Good Fats, Bad Fats by Evan L Lipkis MD

So what’s the scoop on fat?  First, ask the question before imbibing, are you a good fat or a bad fat?

The answer isn’t easy but I will make it simple because simple is what I understand!

 

 

 

Saturated fats. 

 

 

 

Saturated fat such as palmitic acid (meat) and myristic acid (butter) both raise bad cholesterol (LDL) substantially. On the other hand stearic acid (chocolate) doesn't raise LDL and Lauric acid found in coconut oil raises LDL mildly and also raises the good cholesterol (HDL). 

 

Generally, most saturated fats increase the rate of heart disease, although this is still a subject of hot debate. Generally stay away from saturated fat with the above exceptions. Limit such fats to 10% of your diet or less.

 

Once again, saturated fats such as steak (palmitic acid), butter (myristic acid), lard etc. are less healthy.

 

Why do the French have lower rates of heart disease than the USA even though they consume the same amount of saturated fats? 

 

This French Paradox is difficult to explain. The French diet includes more wine and cheese than the American diet and this may be an explanation. Interestingly, in two studies, cheese reduced coronary disease by 18% and strokes by 13%.(British Journal Nutrition 2016;115/JAHA 2016;May 115). 

 

The largest risk reduction in heart disease occurred with greater cheese intake of 40gms or higher per day and cheese is a saturated fat. Another idea is that the French are more active and therefore have lower heart disease and strokes.

 

Eggs have little saturated fat but do not raise cholesterol. Eggs are also a good source of protein and likely do not correlate with heart disease. Finally, according to Mol Nutr Food Res.published online December 12, 2018, people who ate 1 egg a day had a decreased risk of type 2 diabetes. It is proposed that the chemicals in eggs, choline and carotenoids, may be responsible. 

 

On the other hand the March 19th 2019 edition of JAMA showed that increasing egg consumption (6 pooled prospective studies) correlated with more heart disease and over all mortality.

 

What should we do? At this point, I would be more inclined to lean towards egg whites or to limit consumption of eggs. Sometimes the truth in medicine isn’t always crystal clear. So let’s just take a cautious approach until we accumulate more knowledge.

 

The PURE Study (Lancet Sept 18, 2018) implies that yogurt and milk reduce cardiovascular outcomes. Additionally, it appears that high fat dairy is better. This is counterintuitive but such patients gain less weight than patients who consumed low fat dairy.

 

With regards to saturated fat, many people choose to supplement with coconut oil but until more information is known, cut down most saturated fats.

 

Interestingly, in the south pacific, the Katavin people consume 40% coconut oil but have a low incidence of heart disease. Additionally, pigs get thin on coconut oil vs. corn oil. Since coconut oil is controversial, it might be wise to wait till more knowledge is known on this subject.

 

 

Chocolate is a great antioxidant in moderation. So even though chocolate is a saturated fat, it can be healthy in moderation. Many studies show reductions in heart disease with this nutrient. Dark chocolate seems to be healthier but even milk chocolate has some benefits. 

 

The saturated fat equation is changing. Dairy products, dark chocolate and coconut oil may be healthy but meat is still deemed to be unhealthy. 

 

So keep saturated fats low in your diet but it’s ok to add some dairy (cheese and eggs) and dark chocolate. Stick to healthy fats which includes polyunsatuated and omega-3 fats. We will discuss these good fats later. Guidelines need to change on saturated fats because all are not alike. Still, saturated fats and carbs are the drivers of high cholesterol.

 

 

Corn syrup 

 

This is not corn oil but rather a sweetener that contains fructose but let’s talk about it anyways.

 

High fructose corn syrup is found in sweetened beverages, canned fruits, baked goods ice cream and desserts. It is contributing to diabetes and obesity. 

 

Also, since it is only broken down in the liver, steatosis or fatty liver can develop. Would you put diesel fuel in a car that uses gasoline? Of course not and we should be careful to reduce or avoid high fructose corn syrup. Just because it is sweeter, doesn't make it better.

 

 

 

Trans fats. 

 

Most of these unhealthy fats should already be eliminated in the US as of 2018 and it is a major contributor to coronary disease. If you see on the food label partially hydrogenated or shortening avoid it like the plague as this represents a trans fat. Maybe it's called shortening because it shortens your life! 

 

This fat causes at least 30,000 excess deaths per year from heart attacks as it raises the LDL or bad cholesterol and lowers the good cholesterol or HDL. These fats likely increase cancer and diabetes as well. 

 

Also if a product says zero trans fats it is still allowed to have one half gram of trans fats per serving so check the label for partially hydrogenated which means it does indeed have trans fats.

 

Unsaturated fats

 

We have already discussed saturated fats and now we go on to the healthier fats.

 

Monounsaturated fats contain certain nuts, avocados and olive oil, canola oil and other oils.

 

Polyunsaturated fats contain seed oils such as canola, safflower, corn and sunflower. Also this category includes omega 3 fats. 

 

There are 2 types of omega 3s: Fish oils (EPA and DHA are the active ingredients) and alpha linolenic acid (ALA). ALA includes flaxseed oil, vegetable oils and walnuts.

 

Actually, nearly every oil is a combo of all the fats. Coconut oil is 86% saturated fat but it does contain unsaturated fats as well. Sunflower oil contains very little saturated fat and more mono and poly unsaturated fats. 

 

The take home message is that unsaturated oils are healthy for you!

 

 

 

 

 

Restrict red meat.

 

Steak actually leads to the production of a toxic chemical in our gut called TMAO. It causes the gut to leak inflammatory chemicals which can cause blockages in our coronary arteries. 

 

Ok, let’s summarize a few studies which can give us additional insight regarding healthy fats

 

—If you reduce carbs or even saturated fat in your diet and add polyunsaturated foods, you reduce coronary heart disease according to JAMA Internal Medicine, July 5th, 2016. Additionally there were reductions cancer, neurodegenerative disease, and respiratory disease, compared with those who maintained high intakes of saturated fats. 

 

So go with healthy fats and and oils such as fish, avacados, sunflower and other vegetable oils. Cut down the meat, butter, sweets and high carb foods.

 

—While a low carb diet is beneficial in lowering cholesterol, triglycerides and sugar, the diet with the best clinical outcomes is the Mediterranean diet. This is a lower carbohydrate diet as well. 

 

The Mediterranean diet is the healthiest diet and consists of whole grains, fruits, vegetables, nuts, olive oil, fish and a little alcohol. The diet helps to prevent heart disease, cancer and Alzheimer's as shown in NEJM 2013, Feb. 25 issue. Even just adding a liter of olive oil to your diet per week cuts heart disease by 30%. Additionally, this diet helps our good cholesterol (HDL) to function better. This means that the Mediterranean diet can potentially reverse plaque in the arteries. 

 

 

 

Conclusion: All oils and fats are combos of saturated, monounsaturated and polyunsaturated fats. A great chart can be found at https://en.m.wikipedia.org/wiki/Fat 

 

Generally, most saturated fats are unhealthy while monounsaturated and polyunsaturated fats are more healthy.

 

SATURATED

 

—animal fats like meats

—tropical oils like palm, coconut and cacao

—cacao is used to make chocolate.

—dairy products like cheese, milk, butter

—cakes, pastries

 

 

MONOUNSATURATED

 

—olive oil, canola oil

—nuts

—avocados

 

POLYUNSATURATED

 

—omega-3s like fish oil and flaxseed

—omega-6s like seed oils (corn, safflower, sunflower, soybean, vegetable oil)

 

Dr’s. Rx: 

Avocados, nuts, fish, flaxseed oil and olive oil are healthy fats while trans-fats and some saturated fats are harmful. Choose wisely.


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