Aseem Malhotra, interventional cardiology specialist registrar at Croydon University hospital, London, has some advice: don’t fear the fat.
Saturated fat, that is. Contrary to the dietary guidance we’ve been hearing for decades, Malhotra writes in the British Medical Journal that butter, cheese and even red meat are not as bad for the heart as we once thought.
He also suggests that statins have been misguidedly over-prescribed in an effort to lower cholesterol to reduce heart disease, but that the side effects outweigh the benefits for millions of people.
“The mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for almost four decades,” Malhotra writes.
“Yet scientific evidence shows that this advice has, paradoxically, increased our cardiovascular risks,” he adds. “Furthermore, the government’s obsession with levels of total cholesterol, which has led to the overmedication of millions of people with statins, has diverted our attention from the more egregious risk factor of atherogenic dyslipidaemia.”
Malhotra goes as far as to say that the decrease in saturated fat from the diet has paradoxically increased the risk of cardiovascular disease; people looking to lower saturated fat often opt for low-fat products, which are generally high in sugar and may contain trans-fats, which remain a no-no.
"Recent prospective cohort studies have not supported significant association between saturated fat intake and cardiovascular risk," he argues. "Instead, saturated fat has been found to be protective."
But not all foods containing saturated fat are equal. Malhotra notes that dairy products supply significant amounts of vitamins A and D; studies have found a link between vitamin D deficiency and a significantly increased risk of cardiovascular mortality. Furthermore, the calcium and phosphorus in dairy foods may decrease cardiovascular risk. But he doesn’t recommend processed meats and cheeses.
Rather than take statins, he advises people with cardiovascular risks to follow a Mediterranean diet – one rich in olive oil, fruit, vegetables, fish, nuts, and low in sugar and junk food – noting a recent study that showed a Mediterranean diet after a heart attack is three times more effective in preventing further illness than statins.
Although many other experts are not yet ready to heed the maverick call to eat saturated fat, others support his theory. Robert Lustig, pediatric endocrinologist at the University of San Francisco told The Guardian, "Food should confer wellness, not illness. Real food does just that, including saturated fat. But when saturated fat got mixed up with the high sugar added to processed food in the second half of the 20th century, it got a bad name."
"Instead of lowering serum cholesterol with statins, which is dubious at best," he adds, "how about serving up some real food?"
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