By AMERICAN HEART ASSOCIATION NEWS
Saturated fats found in butter, fatty meats and tropical oils raise LDL, or “bad” cholesterol, which contributes to heart disease, and they should be replaced with healthier options.
It seems a simple statement. But reaction to it – and the American Heart Association advisory issued last month reaffirming that longstanding advice – has been anything but simple. Headlines, blogs and social media posts have run the gamut on how the recommendations are being interpreted.
“[The reaction has] gotten so many people confused, and that’s unfortunate,” said Penny M. Kris-Etherton, Ph.D., R.D., Distinguished Professor of Nutrition at Penn State University who serves as a volunteer on the AHA’s Nutrition Committee.
The advisory, an analysis of more than 100 published research studies dating as far back as the 1950s, pointed out there are great benefits to replacing saturated fats – such as coconut oil, butter, beef fat or palm oil – with healthier polyunsaturated fats. Some studies found this could help lower cardiovascular disease risk as much as some cholesterol-lowering statin drugs, the advisory authors noted.
The AHA has been issuing dietary recommendations for decades. In 1961, it recommended for the first time that vegetable oils replace saturated fats. Governments, including in the United States and internationally, as well as other nonprofits have been cautioning about saturated fats, too, said Kris-Etherton.
“With saturated fats,” she said, “it’s not just the American Heart Association, but the American College of Cardiology and the U.S. Department of Agriculture’s Dietary Guidelines for Americans.”
The U.S. government issued guidelines discouraging saturated fats as far back as 1980, and every five years thereafter. And a review of many years of evidence of the link between heart disease and saturated fats was published in 2012. The authors of the analysis published in the independent not-for-profit Cochrane Reviews concluded that people should continue to limit saturated fats for health reasons. Another such report with a similar conclusion was published in 2015.
The basis for the AHA’s advice about nutrition is a systematic review of the best available scientific information, conducted by volunteer committees of expert researchers and physicians. More information on the AHA’s statements and guidelines development is available online.
Healthy living guidelines issued by the AHA and the American College of Cardiology in November 2013 were a major scientific undertaking, involving some of the nation’s top scientists. For five years, they studied existing research and then issued recommendations that help healthcare professionals treat patients.
The scientists concluded that saturated fat should be no more than 5 percent to 6 percent of daily calories. So, for a diet of 2,000 calories a day, that would mean no more than 120 of them should come from saturated fats. That’s about 13 grams of saturated fats a day.
“It’s one thing to ignore the science, but not paying attention to saturated fats ignores the reality of how consumers are eating today and how having excess saturated fat in the diet does not leave room for healthy foods,” Kris-Etherton said.
American diets are filled with staples of pizza, burgers and sandwiches, she said. “It’s not about suggesting they switch to a deprivation diet, but looking at healthy alternatives for the saturated fats in their diet — foods with fats that meet current dietary guidelines, such as avocados, hummus and nut butters,” she said.
The 2013 AHA/ACC guidelines recommend limiting saturated fats as part of an overall healthy diet. It advises consumers to focus on a diet that emphasizes vegetables, fruits and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils and nuts; and limits intake of saturated fats, sodium, sweets, sugar-sweetened beverages and red meats.
The most recent advisory, the one causing a not-so-new wave of attention, reaffirms that longstanding advice. Here are some of the scientific highlights:
— Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by about 30 percent – similar to results achieved by some cholesterol-lowering drugs known as statins.
— Prospective observational studies in many populations showed that a lower intake of saturated fat with a higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease.
— Several studies found that coconut oil – which is predominantly saturated fat but has been widely touted recently as healthy – raised LDL cholesterol to the same degree as other saturated fats found in butter, beef fat and palm oil.
— Replacing saturated fat with mostly refined carbohydrate and sugars does not lower rates of heart disease, but replacing these fats with whole grains is associated with lower rates. This indicates that saturated fat and refined carbohydrate are equally bad relative to heart disease risk, Kris-Etherton said.
- American Heart Association Presidential Advisory on Dietary Fats and Cardiovascular Disease
- Advisory: Replacing saturated fat with healthier fat could lower cardiovascular risks
- Saturated fats: Why all the hubbub over coconuts?
- Recommended Dietary Pattern to Achieve Adherence to the AHA/ACC Guidelines
- AHA experts reiterate importance of limiting saturated fats
- Saturated fat facts