Comments on: Modern Dietary Myth No. 8: Saturated fat is better for you than carbohydrate

By: rob

rob — Thu, 08 Oct 2015 04:17:57 +0000

Margarine is yesterday’s hero

By: Robert

Robert — Wed, 09 Sep 2015 21:09:25 +0000

Hi Bill, I just wondered what are your thoughts on this recent paper:
The association of substituting carbohydrates with total fat and different types of fatty acids with mortality and weight change among diabetes patients.
Clin Nutr. 2015 Aug 28. pii: S0261-5614(15)00224-1. doi: 10.1016/j.clnu.2015.08.003.

By: Simon

Simon — Sun, 12 Jul 2015 10:21:11 +0000

Reply no longer needed Evelyn at Carb-Sane Asylum has been following him and blogged on him.

By: Frank

Frank — Wed, 03 Jun 2015 23:45:25 +0000

But what would be the message to send to the population, that SFAs are healthy? That would be wrong when you look at the whole picture. Clearly we’re still lacking strong and well-designed prospective cohort study to know the full effect of SFAs on CHD risk. Making matters more complicated, different SFAs might have different effect, and comparing it to another nutrients does not have the same impact. We know that less SFAS, more PUFAs decrease risk. The effect of carbs and MUFAs are less clear as of now.

But, let’s look at the full picture.

SFAs might impairs IS. Not yet clear, studies are conflicting.

SFAs looks inflammatory, primilarly but not exclusively through an impact on the microbiome

Diets high in saturated fat increase intestinal inflammation associated with IBD via alterations in the microbiota

Influence of dietary fat on intestinal microbes, inflammation, barrier function and metabolic outcomes

A saturated fatty acid–rich diet induces an obesity-linked proinflammatory gene expression profile in adipose tissue of subjects at risk of metabolic syndrome

Differential Effects of Cream, Glucose, and Orange Juice on Inflammation, Endotoxin, and the Expression of Toll-Like Receptor-4 and Suppressor of Cytokine Signaling-3

Consumption of Saturated Fat Impairs the Anti-Inflammatory Properties of High-Density Lipoproteins and Endothelial Function

In mice, a high SFAs, LC diet increases mortality

High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice

SFAs might impairs endothelial function, althought studies are conflicting

SFAs do not impair endothelial function and arterial stiffness

Flow-Mediated Dilatation Is Impaired by a High–Saturated Fat Diet but Not by a High-Carbohydrate Diet

SFAs is most likely to results in abdominal fat accumulation compared to PUFAs

Overfeeding Polyunsaturated and Saturated Fat Causes Distinct Effects on Liver and Visceral Fat Accumulation in Humans.

SFAs are obegenics

Saturated fat stimulates obesity and hepatic steatosis and affects gut microbiota composition by an enhanced overflow of dietary fat to the distal intestine

Whole body oxidation of dietary fatty acids : implications for energy utilization
Differential oxidation of individual dietary fatty acids in humans

Increasing dietary palmitic acid decreases fat oxidation and daily energy expenditure

And I mean this is only the tips of the iceberg. This is far from looking healthy to me and anyone in for the science should at least still be very cautious on how they interpret the evidence and what kind of recommendations comes out of it. It really does not look to me as if increasing SFAs is a good idea at all.

By: George Henderson

George Henderson — Fri, 08 May 2015 02:44:10 +0000

Bill, if I was to go with serum lipids, I would say that the effect of CHO is mediated through post-prandial triglycerides, with the depleted VLDL particles playing the role usually attributed to LDL.
We have a situation where the risk of diabetes is common and the effect of glycosis on blood vessels should also be considered. However, the difference between SFA and mixed CHO in Farvid et al. is slight, there is a similar relationship in Jakobsen et al., but there is no reason to read much into it. Generally any energy source that is not PUFA increases CHD to much the same extent if it is substituted for PUFA in this type of analysis.
Except perhaps if they measured fibre and protein, but these are as rare as PUFA, and the analyses may just be showing up the value of scarcity.
Certainly if wholefood carbs – carbs from fruit and veges, which Westerners do eat, and wholegrains, which they might depending how this is defined, are thought to be healthier than refined carbs, then isolating refined carbs in a substitution meta-analysis (which should be done some day soon) will surely show them to be more strongly associated with CHD than any fat type.
But how much of this effect will be due to diabetes, metabolic syndrome, insulin resistance, in other words, on the effect of carbohydrates in people who don’t tolerate them very well for medical reasons, and how much – if any – is intrinsic to sugar and starches, which seem to be healthy enough in some populations?

By: Bill Shrapnel

Bill Shrapnel — Mon, 04 May 2015 00:27:24 +0000

Hello Mie. Echoing my reply to George, I don’t yet understand how carbohydrates confer the coronary risk that they do. The current vogue is to blame sugar for everything though I suspect glycaemic index/load is important. If it is, we need to be careful about how we advise people on carbohydrate-rich foods. For example, wholemeal bread isn’t usually considered a refined carbohydrate yet it has a high GI.
Carbohydrate quality is a complex subject and am sure we will hear a lot more about it in the next decade, Regards, Bill

By: Bill Shrapnel

Bill Shrapnel — Mon, 04 May 2015 00:19:53 +0000

Hello George. Why do you think carbohydrate is (roughly) equivalent to saturated fat in relation to CHD mortality/events? Based on effects on LDL-C you would expect carbohydrate to be protective, so another mechanism(s) must be at play. What do you think it is? Regards, Bill

By: Mie

Mie — Sat, 02 May 2015 20:16:56 +0000

“For CHD events, saturated fat is better than carbohydrate.”

Oh yes, so very much better indeed.

“Now, this isn’t refined carbohydrate – it’s mixed carbohydrate that includes carbohydrate from vegetables, fruit, and wholegrains. If you think those carbs would look better, in that case refined carbs would look worse.”

… and since the study populations have been Westerners, it’s been MOSTLY refined carbs as that is – unfortunately – what we eat. In addition, bear in mind that the effects of safa intake have likely been attenuated by e.g. its intake from fermented dairy products (foods relatively rich in safa which have ingredients that tone down the effect of safa on lipid levels).

By: Simon

Simon — Fri, 24 Apr 2015 00:19:31 +0000

Bill how familiar are you with Mozzaffarian’s resent research into SFA’s and are you able to sum them up for me? He is often quoted by advocates of high fat diets and when I go to read his studies I get confused (I don’t have the background ). Is he suggesting we re think the role of SFA in the diet or is he being quoted out of context.

By: Callum

Callum — Thu, 23 Apr 2015 05:18:42 +0000

Except the argument wasn’t about insulin instability, for which a low carb diet is ideal (depending on the nature of the impaired insulin response), the argument is that increased saturated fat has a scientifically based association with increased cardiovascular disease risk.