From Cecilia Brainard: For years I have read and heard about saturated fats being a health risk. Even though I listen to my doctors, I've always double checked what they say. This double checking has paid off. I've learned Western doctors are not always right, nor they necessarily have all the information. The following article is an eye-opener. It makes one realize a wrong premise can be the basis of often -quoted health beliefs.
The article is reprinted with permission from Manny Gonzalez of Plantation Bay, Mactan. Here is the link. The complete article follows.
https://plantationbay.com/english/satfat/
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A Spurious Study Has Damaged the Health of Billions for the Past Sixty Years
By Manny Gonzalez
I'm not a doctor but unlike some doctors who learned medicine 20 years ago — and nothing since — I keep abreast of news in nutrition and health. While researching the science for The Plantation Bay Keto But Not Kwite Diet, I discovered something you should know.
You have probably heard that you should avoid saturated fats (pork, eggs, butter), and consume polyunsaturated fats or low-fat foods instead.
Where did this advice come from?
In 1958, researcher Ancel Keys published his famous Seven Countries Study (SCS), which claimed to demonstrate a "correlation" (not causation) between high saturated fat consumption and cardiovascular mortality. The "seven countries" were actually some railroad workers in the US, remote villages in Japan, remote villages in Italy, one village in the Netherlands, one island in Greece, a remote part of Finland, and isolated parts of then-Yugoslavia. So it should really have been called the Some Scattered Villages and Selected US Railroad Workers Study.
Present-day apologists for Keys claim these choices were necessitated by practicalities such as participant availability. Critics on the other hand say Keys chose oddball groups that supported his thesis, and just omitted the many more that didn't.
Were the Keys study conducted today, no serious clinician would give it the slightest credence, because:
No women were included;
Obvious countries like UK, France, West Germany, etc., were simply excluded;
Remote villages or one kind of worker can't be a proxy for the general population of a country, much less everyone on earth;
In most cases the presumed saturated fat consumption of the individuals was based on very few data-points from memory ("tell me what you ate last week, and we'll assume that's what you ate all your life"), not actual measured/verified consumption over time;
Other factors like smoking, education level, income, etc., were simply ignored.
Today's clinical standard (before approving a new drug, for example) is "random, placebo-controlled, at least single-blind". The Keys study was none of these.
Nonetheless, abetted by the soybean and sugar industries, the study quickly turned into medical dogma that was parroted and re-parroted, until it became common wisdom worldwide that "saturated fat is bad, low fat and polyunsaturated fat are good, sugar and starch weren't mentioned by Keys so they're just great".
The food industry rushed to de-fat everything in sight, usually compensating with starch and sugar or synthetic additives. Not 3.5% whole milk, but 1% skimmed milk packed with extra starch and sugar to make up for the poor taste. Not butter but margarine (a trans-fat). Not lard but ultra-processed seed oils (canola, soy, corn, others), whose industrial production begins by dissolving seeds in hexane (a chemical in gasoline).
No serious person denies that in the past 60 years just about every Westernized country has determinedly spurned saturated fat yet has gotten less healthy. In the US, obesity trebled, early colon cancer quadrupled, kidney disease doubled, and diabetes ten-tupled (though this number is exaggerated because the cutoff was progressively lowered from 140 to just 100 FBS).
It's true cardiovascular mortality has declined. But that decline is probably less attributable to eating less saturated fat and more attributable to better technology, modern interventions (bypasses, stents), broader medical insurance, and improved emergency services.
If Keys was right, now that everyone followed his advice for 60 years, why are so many people sicker?
The answer is simple: Keys was wrong.
And what's more, within just a few years of becoming famous, Keys knew he was wrong, but hid the evidence.
The Minnesota Coronary Experiment (MCE), 1968-1973 was a randomized controlled trial, single-blind (therefore, much more credible than the original study), and was conducted by Keys himself, with Dr. Ivan Frantz. Objective? Prove through a genuine clinical trial that the earlier study was correct, and Keys's now worldwide fame merited.
Here's how MCE was conducted. The subjects were patients in state mental institutions and one nursing home. Average age in 1968: 52. Some were given a diet high in saturated fats (about 18% of calorie intake), others had a diet with much less saturated fat (9%, the balance replaced with polyunsaturated to keep total fat and calorie intake similar). Being "inmates", they had to eat what was given to them over the years, ensuring complete adherence, which few studies can. The one weakness in the study was that many of the original participants were released and could not be tracked. But in the end, almost 2500 men and women completed the experiment, a very large number for a clinical trial.
The full result of the Minnesota Coronary Experiment was never revealed until 40 years later.
As soon as the results were known to him privately, Keys removed his name from the study, and he and Frantz promptly buried it. 16 years later in 1989, Frantz may have had a bout of conscience and submitted a half-hearted report which didn't clearly explain the results, but speculated that maybe younger participants would have eventually yielded more deaths from saturated fat.
Hardly anyone noticed Frantz's 1989 report. So the world continued demonizing saturated fats.
Another 20 years later, Dr. Christopher Ramsden of the National Institute of Health decided to reconstruct the raw data findings of the MCE with the help of Frantz's son, also a doctor. In the basement of the elder Frantz's home, the younger Frantz discovered obsolete computer files with the data, which was slowly reconstructed.
In 2016, for the first time, the full results of the 1968-1973 MCE were published: NO mortality difference between the saturated-fat and polyunsaturated-fat groups. HIGHER mortality for the patients who had reduced their cholesterol the most.
Ramsden's report appeared in BMJ (British Journal of Medicine; possibly he couldn't get any American medical journal to publish, all of them having been 100% in agreement with Keys's anti-saturated-fat "findings"). For a lay-person's discussion, see https://www.scientificamerican.com/article/records-found-in-dusty-basement-undermine-decades-of-dietary-advice/
That was 10 years ago but due to determined inertia within the medical community, most doctors will still tell you they KNOW saturated fat is bad, and that if you have "high cholesterol", you must take statin drugs or die early.
To sum up where we stand today: saturated fat may or may not be bad for you. We're not sure. The deeply-flawed Seven Countries Study implies bad. But the more rigorous Minnesota Coronary Experiment shows no difference in mortality. Most likely saturated fat is like most food, good in reasonable amounts, less good if overeaten.
Now many doctors will retreat to the statin and cholesterol argument: "Never mind about those old trials. New studies prove that if you have high cholesterol, taking statin drugs for the rest of your life will lower your risk of dying from cardiovascular disease by 35%."
This sounds convincing until you probe and find out that all those studies were funded by Big Pharma, and that "35% less" means 3% absolute risk down to 2% (— in some studies, while others show no benefit). In other words, out of every 100 persons taking statins, statistically just 1 might benefit mortality-wise, 99 will not, and no one will ever know which. I may not be a doctor but I understand statistics.
To put this into an everyday context, aspirin is (let's say) 50% likely to relieve a mild headache, so many of us are willing to try it. Now imagine aspirin were marketed as "10% likely to relieve a headache". Would you still buy it? And what if the claim were "1% likely"? Comparatively, that is the Big Pharma claim for statins — somewhere between 0% and 2% chance of prolonging your life, depending on who conducted the study.
I'm not going to contradict your physician, but this is not a lottery that makes sense to me, and you might get better odds by losing a little weight. . .
Key Scientific Studies:
Keys, A., Menotti, A., Karvonen, M.J., et al. The diet and 15-year death rate in the Seven Countries Study. American Journal of Epidemiology. 1986;124(6):903–915.
Keys, A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Harvard University Press, 1980.
Ramsden, C.E., Zamora, D., Majchrzak-Hong, S., et al. Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from the Minnesota Coronary Experiment (1968–73). BMJ. 2016;353:i1246. doi:10.1136/bmj.i1246.
Scientific American. Records Found in Dusty Basement Undermine Decades of Dietary Advice. April 12, 2017.
https://www.scientificamerican.com/article/records-found-in-dusty-basement-undermine-decades-of-dietary-advice/
Additional References:
Frantz ID Jr., Dawson EA, Ashman PL, et al. Test of Effect of Lipid Lowering by Diet on Cardiovascular Risk: The Minnesota Coronary Survey. Arteriosclerosis. 1989;9(1):129–135.
Yerushalmy J, Hilleboe HE. Fat in the diet and mortality from heart disease: a methodological note. New York State Journal of Medicine. 1957;57:2343–2354.
Chowdhury R, Warnakula S, Kunutsor S, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Annals of Internal Medicine. 2014;160(6):398–406
Newport MT, Dayrit FM. The lipid–heart hypothesis and the Keys equation defined the dietary guidelines but ignored the impact of trans-fat and high linoleic acid consumption. Nutrients. 2024;16(10):1447. doi:10.3390/nu16101447.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. American Journal of Clinical Nutrition. 2010;91(3):535–546.
Harcombe Z, Baker JS, Cooper SM, Davies B. Evidence from randomized controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis. Open Heart. 2016;3:e000409.
Tags: #healthyfats #cholesterolfacts #healthyliving
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