of Epidemiology. April 2017, Volume 32, Issue 4, pp 269–287. http://link.springer.com/article/10.1007/s10654-017-0243-1 Specifically, the researchers looked at a total of 29 cohort studies with a total of 938,465 participants, among whom, during the course of the study, there were 93,158 deaths, 28,419 cases of coronary heart disease, and 25,416 cases of cardiovascular disease (CVD)) with an eye to examine the impact of high-and low-fat dairy, milk, fermented dairy, cheese, and yogurt on cardiovascular health. Again, what they found was that there is no association between the total consumption of either high or low-fat milk and/or milk products and mortality, or even the incidence of CHD or CVD. Even more astonishing, they actually found an Inverse association between total fermented dairy products (including sour milk products, cheese, and yogurt) and any heart issues. However, in the service of full disclosure, as the authors themselves acknowledged, that positive result for fermented dairy was driven by a single study.

In summary, as Ian Givens, one of the researchers, said, “There’s quite a widespread but mistaken belief among the public that dairy products in general can be bad for you, but that’s a misconception. While it is a widely-held belief, our research shows that that’s wrong. There’s been a lot of publicity over the last five to 10 years [Actually closer to 50. Ed.] about how saturated fats increase the risk of cardiovascular disease and a belief has grown up that they must increase the risk, but they don’t.”⁷ Matthew Diebel. “That full-fat dairy stuff — cheese, yogurt, milk — isn’t bad for you, study finds.” USA Today. May 9, 2017. (Accessed 23 May 2017.) http://www.usatoday.com/story/news/health/2017/05/09/full-fat-dairy-stuff—-cheese-yogurt-and-so—-isnt-bad-you-study-finds/101461372/ That conclusion, of course, doesn’t address my concerns about dairy and bone health and diabetes and all of the other issues I have with dairy–but it certainly is another nail in the coffin of the saturated fat and heart disease theory.

A Little Bit of History

Okay, so we know that over the last half century mainstream medicine has had a bit of a fixation on saturated fat–convinced that it is the primary factor in the onset of heart disease. On the other hand, we now know that over the last several years, there have been a number of studies that have disputed that belief (if nothing else, the several dozen studies cited in the two meta-analyses discussed above). And yet, despite these studies, as is their wont, mainstream medicine holds firm to the more headline grabbing narrative about the dangers of saturated fat (see the quote from the American Heart Association website at the top of the newsletter). But none of this narrative is actually true–nor is it true that the AHA has carefully considered all scientific evidence. In fact, disagreement with the saturated fat/cholesterol theory of heart disease has been consistent in the medical community from day one. The naysayers, however, we’re just pushed into the background. To better understand how we got here, it probably would be helpful to journey back in time a few decades.

It really all began in the late 1940’s when Ancel Keys, an American physiologist took note of the fact that American business executives, “presumably” among the best-fed people in the world, had high rates of cardiovascular heart disease, whereas in post-war Europe, CVD rates had decreased sharply in the wake of reduced food supplies. From this observation, Keys postulated a correlation between cholesterol levels and CVD and initiated a study of CVD by examining the diets and health of Minnesota businessmen (the first prospective study of CVD).⁸ Keys A, Taylor HL, Blackburn H, et al. “Coronary heart disease among Minnesota business and professional men followed 15 years.” Circulation. 1963 Sep;28:381-95. http://www.ncbi.nlm.nih.gov/pubmed/14059458 The study itself took 15 years to complete and would not be published until 1963. Nevertheless, by 1955, Keys had seen enough to present his diet-lipid theory of heart disease at a meeting of the World Health Organization in Geneva. It was not well received–at least in Europe. As his critics stated, “…. the evidence from 22 countries for which data are available indicates that the association between the percentage of fat calories available for consumption in the national diets and mortality from arteriosclerotic and degenerative heart disease is not valid; the association is specific neither for dietary fat nor for heart disease mortality. Clearly this tenuous association cannot serve as much support for the hypothesis which implicates fat as an etiologic factor in arteriosclerotic and degenerative heart disease.”⁹ Yerushalmy, J. and Hilleboe, H.E. “Fat in the Diet and Mortality from Heart Disease. A Methodologic Note.” New York State Journal of Medicine, 57, 2343-2354. http://www.scirp.org/reference/ReferencesPapers.aspx?ReferenceID=1307558 Oh snap!

In America, however, Keys’ theory received a very different reception. In 1956, representatives of the American Heart Association (AHA) appeared simultaneously on the three television networks (yes, there were only three back then) broadcasting to the entire country and promoting Key’s lipid hypothesis in general, and what was termed the “Prudent Diet” in particular. They informed (or more accurately terrified) the country that a diet which included large amounts of butter, lard, eggs, and beef would lead to coronary heart disease. Instead, they recommended substituting corn oil and high-trans-fat margarine for butter, cold breakfast cereals (based on high-glycemic, refined grains and sugar) for eggs, and chicken and fish for beef. To be sure, as I’ve already mentioned, there were dissenting voices. For example, the founder of the AHA, Dr. Paul Dudley White, agreed with his European colleagues. “See here, I began my practice as a cardiologist in 1921, and I never saw an MI (myocardial infarction or heart attack) patient until 1928. Back in the MI free days before 1920 the fats were butter and lard, and I think we would all benefit from the diet we had at that time when no one had heard the word[s] corn oil.” Unfortunately, as I’ve already mentioned, dissenting voices were ignored. This show, along with behind the scenes pressure from the AHA, resulted in the American government recommending that people adopt a self-defeating, perverted form of the Mediterranean diet in order to prevent heart disease. (More on this a bit later.)

Having achieved initial acceptance of his theory, at least in America, Keys looked to press his advantage, beginning work on his Seven Countries Study.¹⁰ http://www.sevencountriesstudy.com/about-the-study/history/ The results of that study appeared to clearly demonstrate that his initial theory was indeed correct, that serum cholesterol was strongly related to coronary heart disease mortality both at the population and individual level. At the population level, differences in coronary heart disease mortality rates could almost completely be explained by differences in saturated fat as found primarily in meat and dairy (an important determinant of serum cholesterol), flavonoids (strong antioxidants), and cigarette smoking (producer of free radicals).

This, along with the Framingham Study,¹¹ http://www.framinghamheartstudy.org/ turned theory into accepted fact. It was now medical gospel that:

• Cholesterol caused heart disease
• Saturated fats associated with meat and dairy raised cholesterol levels
• Polyunsaturated, omega-6 vegetable oils were a healthy alternative
• And worst of all: high trans-fat margarine was the healthy alternative to bad, bad butter, and high-glycemic, highly refined grains were a healthy alternative to meat and eggs.

What Could Possibly Go Wrong?

As numerous cholesterol dissidents have pointed out, “Correlation is not causation.” Either deliberately, or accidentally, Keys excluded any data that didn’t fit his hypothesis. In fact, the countries that he singled out as having the highest rates of heart disease–to prove his theory–also happened to be the countries with the highest intakes of sugar and refined carbohydrates. And remember, Keys and the AHA promoted cold breakfast cereals made with highly refined grains and added sugar as the healthy breakfast alternative. They also promoted the use of highly refined, polyunsaturated vegetable oils, which were gaining popularity in America–but, crucially, were not found in the Mediterranean diet referenced in his studies–over the consumption of saturated fats. And perhaps most damaging of all, he promoted the consumption of high trans-fat foods, such as all oleomargarines of the day, over saturated fats such as butter and lard.

What could possibly go wrong with this approach?

If we set aside, for the moment, the saturated fat/cholesterol theory of heart disease, what else in the data could account for the high incidence of heart disease in the seven countries cited in Keys’ study?

Carbohydrates

First of all, those same countries that had a higher incidence of CHD also happened to have the highest consumption of sugar and high-glycemic refined grains. Why is that a problem? Quite simply, they promote inflammation in the cardiovascular system and are highly acid forming in body tissue, which is also highly inflammatory to that same tissue–especially arterial walls. (Remember our quote from Dr. Farkouh at the top of the newsletter: “What this editorial really brought to light was that your diet, if it’s a diet rich in carbohydrates, can be associated with what’s called insulin resistance. That allows your innate inflammatory process in the body to attack the vessel wall and start the process of hardening of the arteries.”) This is important because, as I have explained many times before, cholesterol is part of the patching material (plaque) that is used to cover damaged arterial tissue–damage inflicted by inflammation. Effectively, cholesterol is not guilty of the crime (CVD), only of being found at the scene of the crime.

On the other hand, to repeat what we’ve already mentioned, sugar and refined carbs contribute to CVD in two ways. First, as we’ve already mentioned, a diet rich in carbohydrates is associated with insulin resistance. That allows your innate inflammatory process in the body to attack the vessel wall and start the process of hardening of the arteries. And two, these same foods are highly acid forming in the body. Your blood itself is not subject to changes in acidity, but the arterial walls are–and especially the muscle tissue in and around those walls. And sustained acidity causes inflammatory damage to those walls. The bottom line is that Keys missed this important piece of data. But even more significant, both Keys and the American Heart Association encouraged people to eat more of these very same inflammatory foods–thus leading to an exponential increase in cardiovascular disease. Over the years, this advice has killed millions of people.

Refined Vegetable Oils

Yes, both Keys and the AHA mentioned the value of consuming monounsaturated fats such as olive oil, but they also promoted the virtues of refined vegetable oils such as corn oil and safflower oil, and that’s what stuck with the public. The problem here is that for good cardiovascular health, your diet needs to balance omega-6 fatty acids with omega-3 fatty acids ideally at a 1:1 ratio, but at worst 2:1. As it turns out, virtually all of the commercial vegetable oils are far from that ideal. Corn oil runs about 83:1 and safflower oil about 133:1. And that brings us to NEFAs.

NEFA stands for non-esterified fatty acids (or free fatty acids), which are an important metabolic fuel. Both the concentration of NEFAs and their flux through the circulation vary widely from hour to hour, reflecting your nutritional state and physical activity. That said, inappropriately elevated plasma NEFA concentrations have a number of adverse effects. Specifically, studies have shown that high fasting plasma NEFA concentration is an independent risk factor both for arterial inflammation¹² Mas S, Martínez-Pinna R, Martín-Ventura JL, Pérez R, et al. “Local non-esterified fatty acids correlate with inflammation in atheroma plaques of patients with type 2 diabetes.” Diabetes. 2010 Jun;59(6):1292-301. Epub 2010 Mar 3.http://www.ncbi.nlm.nih.gov/pubmed/20200316 and sudden death from heart attacks.¹³ Xavier Jouven, Marie-Aline Charles, Michel Desnos, Pierre Ducimetière. “Circulating Nonesterified Fatty Acid Level as a Predictive Risk Factor for Sudden Death in the Population.” Circulation. 2001;104:756-761. http://circ.ahajournals.org/content/104/7/756.full And here’s the punchline: high levels of NEFAs in the blood are primarily driven by excess omega-6 fats in the body, which is caused by eating an overabundance of polyunsaturated fats such as corn, peanut, sunflower, and safflower oils — in other words, virtually every single bottled vegetable oil and processed food that Dr. Keys and the AHA recommended as a healthy alternative to meat and dairy. It’s also the reason that taking omega-3 supplements lowers levels of NEFAs by bringing the omega-6 to omega-3 fatty acid levels back into balance.

Incidentally, there’s one other primary source of excess omega-6 fats in the diet: conventionally raised livestock, chicken, and fish that have been fattened on corn because corn is high in Omega 6 fatty acids. Ultimately the fat composition of these animals begins to reflect the fat composition of the foods they eat. Animals raised on corn have high omega-6 to omega-3 ratios. Livestock raised in nature, such as grass fed beef, reflect an omega-6 to omega-3 ratio closer to 2:1. In other words, it’s not the saturated fat in these animals that is causing health problems; it’s the out-of-whack omega-6 to omega-3 ratios.

So, once again, the recommendations from Keys and the AHA are responsible for the deaths of millions of people.

High Trans-Fat Margarine

As I’ve already mentioned, the AHA campaign against saturated fat includes a recommendation to substitute margarine for butter. But keep in mind, the oleomargarines of the 50’s, 60’s, 70’s, 80′, and 90’s were not the same as the alternative spreads we see today. Back then, margarine was made with partially hydrogenated corn oil–the definition of high trans-fat. Ouch! For over a quarter of a century, I have been railing against manmade trans-fatty acids. In fact, in the very first edition of Lessons from the Miracle Doctors, I called products made from trans-fats (partially hydrogenated oils) the number one killer in our diet.

But this is one area that has seen a dramatic change in the last ten years. Whereas at one time medical authorities promoted these products as “healthy” alternatives to saturated fat products such as butter (and yes, at one time the Journal of the American Medical Association even carried ads for partially hydrogenated corn oil margarines), these same authorities gradually became aware (about fifty years after the alternative health community) that trans-fats were, in fact, decidedly unhealthy. But how many millions of people died as a result of their original recommendation before they got around to correcting it? And then, of course, they’re still killing people with their amended recommendation–having swapped out the dangers of trans-fats for the dangers of polyunsaturated vegetable oils, which as we’ve already seen increase the incidence of CVD all by themselves.

The Journal of the American Medical Association actually ran ads for high trans-fat, partially-hydrogenated oleomargarine back in the day. This is one from a 1970 issue. No joke. This is a real ad. Over the decades this information persisted, heart disease was the leading cause of death. This advice and these ads literally killed millions of people

But back to trans-fats.

They are major contributors to cancer, heart disease, and diabetes. To be sure, over the last couple of years, government agencies have jumped onboard and started pressuring food companies and restaurants to ban trans-fats from our diets. And trans-fats are absolutely unnecessary and have no place in your diet or in any of the foods you eat — if you wish to be healthy, that is. However, in their infinite wisdom, the medical institutions and government agencies still managed to get it wrong. Yes, synthetic trans-fats created through hydrogenation are extremely harmful, but naturally occurring trans-fats, not so much. In fact, some natural trans-fats are downright healthy. One such trans-fat is CLA (conjugated linoleic acid). CLA is both a trans–fatty acid and a cis–fatty acid. The cis bond causes a lower melting point and may account for its health benefits. What health benefits are we talking about?

Well, for one thing, studies have indicated that CLA is a potent cancer fighter across a wide variety of tumors, including cancers of the skin, breast, prostate, and colon. And whereas most anti-cancer agents block only one of cancer’s three stages (initiation, promotion, or metastasis), very small amounts of CLA have been shown to block all three.

In addition, CLA has been found to lower LDL levels and prevent bone loss and atherosclerosis, while at the same time helping to build the immune system.

And where is CLA found?

In the meat and dairy of grass fed cows. In fact, it is produced naturally from linoleic acid by bacteria in the stomachs of herbivores (such as cows). It can also be produced synthetically by heating linoleic acid in the presence of a base. However, there may be some issues as to whether synthetic CLA performs as well as natural CLA. And take note: I did say grass fed cows. As it turns out, grazing animals have 3-5 times more CLA than grain fattened animals — providing yet one more reason for consuming grass fed animal products.

As a side note, the breast milk of mothers who consume foods high in CLA is likewise high in CLA, providing tremendous health benefits for the baby. If you are looking to supplement CLA, your best bet is probably butter oil — made seasonally from May through October from the milk of cows feeding on rapidly growing pasture grass. Rapid growth in the grass is the key to high CLA levels in the cows, not to mention high alkylglycerol content, and naturally occurring vitamin K2 (the Activator X first identified by Dr. Weston Price¹⁴ CHRISTOPHER MASTERJOHN. “Cure for Cancer: Activator X May Be the Missing Link.” The Weston A. Price Foundation. JANUARY 8, 2010. (Accessed 28 May 2017.) http://www.westonaprice.org/our-blogs/cure-for-cancer-activator-x-may-be-the-missing-link/ ).

In any case, it’s now time to go full circle and bring our discussion back to where we bagan–saturated fat.

So, What Is the Bottom Line with Saturated Fat?

Taking another look at the Malhotra editorial,¹⁵ Aseem Malhotra it’s now easy to see why the authors feel that virtually everything the establishment has been advising about cutting fat from the diet and lowering cholesterol is wrong. In fact, in a previous study, Dr. Malhotra definitively pronounces that our obsession with cutting down on dietary fat has “paradoxically increased our cardiovascular risks.”¹⁶ Malhotra, Aseem. “Saturated fat is not the major issue.” 22 October 2013. British Medical Journal.  25 October 2013. http://www.bmj.com/content/347/bmj.f6340 “Recent prospective cohort studies have not supported any significant association between saturated fat intake and cardiovascular risk. Instead, saturated fat has been found to be protective.”

In addition, he states that reducing saturated fats in the diet is probably accountable for much of the weight gain we have seen in the US and throughout the world. As Dr. Malhotra points out, while overall saturated fat consumption has dropped in the US from 40 percent of the typical diet to 30 percent, obesity rates have nevertheless skyrocketed.  He attributes this trend, at least in part, to the fact that as manufacturers have cut the fat in food products, they’ve compensated by increasing the sugars and carbohydrates.

The bottom line is that the bromide of mainstream nutrition that it’s important to reduce saturated fat intake since high levels of saturated fat increase the risk of cardiovascular disease is, quite simply, a myth — for two reasons. First, not all saturated fat is bad; in fact, a certain amount is essential, and some saturated fats, such as coconut oil, are extremely health promoting. (For a number of years, coconut oil has been vilified by medical health experts due to its saturated fat content, but coconut oil is unique in its structural makeup. Yes, it is the highest source of saturated fats (92 percent), but included in that number are the medium-chain triglycerides (MCTs), which are extremely beneficial to the body. In addition, approximately 50 percent of these MCTs are made up of lauric acid, the most important fatty acid in building and maintaining the body’s immune system. The only other source of lauric acid found in such high concentrations is mother’s milk.)

The second reason we have for understanding that the saturated fat/CVD connection is a myth is that prolonged experience with high meat/high fat/low carb diets has shown that natural saturated fat does not necessarily raise cholesterol levels and clog arteries (although these diets are quite likely to promote osteoporosis and colon cancer — but that has nothing to do with the fat in those foods). The “simple” truth is that the whole issue of saturated versus unsaturated fat is false.

A Further Note on Fats

There’s a simple rule of thumb to follow here: If it’s a fat found in nature and people have successfully consumed it since the dawn of time, it’s probably healthy to eat in moderation. On the other hand, if it’s highly processed or newly created or consumed to excess, you can pretty much bank on its being questionable. So, what does that mean?

Quite simply, it means that you want to consume the whole gamut of natural fats…in moderation. We’re talking about:

• Saturated fats from natural, organic, grass fed sources
• Omegas-3, 6, 7, and 9
• GLA
• DGLA
• Natural trans-fats such as CLA
• Alkylglycerols
• Etc.
• And all consumed in moderation and in balance

It also means that you don’t want to consume manmade fats (can you say partially hydrogenated oils and trans-fats?) or any highly refined polyunsaturated fats (meaning almost any bottled vegetable oil you find in the supermarket).

What Should You Do?

Dr. Keys and the AHA were right about one thing: The Mediterranean diet is the best diet, not just for cardiovascular health, but for overall health. Unfortunately, they were wrong about the cause of heart disease and, therefore, wrong about why the diet was beneficial and wrong about the version of the diet they promoted…and killed millions of people as a result.

Then again, doctors don’t really know diets, do they? Most doctors eat badly, drink excessively, have high rates of drug addiction, and are personally unhealthy. Why would you turn to them for advice about nutrition? Broken limbs and automobile accidents for sure, nutrition not so much. So, what do I recommend?

After intensively studying this field for 50 years now, my diet of choice, like Dr. Keys, is the Mediterranean diet–but a very particular form of it. Historically speaking, the Mediterranean diet is not “actually” the diet of any country or area; instead, it is “inspired” by the “traditional” dietary patterns of the peoples of southern Italy, Greece, and Spain. The more generic forms of the diet–and the forms followed by most physicians today–center around high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, with moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of meat and meat products. In other words, they have evolved from the early Keys and AHA diet that included trans-fats and refined grains and sugars. Nevertheless, they still include and emphasis on grains, even if unrefined, and significant consumption of polyunsaturated vegetable oils.

The version of the Mediterranean diet that I recommend modifies their recommendation as follows:

• High consumption of non-starchy vegetables and greens. Although the Mediterranean diet is not necessarily a vegetarian diet, fresh vegetables and salad greens are its single most important component. Fresh vegetables have high nutrient density. That is: they provide high levels of nutrition with the fewest number of calories. Broccoli, for example, provides more protein per calorie than a lean steak. Note: that’s per calorie, not per ounce or pound; and it’s not a complete protein. You need other amino acid rich foods to complement it so that you can maximize its protein value. But that said, fresh vegetables are among the most nutrient dense foods available. Vegetable juices are also extremely healthy. Just don’t go crazy with the high sugar vegetables such as beets and carrots.
• Moderate to high consumption of wild caught fish (if desired…and if it’s still available).
• Moderate consumption of organic, free-range chicken or turkey (if desired). Remember: non-organic poultry is likely to contain high levels of arsenic and chicken tumors.
• Moderate consumption of nuts and seeds (if not allergic). And keep in mind that sprouting nuts and seeds–if you can find any that are not pasteurized nowadays–dramatically improves their nutrition level and health benefits, while reducing the possibility of any adverse reactions. Among the best nuts to eat are almonds and walnuts, and for seeds we’re looking at sunflower, flax, and chia seeds.
• Moderate consumption of chlorella, spirulina, and blue green algae (if not allergic). They are a great source of protein (albeit quite expensive). They are also nutrient dense and are great for removing toxins and heavy metals from the body, especially chlorella.
• Moderate consumption of fruit. Fruits are incredibly high in antioxidants, which is good. But they are also very high in sugars, which is not so good. Eating whole fruit helps modify the sugar hit. If you drink fruit juices, then you absolutely must restrict yourself to fresh squeezed–and dilute them with fresh water when you drink them…to cut the sugar hit.
• Moderate consumption of oils and fats such as:
  • Olive oil
  • Walnut oil
  • Avocado oil
  • Coconut oil
  • Organic butter from grass fed cows
  • With supplemental krill oil, squid oil, fish oil, and flax lignans
• Avoid like the plague all manmade trans fats (natural ones are fine) and all ultra-refined, high omega-6 vegetable oils (the kind that can last on your shelf for years without ever going rancid).
• Moderate consumption of organic, cage free eggs (if desired).
• Low to moderate consumption of organic, free-range meat and meat products (if desired).
• Low consumption of organic, raw dairy products–mostly as yogurt and cheese (if desired). Whey is certainly a concentrated source of supplemental protein, but it’s also extremely high in allergens. I would keep consumption moderate to low.
• Low consumption of legumes and, if you eat them, make sure you soak them before cooking and then cook them well before eating.
• Low consumption of unfermented soy products such as tofu and soy milk. Adults can consume moderate levels of fermented soy, but children should avoid all soy as the phytoestrogen content is just too much for them.
• Low consumption of unrefined, organic grain products. (Avoid the newer strains of non-organic high gliadin wheat.) And if you have celiac disease, then avoid them altogether. Do not substitute with high glycemic, non-gluten knock offs. Since this diet recommends low consumption of these foods anyway, simply eliminating them is not that big a sacrifice. If you don’t have a gluten problem, barley is not a bad choice as it is low glycemic. Even better is pre-sprouted barley, which is a nutritional powerhouse.
• Extremely low (or no) consumption of high glycemic refined grains, starches (e.g. potatoes), isolated sugars, and any modern, high-gliadin, genetically engineered strains of wheat.

It is said that we dig our graves one forkful at a time. There is much truth in that statement. Likewise, making smart dietary choices gives you much better odds of living a long, healthy life. Not a guarantee–just better odds. In the end, it’s your body, your life, your choice. Only you can determine what that choice will be–not your doctor, not even me.