Dietary Fats and Cardiovascular Disease: An American Heart Association Advisory | Hacker News Reader

Dietary Fats and Cardiovascular Disease: An American Heart Association Advisory

ahajournals.org

36 pointsjasonhansel55 comments

This article implies the opposite of the claims in this study.

https://www.bulletproof.com/diet/healthy-eating/good-fats/

"Saturated fat got some negative press back in the 1960s, when a scientist named Ancel Keys published research that claimed it caused heart disease. You’re probably familiar with the theory — that the saturated fat in butter, red meat, and egg yolks drives up cholesterol, which builds up in the arteries, blocking the flow of blood to the heart. The study was later debunked — it turned out Keys had manipulated the research to demonize fat. Later studies showed that saturated fat doesn’t raise levels of bad cholesterol (LDL) in the body.[15][16] Yet saturated fat is still shaking off its reputation as an artery-clogger.

The fact is, saturated fat is the most stable fat that there is. A stable fat is the least likely to be damaged by oxygen (aka oxidized). Oxidized fats accelerate aging, cause inflammation in the body, and make weaker cell membranes."

From reference 16 (the link to 15 doesn't work):

> Results: During 5-23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD.

From OP's article:

> Meta-analyses of prospective observational studies aiming to determine the effects on CVD of saturated fat that did not take into consideration the replacement macronutrient have mistakenly concluded that there was no significant effect of saturated fat intake on CVD risk.

Their reference points to the same study (Patty W Siri-Tarino et al.) that the bulletproof article used. OP's article already acknowledges and disputes that information.

There seems to be lots of conflicting info out there on "good" fats. I think everyone agrees that monounsaturated fats are relatively good (e.g. olive oil), but there are two camps for saturated vs polyunsaturated. Each thinks the other fat is the root of many health problems. I suspect that different industries are behind the apparent dichotomy rather than science.

No, the science is very very clear on that questions: it's absolutely in favor of poly-unsaturated fats. There is however a pocket of quacks and grifters on the internet concocting conspiracy theories about nutritional organizations/guidelines to sell books and whatnot.

So as americans have been eating more and more Omega-6 & PUFAs over the last century or so, they've been getting healthier and healthier, right?

Maybe you can share some more predictions of your model.

No, that obviously doesn't follow.

Current scientific thinking is that ultra-processed, ultra-palatable food high in both sugar and fat is likely responsible for the obesity epidemic. Of course, the fat in those foods is, most of the time, vegetable oils (because they're cheap & most of them are healthier than their animal counterparts).

However, it absolutely doesn't follow that vegetable oil in particular is the driver here. If one switched all of the vegetable oil in ultra-processed, ultra-palatable food with animal fats the result will very likely be exactly the same, except for an increase in CVD due to the increased saturated fat content.

Sounds like you are in one of the camps.

If you are going to call out "the science" and speak disparagingly, you'd better provide references. Preferably comprehensive analysis, and not a few cherry picked studies. Otherwise you are just adding to the noise.

You are free to peruse the reports by pretty much every national nutrition & dietetics organization in the world; they already did the hard work of combing through and evaluating all relevant studies in that area.

Any individual "assessment" of the scientific literature by someone who doesn't have scientific training in general or in that particular area is much more likely to result misleading or even dangerous conclusions.

Are you saying you have scientific training in the area? Because you made a clear assessment.

No, I repeated the position of organizations like the AHA, not read a couple studies and made up my own mind.

OK, presumably you'd also need scientific training to discount papers and theories as well. How are you coming to the conclusion about the quackery of other theories?

You mean quacks and grifters like Dale Bredesen, MD, researcher in Alzheimer's, who recommends everyone omit oils except olive, avocado and coconut oil entirely from their diets because they promote chronic inflammation?

(Bredesen probably does not maintain that coconut oil is good for you, just that it doesn't have the problem of contributing to chronic inflammation.)

Yes, exactly like that [0]:

"In her editorial in the Lancet Neurology, published in May 2020, Joanna Hellmuth, MD, of the UCSF Memory and Aging Center, said the “Bredesen protocol” – named by neurologist Dale Bredesen, MD – has reeled in patients and their families seeking hope outside of the physician’s office for a disease that is currently incurable.

The Bredesen protocol is propounded in his 2017 bestseller and can be accessed for $1,399, which includes protocol assessments, lab tests and contact with practitioners, who provide the regimen for additional fees. Online support and cognitive games are available for an additional monthly charge. A follow-up book will come out in August, aimed at anyone concerned about their memory.

The three papers, which were published in 2014, 2016 and 2018, and are cited as evidence that the Bredesen protocol is effective, have major flaws, said Hellmuth, who is also affiliated with the Weill Institute for Neurosciences."

[0] https://www.ucsf.edu/news/2020/05/417431/pricey-protocol-not...

Also, being affiliated with the Institute for Functional Medicine is kind of a red flag [1].

[1] https://sciencebasedmedicine.org/functional-medicine-the-ult...

More likely than something nefarious, I think it's more likely that both kinds of fat have differing adverse health effects. Saturated fats, as this paper suggests, increase LDL, which is bad for heart health. Polyunsaturated fats, especially when used as cooking oils, introduce free radicals that may cause a host of modern health issues, such as Alzheimer's, type 2 diabetes, and general aging [0][1][2].

The nature of agriculture has changed so much in the past 100 years that it's clear we don't know most of the consequences. Studies like this one correlate saturated fat to adverse health effects, but as far as I can tell they don't control for the quality of saturated fat used, lumping them all into the same statistical category. However, there is a substantive difference on health effects, including cholesterol levels, from grass-fed vs grain-fed meat [3], as well as other animal products like eggs and butter. Even worse is the inclusion of plant derived saturated fats like palm oil, which besides raising LDL [4], is a third-world environmental disaster.

That being said, my recommendation is to avoid fried things as much as possible, especially when you don't know what it was fried in and how long that oil stayed hot. Buy grass-fed beef, milk, butter, etc at the store. Replace vegetable oil with olive oil and avocado oil. I could be wrong about this, but it aligns with the heuristic of eating as our ancestors did before the rise of industrial agriculture, and it tastes better.

[0] https://www.semanticscholar.org/paper/Vegetable-Oil%3A-The-R... [1] https://academic.oup.com/advances/article/11/6/1489/5867525?... [2] https://www.tandfonline.com/doi/full/10.3109/10715762.2010.4... [3] https://nutritionj.biomedcentral.com/articles/10.1186/1475-2... [4] https://academic.oup.com/jn/article/145/7/1549/4616780?login...

>increase LDL, which is bad for heart health

This is a gross over simplification

Many people have high Ldl and no cardiovascular disease.

Some have low ldl and have cardiovascular disease.

The reality is there's multiple forms of Ldl.

If you eat a diet high in sugar and fats, your triglycerides will be high and your Ldl will be high. But it'll be a form of Ldl where the particle size is small and much more likely to clog your arteries.

If you eat low to moderate carbs (20-150 net carbs a day) your triglycerides will be low, HDL will be higher and IF your Ldl is high it's likely the ldld particle size is much larger and poses far less of a danger.

the pro-PUFA crowd are largely vegetarians and processed food industry trying to convince you that Criso is healthy.

the fact that saturated fats, which are mainly animal fats, arent that bad is inconvienent to their cult and profits, respectively.

The opposite could be said as well, no? There are vested interest, both corporate and consumer, on both sides.

Yes but one side says Cheese-its and Pringles are OK and the other side is saying eggs are.

Make your choice. What will it be? The side convincing you Crisco is healthy? Or the side thst says a steak isn't that bad in moderation?

This other side aren't just grifters, they're dangerous.

50+ years of their shit science has made our society fatter and increasingly unhealthy and their solution is more of the same.

Both factory processed PUFAs and animal products are unhealthy in my estimation.

My dad (62) just had big heart attack in January. 100% blockage in a vein covering 60%+ of his heart. The surgeon who put his stent in called his EKG “impressive”. He’s never eaten very well or exercised much, and the Mediterranean diet was one of the ones they recommended. My mom (always reading health books) decided to go for an extreme no fat, no oil(!) diet instead, which is difficult in practice. His labs six weeks later showed a greater than 100pt drop in his cholesterol and 30lbs+ of weight loss. He’s able to come off of his previous blood pressure medication, is sleeping better than ever and adding distance to his daily mile walk. Anyway, if you or someone you know is at high risk, turnarounds are absolutely possible with diet, and it might be worth further examining oils and “good fats” if your body doesn’t process cholesterol well.

Were there any changes to his carb intake? Did he also reduce use of simple carbs and processed foods?

Just about everything he ate changed, but he didn’t eliminate carbs. He ate homemade pizza with no cheese, crackers, pretzels… The mix absolutely included fewer processed foods, but pretzels out of a bag are processed, no? He looks forward to anything with flavor—salsa is popular, and small amounts of sorbet after dinner.

Sounds like he adopted the diet that Dr. Esselstyn recommends (http://www.dresselstyn.com/site/). There’s an excellent documentary, Forks over Knives, about his approach and he’s written a book that is awesome.

That’s the one, thank you for linking.

This is from 2017 (although it appears to have some updates from 2020 with respect to the "Dietary Guidelines for Americans").

Am I missing something? What's the significance now? Just "this is still important so let's repost it"?

It's sad about coconut oil; coconut milk makes a really nice chia pudding, way better than the alternatives. It's the only bad part of my keto / low carb diet, otherwise my fat intake is overwhelmingly from olive oil.

What is wrong with coconut oil? My breakfast is typically coffee with grass fed butter & coconut oil - in the coffee.

So sounds like we should be replacing saturated fats with polyunsaturated fats.

Further googling gives:

Polyunsaturated fats are found in high concentrations in Sunflower, corn, soybean, flaxseed oils, Walnuts, Fish.

Canola oil – though higher in monounsaturated fat, it’s also a good source of polyunsaturated fat.

I need a few downvotes, here’s the best book on which oils are healthy vs not:

https://www.amazon.com/Deep-Nutrition-Your-Genes-Traditional...

Your gambit for downvotes appears to be successful.

Never fails on this topic.

That book is written by someone advocating "seed oils" being extremely unhealthy for you, a position that is not held by the relevant scientific community; actually exactly the opposite is true.

seed oils are unhealthy. and there are plenty of studies proving so.

No, this is simply not true.

Well, as convincing as all your citations here may be, just going from first principles, I will continue to avoid the highly-processed, very profitable industrial waste known as 'seed oils.'

https://youtu.be/Cfk2IXlZdbI

Mmmmm. Health food.

Well you enjoy your Crisco, dude.

I thought the Mediterranean diet was what we should all be eating, which would include a lot of olive oil. But that document suggests olive oil is high in monosaturated fats and thus not as healthy as canola oil (poly). Lolwut??

There's nothing surprising about canola oil being considered very healthy. Olive oil is also good.

Olive oil has the most research behind it, thus scientists feel most comfortable advocating for it; but that doesn't mean that something like canola/rapeseed oil isn't also similarly healthy for you, given its fatty acid ratios and polyphenol content.

Mono-saturated doesn't make sense! Saturated means all the carbon atoms have as many hydrogen atoms as they can bear.

Mono-unsaturated is off by one. It's generally regarded as more healthy, and olive oil is generally strongly recommended over saturated fats.

Funnily enough, your body only knows how to synthesize saturated fats (palmitate), so your own natural fat is the "bad" one :)

The AHA is full of shit. Monosaturated fats and even saturated fats are endlessly better for you than Omega6 PUFAs.

Your daily fat intake should be more olive oil based, get some omega3s from fish 1-2x a week, and a moderate amount saturated fats.

Omega6s are fine in the levels you get in Olive Oil (there's a little), or in nuts (macademia nuts being the lowest in omega6s) and say the odd avocado.

To eat them in nthe levels that the West eats them in is toxic and there are endless studies about Omega6s being inflammatory and even contributing to insulin resistance in conjunction with sugar (yes.. a fat encouraging diabetes).

Or maybe it is not really about the oil used, but other components in that diet...

You need certain amount of fats for fat soluble nutrients. But I don't think lot makes too much sense compared to anything else.

There are serious health concerns with soybean oil.

https://www.universityofcalifornia.edu/news/americas-most-wi...

Only if you're deeply concerned about the health of mice.

No (non-quack/grifter) scientist is advocating the position that soybean oil is generally (as opposed to in e.g. exorbitant amounts, but then that goes for any fat) unhealthy for humans; quite the opposite in fact.

Please point out the quackery/grifting in https://academic.oup.com/advances/article/11/6/1489/5867525?...

Note that soybean oil rewrites the genome of mice that consume it [0].

[0] https://www.sciencedaily.com/releases/2020/01/200117080827.h...

It changed gene EXPRESSION, not the underlying coding.

The AHA is passing off horrible, unhealthy information.

Omega6s in high concentration are horrible for you and are inflammatory.

Rapeseed oil was used as industrial lubricant and to fatten livestock before selling to slaughter. I won't be participating in the human experiment of consuming CANadian OiL.

It appears this is from 2017. It also doesn't seem to tell us what we didn't already know, right?

I could drive myself crazy paying too much attention to this stuff. Eat a balanced diet, lots of plants, not too much added sugar, not too much saturated fat. Don't eat more than you need. Get some exercise.

The AHA is completely and utterly full of shit and just like most major bodies pushing nutritional standards, peddles some fairly dangerous information:

https://www.health.harvard.edu/newsletter_article/no-need-to...

Seed-oils that wouldn't, largely, exist without industrial processes creating them as a byproduct (cottonseed oil, corn oil, soybean oil/Crisco, safflower oil, canola, etc.) are a HUGE driver of inflammation which is basically the root of every single disease - cardiac issues, cognition problems, neurological issues, autoimmune issues, cancer).

And there's a lot of theory supporting evidence they explain why people in the 80s - who ate roughly the same amount of calories and had the same level of activity as people today... were on average, a lot lighter in weight.

See: https://www.theatlantic.com/health/archive/2015/09/why-it-wa...

See: https://pubmed.ncbi.nlm.nih.gov/32008872/ and a whole ton more studies too: https://duckduckgo.com/?t=ffab&q=omega-6+insulin+resistance&...

We've been peddled industry lies since the 1950s, largely by coroporations who are founded by 7th Day Adventists ( who are vegetarian by faith and founded companies like Kellog), that Omega-6 PUFAs are healthy and it's the Saturated Fats (animal fats, largely) that are bad bad bad. Yet, since the 1950s ..our health keeps getting worse and worse while omega-6 consumption goes up and up and up..

These companies have influenced nutritional boards and peddle the Ancel Keys, Seven Nations Study ( https://en.wikipedia.org/wiki/Seven_Countries_Study ) as the basis for Saturated Fats being the main driver behind CVD. But the study intentionally left off nations that would have radically changed the results and thus the conclusion. 50+ years of nutritional health has been guided by this b.s.

Find me non-whole/fresh foods not jam packed with seed-oils. It's in marinades, tortilla shells, most bread, every body of packaged food you can imagine - chips, crackers, cookies, pre-made pies and cakes. Hell - i bought some salted pecans the other day from amazon and they were slathered in cottonseed oil for some reason. They're i n salad dressings, bbq sauces, wing sauces. It's even in dry-rubs for wings. Every. Thing.

Mark my words - when history has had it's say, seed-oil delivering a level of omega-6s that the human body was never meant to endure long term, will go down as causing more suffering than sugar ever did, but made infinitely worse by the level of sugar we eat as well.

The amount of omega6s we got from nuts or avocados or oats or whatever, was fine. Condensing it in the way we have and shoving it into everything has raised the titled the scale of consumption to toxic levels. And the AHA is Ok with this.

The AHA, IMHO, is an organization with zero credibility when it comes to understanding human beings and lipids. They're a captured front for industry who would pass off Omega-6s as "heart healthy" and muddy the waters of the debate with shit quality studies.

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