Does saturated fat really cause heart disease?

By | Big Fat Lies, Conflicts of Interest, Vegetable Oils | 9 Comments

We’re not eating enough margarine and it really is starting to bother people who make it. According to Dairy Australia’s 2009 report, butter (and butter-like substances) have steadily increased from 30 percent of the spread market in 2001 to 43 percent in 2009. And the outlook to 2012 is even rosier with expected growth of almost 10 percent.

I blame MasterChef (and its ilk). You never see the latest quasi-celebrity cracking open a nice tub of marg do you? No, its great dollops of butter all the way. Of course it could just be that we’re getting wary of how many chemists were involved in creating the stuff we spread on our bread.

Goodman Fielder (the maker of Meadow Lea) has obviously decided not to take our growing disdain for manufactured spreads lying down. In the last few weeks a commercial has been airing featuring a smart young fellow by the name of Andrew Wilson chatting to us about the evils of eating butter.

Andrew ought to know what he’s talking about. He’s a cardiologist with the Department of Medicine, St Vincent’s Hospital in Fitzroy, Melbourne. I know this because, not only does his mug appear regularly on the teev, he features on a website called Spread the Facts.

Andrew tells us that “as a cardiologist he understands what saturated fats can do to your child’s health,” and illustrates this with a graphic of a “child’s artery” filling with saturated fats from butter. He then goes on to suggest that we should switch to a margarine spread made with plant seeds (tight shot of plant seeds in doc’s hands), “because most contain at least 65% less saturated fat than butter.”

The website (and the ad) are bought to us by Goodman Fielder and both appear to be in some (nonspecific) way associated with the Australian Heart Foundation (if the constant use of their logo is anything to go by).

On my telly, whenever Andrew appears in an ad break, you can put money on the probability of an ad for Meadow Lea materialising an ad or two later in the break. The Meadow Lea ad features children gambolling in a field. Mother then enters and the voice-over points out that Meadow Lea is made from plant seeds (tight shot of mother’s hands holding plant seeds) which contains 65 percent less saturated fat than butter. Enough dots for you to join there?

All that authorititive advice (followed coincidentally by an ad for a product that fits the bill) should have any self-respecting parent hurtling towards the margarine section of the supermarket before Hermione and Jeremy’s arteries are irreversibly clogged.

The only problem with all of this is that the science doesn’t appear to match the advertising spin. A study to be published next month in the American Journal of Clinical Nutrition concludes that “there is no significant evidence that dietary saturated fat is associated with increased risk of [heart disease].” Huh? But didn’t Andrew show us pictures of children’s arteries being pumped full of saturated fat?

The study arrived at that conclusion after examining 21 previous studies of a total of 347,747 people. It was however supported by the National Dairy Council (who might like us to eat a little more butter).

Fortunately (for the suspiciously inclined), a comprehensive review (which has no dubious sources of funding) of the evidence was published in the British Medical Journal back in 2001.

The British review decided that despite decades of research (and thousands of people participating in randomized trials), there “is still only limited and inconclusive evidence” that the amount or type of fat you eat makes any difference to your chances of death by heart attack. Not exactly resounding support for the line being pushed by Andrew, the Heart Foundation and Goodman Fielder, now is it?

These results are quite a contrast to a review published by the American Heart Association (AHA) last August. That review summarised the available research on the relationship between sugar intake and cardiovascular health. It noted that “sugar intake appears to be associated with increased triglyceride levels, a known risk factor for coronary heart disease,” and concluded that the average American needed to dramatically reduce their sugar intake.

The AHA was so concerned they recommended that an adult male consume no more than 9 teaspoons (5 for women and 3 for kids) of added sugar a day (about the same as a can of soft drink or a large bowl of fruit muesli for the man). Even worse, alcohol had to be deducted from the allowance, so one full strength beer would reduce a man’s sugar quota to zero.

I can’t blame Goodman Fielder for having a go. They’re not a charity and they’ve got a product to sell in a market populated by mini-me MasterChefs. But why is a cardiologist fronting up and suggesting something that isn’t supported by the research? And why is the Heart Foundation in there helping them both out? Why aren’t the Australian Heart Foundation telling us what their American cousins know about sugar? Surely it’s not because no-one is paying them to – surely not?

Sugar, not salt, causes high blood pressure

By | Big Fat Lies, Sugar | 10 Comments

A study published in last week’s British Medical Journal (BMJ) seemed to confirm what our health gurus already know. Apparently salt is not good for you.

The paper reviewed a series of studies on salt intake conducted between 1985 and 2007. The results were all over the map. But the authors said if you looked at them just the right way, they showed that if you ate more salt your risks of stroke and heart disease were much higher than otherwise.

The theory goes that if you eat less salt, less water will be drawn into your bloodstream and you will have lower blood pressure. And blood pressure is a known risk factor for heart disease and stroke. So they concluded we should all continue to try harder to reduce our salt intake.

Huh? Didn’t we already know this? Isn’t this old news? Why on earth would anyone need to confirm something that we’ve been told since at least 1979? Well it seems the dangers of salt are nowhere near as certain as we have been led to believe.

According to the salt industry, the results are questionable because two of the study’s authors are members of a strident anti-salt group, but didn’t disclose this to the BMJ. And it doesn’t take long to find major studies which flat out contradict those results. Just last year, a significant study showed that (at least in the US), low salt levels actually increase your risk of death from heart disease.

Some small salt studies have shown that decreasing salt will lower blood pressure (and quite a few haven’t). But the favourable results (of less than 2% decrease) are hardly earth shattering. In fact, it’s possible to get similar effects just by decreasing the amount of water someone drinks prior to having their blood pressure taken.

Whether salt really increases (or reduces) your risk of death from a heart attack is clearly far from settled. But that hasn’t stopped nutritionists, Food Standards Australia and the Heart Foundation lobbying furiously for decreases in our daily salt allowance.

Meanwhile the link between sugar (well, at least the fructose half of sugar anyway) and high blood pressure has been growing stronger by the day. A study released last month confirmed that fructose directly causes high blood pressure. The researchers were able to raise participants’ blood pressure by 5 percent in just two weeks by giving them the amount of fructose contained in 3.5 litres of softdrink per day (about 3 times the American average).

The blood pressures returned to normal after two months off the high sugar diet. The study is clearly not a real world example but the effect was pronounced and very, very quick. No study of salt intervention has ever produced anything like it.

Another study released last month backs up the link. In that one, the soft-drink consumption habits of 4,528 people were analysed. Participants who consumed more than 74g of fructose a day (about the same as in 1.3 litres of soft drink and bang on the American average) significantly (87%) increased their risk of having dangerously high blood pressure. Once again, no salt study has ever shown anything like that effect.

But while the Heart Foundation campaigns against salt, it hands out ‘ticks’ to high sugar products like fruit bars and fruit juices. And when salt concerns are put to food processors they respond with good intentions – oh dear, yes there is too much salt in food – we must do better. But try saying that kind of thing about sugar and you get letters from the legal department.

I wonder why that is? Perhaps it’s got something to do with the fact that reducing salt (from anything to anything) is a great marketing claim and it probably won’t affect the sales of the product. But reducing sugar (when your competitors don’t) will probably cost you serious money. Unlike salt, sugar is highly addictive.

It’s time we suspended the phoney war on salt and started a real war on the real culprit: sugar.

Image courtesy of Mister GC at FreeDigitalPhotos.net

Why Iodine is being added to your Daily Bread

By | Big Fat Lies, Sugar | 7 Comments

You may not know it but you need iodine in your life. No, I’m not talking about the brown tincture that your mum smeared all over your bloodied knee, although it’s closely related. The iodine you need even more than that is the kind you eat as part of your diet. You don’t need a lot (about one teaspoon over your lifetime) but it is vital, particularly in the few months before the world is blessed with your presence.

Iodine is used by your thyroid gland to manufacture a couple of hormones (with inconsiderately long names which have thankfully been abbreviated by the research community to T3 & T4). If a pregnant woman’s thyroid gland can’t get enough iodine to make these hormones then there will be disastrous consequences for her baby.

Thyroid hormones are critical for the creation of the protective coating of nerves (called myelanation) which is most active in the period from 22 weeks gestation to just after birth. A range of recent studies show conclusively that even if the mother is only moderately iodine deficient, the child will suffer a reduction in IQ of between 10 and 15 points. Severe iodine deficiency will result in significant mental retardation.

The research on iodine deficiency is well established and is the driver behind the creation of ‘iodised salt’. But in the last decade or so we’ve become a bit too good for plain old salt (rock salt only please) and the alarm bells are starting to ring. Iodised Salt is now less than 10% of all salt sales.

But even if you have a perfectly adequate amount of iodine in your diet you may still be unable to produce enough of the thyroid hormones. Guess how (c’mon it’s not that hard, you’re reading a blog about fructose)? That’s right, just make sure your diet is high in fructose (sugar for the newcomers).

A series of studies published in the eighties by the US Department of Agriculture show that fructose creates a copper deficiency. And a bit more research (from Russia) in the nineties shows that a fructose induced copper deficiency sharply decreases iodine hormone (T3 & T4) production by the thyroid gland.

So even if she has plenty of iodine in her diet, if a pregnant woman’s diet also has plenty of fructose, she’s playing Russian roulette with her child’s IQ (‘scuse pun).

The combination of a high fructose, low iodine diet is starting to have a real impact on Australian women. A recent update to 2001 research out of Westmead hospital in Sydney suggests a 50% increase in thyroid hormone deficiencies in Australian pregnant mothers.

But don’t worry, the Government is on the case. Are they banning fructose? Are they suggesting pregnant mothers take iodine supplements? No, of course not. Their solution is exactly the same as the solution for tooth decay. They’ll mass medicate. From October 2009 all bread sold in Australia will come with a free dose of iodine.

Now don’t get me wrong.I don’t know any mother that wouldn’t give both her arms to ensure her baby had the best possible start in life.And as far as I can discern there is no downside to having too much iodine (at the levels we are likely to be getting).But the research suggests that if we keep increasing fructose in our diet, then no matter how much iodine we put in the bread, we won’t be able to convert it to the hormones pregnant mothers need.

The problem is that, just as with fluoride and now with iodine, the knee jerk response to problems created (at least in part) by overconsumption of sugar is to pull the ‘mass-medicate’ lever. How long will it be before the Government decides the best option for high cholesterol or blood pressure or diabetes is to mass medicate. How about depression? Before you know it there’ll be more medication than bread in our daily bread.

Why is the Government so reluctant to take a proper look at what the research says is the common cause to all of these ailments? I hope it’s going too far to suggest that Big Sugar is pulling the strings. I believe firmly that you should not ascribe to conspiracy that which can be adequately explained by incompetence. But I think all the good marketing work Big Sugar is doing (just to move product) may be operating to muddy the waters for those charged with looking after our health.

It’s time to cut through the spin and look to the underlying cause before we once again reach for the band-aids.

Low Fat Diet = Heart Disease?

By | Big Fat Lies, Sugar | 2 Comments

I know most of you will have already read Fructose intake is a predictor of LDL particle size in overweight schoolchildren (published in the American Journal of Clinical Nutrition last October for those of you who missed it), but dust off your copy because I want to take a closer look. Grab a coffee, this is a long one.

I think the schoolchildren paper explains exactly why many things we have been told about Cholesterol could be wrong and why many of the people taking medication to lower it may be simply doing so for no better reason than to line the pockets of some underprivileged drug companies (a noble cause in itself, I admit).   The current treatment of arterial disease is based on restricting the intake of animal fat, with or without drugs.  But, there is mounting evidence that fructose plays an important role in modifying the fats in the blood in ways that block your arteries a lot more quickly.

That having been said, nothing in this post (or on this blog) should be taken to be medical advice.  Don’t rush out and cancel your medication (or your prescibed diet) unless your doctor tells you to.  But do by all means discuss the studies presented here with your doctor.

Ok, disclaimer over, let’s start from the start. Contrary to popular belief there is only one kind of cholesterol. There is no good, bad or even ugly cholesterol. There’s just cholesterol. Cholesterol is a fat and is therefore not soluble in water. Since our blood is a water-based solution this presents a bit of problem in the logistics department. Cholesterol needs to be transported from the liver (where it is made) to the places where it is needed (pretty much everywhere in the body – it’s used to make cell membranes). That’s where lipoproteins come in. The body packages the cholesterol with some proteins in a bundle of molecules ready for shipping.

Lipoproteins are the transport system for cholesterol (and other fats). There are five major groups of lipoproteins but I want to focus on the group that the doctors sometimes call ‘bad cholesterol’.

Lipoproteins are grouped by size. Low Density Lipoproteins or LDL particles are loosely packed (hence ‘low density’) and as a result, relatively large. LDL particles transport cholesterol manufactured in the liver out to the cells.

When a doctor says you have a bad cholesterol reading, she is talking about LDL being outside a target range (2.6 to 3.3 mmol/L). If you get too far out of that range (greater than 6.5 mmol/L), out will come the ‘script book and there is a good chance you will be prescribed a class of drugs called Statins (more on them in a later post) to lower your LDL cholesterol levels.

LDL particles also come in a range of sizes and people can be divided into two main groups according to which size is most common. Some people have mostly large LDL particles and some people have mostly small ones. The folks with the large particles are called Pattern A and the others, Pattern B. Whether you are Pattern A (large) or Pattern B (small) is largely a matter of genetics. If both your parents are Pattern A then you are more likely to be Pattern A and vice versa if they were both Pattern B.

Which pattern you are matters because if you are Pattern A, your LDL reading is not an indicator of the risk of heart disease. But Pattern B people are at considerable risk. It seems the small size of the Pattern B LDL particles means they are more easily embedded in the walls of blood vessels and this ultimately leads to the development of blockages.

In June 2000, Dr Krauss and his team over at the Lawrence Berkeley National Laboratory, Department of Molecular Medicine at UC-Berkeley published some very interesting results on experiments they had been doing on low-fat diets. What they found was that if you put a Pattern A person on an extreme low-fat diet (less than 25% of the Calories come from fat – the Pritikin diet for example, is 10%-15% fat), they change to Pattern B.

Let me just restate that because it is important. In June 2000, a study was published which showed that if you put some people on a low fat diet you INCREASED their risk of heart disease. This happened because you convert them from Pattern A (large) LDL to Pattern B (small) LDL particles. Did the media health experts forget to mention this as they merrily recommended low-fat foods?
As far as I can tell, Dr Krauss wasn’t concerned what else was in the diet, just that it was low fat. And this is where the article that started my little detour comes in. The schoolchildren paper from 2007 concludes:
“In school-age children, greater total and central adiposity [fatness] are associated with smaller LDL particle size and lower HDL cholesterol. Overweight children consume more fructose from sweets and sweetened drinks than do normal-weight children, and higher fructose intake predicts smaller LDL particle size.”

In other words, a child on a high fructose diet will have small (Pattern B) LDL particles and a child on a low fructose diet will not. Maybe the reason that Dr Krause’s low-fat diet was so destructive was not because of the fat itself but because the diet was by definition high carbohydrate (and therefore high fructose in our modern world)?

There’s a double whammy in all this. Most Low-fat foods you will encounter in the supermarket are higher in fructose than their full-fat equivalents. So whether it is the low-fat or the high fructose part of the diet that is causing the LDL particles to shrink, foods low in fat and high in fructose are probably not a good idea.

Unfortunately there are no cheap and easy tests for LDL particle size. But if this latest study is to be believed, maybe you don’t need to know.  Maybe all you need to know is that you can significantly reduce your risk of heart disease by not eating fructose. This is because this most recent study suggests that the amount of fructose in your diet so accurately predicts your LDL particle size (at least if you are a school age child).

This post has droned on for long enough so I won’t go into the studies that suggest that once again pre-menopausal women are protected from the effects of fructose on particle size. I’ll leave that for another day.

Image courtesy of Nutdanai Apikhomboonwaroot / FreeDigitalPhotos.net