Food companies hate the idea of being regulated i.e. having the government tell them what to do. However, with freedom in the marketplace comes responsibility. The best way to avoid regulation is for an industry to do the right thing by its customers and health authorities when a problem with the industry’s products is identified.

In the United States, the Food and Drug Administration recently announced that partially hydrogenated oils (containing trans fats) were no longer ‘Generally Regarded as Safe’ and gave the fats and oils industry three years to get them out of the food supply. So, begrudgingly, the US industry will be forced to adopt a position that companies in the rest of the developed world adopted 20 years ago.

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There are lots of oils derived from seeds – sunflower, canola, soybean, cottonseed, sesame, flax, grape seed, peanut and safflower to name a few. The first thing that strikes you about these oils is not how similar they are but how different. Traditional sunflower oil is high in polyunsaturated fats, whereas canola has more monounsaturated fats, plus some omega 3. Flaxseed oil has lots of omega 3 and so on.

About the only thing that all these seed oils have in common is that they are relatively low in saturated fat, which is considered to be a good thing by every reputable nutrition and heart health authority in the world.

Of course, things are very different in the curious world of celebrity-driven nutrition advice where for some reason saturated fat is seen as desirable and coconut oil, one of the most saturated of all oils, is promoted a healthy choice.

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Credible nutrition scientists have opposing views on whether omega 6 in vegetable oils is good for heart health. But who is right?

Part 1 of this series examined claims that omega 6 in vegetable oils causes ill health by increasing the risk for cancer, macular degeneration, Parkinson’s disease and inflammatory conditions, such as rheumatoid arthritis, ulcerative colitis and asthma. These claims, frequently expressed on the internet and in social media, were found to be baseless.

Part 2 will consider whether omega 6 increases or decreases the risk for coronary heart disease. Unlike the wild social media claims about omega 6, this issue is argued in the scientific literature with credible scientists on both sides. Whose argument is stronger?

The conventional wisdom

Leading heart health agencies such as the Heart Foundation, the American Heart Association and the World Health Organisation assert that polyunsaturated fats (mainly omega 6) are heart healthy and that they may be the ideal replacement for saturated and trans fats in the diet. The case appears to be strong:

• Polyunsaturated fat (mainly omega 6) has a beneficial effect on blood lipids. When saturated fat is replaced by polyunsaturated fat the level of serum LDL-cholesterol and the total cholesterol/HDL cholesterol ratio both fall, which is consistent with lower risk for coronary heart disease.

• Epidemiological studies indicate that polyunsaturated fat (mainly omega 6) is heart friendly. A pooled analysis of 11 prospective cohort studies conducted in Europe and the United States shows that replacing saturated fat with polyunsaturated fat lowers coronary risk more than other macronutrients.

• In randomised controlled trials coronary heart disease risk falls when saturated fat is replaced by polyunsaturated fat (mainly omega 6) – see Harvard’s meta-analysis.

So the conventional wisdom is based on three consistent lines of evidence with a rare meta-analysis of randomised controlled dietary trials sitting on top. Impressive. How could you argue against it?

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Although the headlines have got it wrong the science relating to saturated fat and heart disease has evolved considerably. But Australia’s public health nutrition policy makers are blissfully unaware and are implementing science that’s out of date.

In March yet another headline appeared in the mainstream media stating ‘No link found between saturated fat and heart disease’. The media delights in stories about diet that appear to contradict the status quo and, of course, relevant industry groups always put their public relations firms into action whenever an opportunity presents itself. Hence the misleading headlines.

Certainly there have been recent developments in how the coronary risk associated with dietary saturated fat is understood but it has to be said that the significance of these findings has still not fully registered with many nutritionists and policy makers in Australia, let alone the media. So let’s recap.

The way things were

Prior to 2009 many dietary guidelines around the world included a recommendation to eat less saturated fat on the grounds that it increased the risk for coronary heart disease. But there was always an unstated corollary to ‘eat less saturated fat’ i.e. eat more of something else. If your body weight is stable and you just eat less saturated fat you will start to lose weight, because saturated fat contains calories. To maintain weight while eating less saturated fat you have to eat more of other calorie-containing nutrients, such as carbohydrate, monounsaturated fat or polyunsaturated fat. So ‘eat less saturated fat’ really meant replace saturated fat with a healthier macronutrient.

The assumption of the old dietary guidelines was that it didn’t really matter what you replaced saturated fat with – it was thought that all replacements would lower the risk for heart disease. However, we now know that this assumption was wrong.

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At last a trial of monounsaturated-rich Mediterranean diets for the primary prevention of cardiovascular disease has been published and the results are impressive. The missing piece of the puzzle is now in place. Mediterranean-type diets, moderate in total fat but enriched with unsaturated fats, are now the preferred model for healthy diets. But will nutritionists pay any attention or cling to the low fat dogma for a little longer?

Although advice to eat less saturated fat has been a fixture in Dietary Guidelines for three decades, the last four years have seen a spirited debate about what should take its place in healthy diets. As saturated fat is a macronutrient, one can’t just ‘eat less saturated fat’ and maintain energy balance. Saturated fat needs to be replaced by something else, such as carbohydrate or unsaturated fats. Carbohydrate is now considered a poor replacement for saturated fat as these two macronutrients confer the same risk for heart disease. This leaves mono- and polyunsaturated fats as the better options to replace saturated fat, but which of these should be preferred?

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