We have made fat a four-letter word. Full-fat is even worse, not fit to be uttered in polite company.
Doctors have been warning us for decades about the ills which fat can visit upon us. Heart disease obviously has been the main issue. The population lives in fear of keeling over dead if it so much as puts another fat calorie into its mouth.
Are we there yet?
The implicit promise seems to be that if we only behave ourselves, if we only avoid this dreadful fat monster, we would get slimmer, we would be free of heart attacks, and we would live happily ever after.
So what happened?
Americans, in particular, have been shunning fat in droves. If you look in large grocery stores, everything is fat-free, or low-fat, or reduced fat. Folks like me, who enjoy full-fat milk, cheese, and yogurt, have almost become pariahs. We have to search far and wide, and at times go to multiple stores, before we can find dairy products to meet our tastes. And then we have to hide them at the check-out counter, so nobody can see what we are guilty of.
So have we gotten any slimmer as a nation after cutting out the fat? Have we eliminated the scourge of heart disease?
Fat consumption is going down, at least in the US, but we are getting fatter. BMI is going up. Kids are approaching the weight adults used to have decades ago. And diabetes is on the rise.
So what gives?
Were we, as physicians, wrong? Horror of horrors!
Is all fat bad? Or, as Paleo-diet proponents might suggest, is fat good?
Are there good fats and bad fats?
Is saturated fat good, bad, or ugly?
What do studies show?
For decades, the fat, or saturated fat-heart disease link was considered settled fact. And then, heretics started to question that. More heretics followed, till they were no longer heretics.
Now, a growing body of literature is calling into question the link between full-fat, saturated fat, and heart disease, obesity, and diabetes.
Types of fat
All fats are not created equal. There is saturated fat and unsaturated fat. Among the unsaturated variety, you can find mono-unsaturated fat, and poly-unsaturated fat. Then, of course, there is trans-fat, omega-3 fat, and omega-6 fat.
I could give you a detailed chemical account of all this, but that would make you stop reading any further. So we will leave that for a later date.
Sources of fat
You do not go to a grocery store and buy five pounds of fat, ten pounds of protein, six pounds of carbohydrates, and a whole lot of sugar.
You buy foodstuff.
This contributes about 10% of the total calories in a typical North American diet. Major sources are animal products: butter, milk, meat, salmon, and egg yolks. Some plant products, such as chocolate, coconut oil, palm kernel oil, and cocoa butter, also contain saturated fats.
Of late, a few studies and meta-analysis of studies have suggested that there may not be a significant link between saturated fat intake and coronary heart disease. A study published in the American Journal of Clinical Nutrition in January 2010 reported on pooled data from 21 studies on saturated fatty acid intake and risk of coronary heart disease, stroke, or cardiovascular disease in general. Over 340,000 individuals were studied.
The researchers found no significant association between high intake of saturated fatty acids and an increased risk of coronary heart disease, stroke, or cardiovascular disease.
But what about becoming fat? Or diabetic?
Let us return to our obsession with low-fat and no-fat products. Before long, we might even be looking for fat-free water. And that might be all right, if it made us slimmer. But it has not. Do not take my word for it. Just look around you.
Thank you, Tufts University
A recent study in Circulation (March 2016) conducted by researchers at Tufts University investigated the link between the intake of dairy fat and the development of diabetes. The scientists checked the blood of more than 3000 people for byproducts of full-fat dairy.
They found that people who had higher level of these byproducts in their blood (thus identifying those who consumed full-fat dairy) had, on an average, a 46% lower risk of developing diabetes during the period of follow-up.
Obesity and dairy fat
There has been a fear in the general population, perhaps abetted by the medical profession in the past, that if you drink full-fat milk or eat full-fat yogurt, you will become fat. This is simply not true.
A study published in The American Journal of Clinical Nutrition in April 2016 evaluated more than 18,000 women who were 45 years or older and whose weight was normal at baseline. These were participants in the Women’s Health Study, and were followed for over 11 years.
The researchers found that a greater consumption of high-fat dairy products was associated with less weight gain during follow up.
They also found that women whose intake of high-fat dairy was in the top 20% in the group had a lower risk of becoming overweight or obese.
Shouldn’t fat make you fat?
That was the logic behind recommending low-fat products to the general public.
However, it now appears that when people cut out the fat in their diets, they start increasing their intake of carbohydrates. The body then turns these carbohydrates into sugar, and then into fat, which is stored.
- It appears that the strategy of focusing on individual nutrients, such as fat, or saturated fat in particular, may not be the healthiest way to proceed.
- It is better to deal with food as a whole, and make healthy choices, incorporating a whole range of nutrients, including plenty of fruits and vegetables.
- The phobia about full-fat dairy appears to be misplaced, and recommending low-fat products may not lead to weight loss or protection from diabetes.
- Multiple mechanisms involving insulin and glucose regulation are probably involved in the link between full-fat dairy consumption and protection from diabetes.
- However, common sense should be used, and people should not go out and start consuming vast amounts of high-fat foodstuffs. Calories do add up.
- Some types of fat are still best avoided, the prime example being trans-fats, which have been regulated or banned in several US cities.
- Processed foods, sugary drinks, and desserts should be consumed sparingly, if at all.