The Sad Saga of Saturated Fat

In the US and Canada dietary guidelines do not take into consideration the recent extensive scientific research into role of saturated fats.

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Two generations of researchers have tried to prove that eating saturated fat (such as beef, pork, dairy, eggs, chocolate, and tropical oils) causes heart disease. This hypothesis is false.For proof look to multiple recent meta-analyses of large populations followed carefully for decades, examining what they eat and what they die of.  All show no consistent association between dietary saturated fat intake and risk for heart disease or death from all causes.In fact some of these studies show just the opposite – they suggest that one’s risk for a coronary event increases when dietary saturated fat is reduced and replaced by carbohydrate.

By continuing to provoke fear about the harmful effects of saturated fat, the likely response is that people will seek out foods low in fat and higher in carbohydrate. In fact, according to a government-funded survey, Americans have decreased their consumption of saturated fat and replaced those calories with an even greater amount of carbohydrate. In the same time interval rates of obesity and diabetes have rocketed skywards.

Much of what we’ve been taught about dietary fat is wrong. How could this be – a good place to start would be to read Good Calories, Bad Caloriesby Gary Taubes andThe Big Fat Surpriseby Nina Teicholz, both highly regarded investigative journalists.

In short, 50 years ago diseased coronary arteries were found to contain buildups of cholesterol and saturated fat. Professor Ancel Keyes of the University of Minnesota hypothesizedthat too much of these two nutrients in the diet were the cause – i.e., his hypothesis was built on the flawed concept that you are what you eat. Then came well-done studies showing that blood levels of saturated fats predict future cases of heart disease and diabetes, thus appearing to support Keyes’ hypothesis. But this works only if you believe “you are what you eat”,a concept that doesn’t pass the common sense test.

Obviously, the key question here is, what’s the precise relationship between dietary saturated fat and blood levels of saturated fat?”The scientific evidence clearly shows that dietary saturated fat intake has little to do with saturated levels in our blood, then what does? There is, in fact, sound evidence that dietary carbohydrate is a major determinant of serum saturated fat levels.

 We know this because two respected research groups fed humans carefully measured, weight-maintaining diets either high in carbohydrate or moderate in carbohydrate. In both studies, blood levels of saturated fats went up dramatically on the high carb diets, even though they were very low in fat.

We (Virta) performed a weight loss study during which we fed diets varying from 32 up to 84 grams of saturated fat per day, with “healthy carbohydrate” making up the energy difference when dietary fat was reduced. In blood triglycerides and cholesteryl esters, saturated fat levels trended upwards when the high carbohydrate, very low fat diet was consumed, despite the diet being energy restricted, causing on-going body fat loss.

A high carbohydrate intake has two effects in the body that promote higher levels of saturated fat.

First, carbohydrates stimulate the body to make more insulin, which inhibits the oxidation of saturated fat. Thus, when insulin levels are high, saturated fat tends to be stored rather than burned as fuel.

Second, a high carbohydrate intake promotes the synthesis of saturated fat in the liver.

This is particularly problematic for individuals with insulin resistance, characterized as “carbohydrate intolerance” in our recent book, (Volek J, Phinney SD. The Art and Science of Low Carbohydrate Living. Beyond Obesity, May 2011.) Available through Amazon

Insulin resistance makes it harder for muscles to take up and use blood sugar, thus causing a higher propensity for the liver to convert dietary carbohydrate into body fat.

This combination of decreased oxidation and increased synthesis of saturated fat therefore results in accumulation of saturated fats in the blood and tissues.The culprit then is clearly not dietary saturated fat, but rather consumption of more carbohydrate than an individual’s body can efficiently manage.This threshold of carbohydrate tolerance varies from person to person, and it can also change over a lifetime.

In addition to the studies mentioned above in which high carbohydrate feeding increased blood levels of saturated fats, we conducted a pair of studies allowing 6-12 weeks for adaptation to moderate carbohydrate or very low carbohydrate diets. Because these were not very low-calorie diets, the low-carb diets were naturally pretty high in fat, containing 2-3 fold greater intakes of saturated fat than the moderate carbohydrate diets used as controls.

The results were pretty striking: compared to low-fat diets, blood levels of saturated fat were markedly decreased in response to the low carbohydrate, high fat diets.Our data indicates that this occurred because the low insulin levels accelerated the oxidation of all fats (and particularly saturated fat); plus the relative few dietary carbohydrates meant there wasn’t much of it to be converted into saturated fats. Thus, from the body’s perspective, a low-carbohydrate diet reduces blood saturated fat levels irrespective of dietary saturated fat intake.

There is convincing evidence that dietary carbohydrate exerts an important influence on how the body processes saturated fat. Thus, saturated fat, whether made in the body or eaten in the diet, is more likely to accumulate when aided and abetted by high levels of dietary carbohydrate, particularly in insulin-resistant individuals (as in type 2 diabetes or metabolic syndrome*).

* Metabolic syndrome is a clustering of at least three of the five following medical conditions: central obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein. Metabolic syndrome is associated with the risk of developing cardiovascular disease and type 2 diabetes. Source:

A one-size-fits-all recommendation to aggressively lower saturated fat intake with the expectation of lowering blood saturated fat levels is intellectually invalid and likely to backfire.

SOURCE: The Sad Saga of Saturated Fat by Jeff Volek, PhD, RD and Stephen Phinney, MD, PhD Categories: Science & Research. Please see the extensive list of studies under References.

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Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.

Nutritional Ketosis, Treating Type 2 Diabetes

Nutritional ketosis is a natural metabolic state in which your body adapts to burning fat rather than carbohydrates. It is clinically proven to directly reduce blood sugar (HbA1c), improve insulin sensitivity (HOMA-IR) and reduce inflammation (as measured by white blood cell count and CRP).

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Dr. Phinney answers viewer’s questions:

Q: I am interested in reversing type 2 diabetes – is a ketogenic diet recommended?? Thx! —Susie T.

Dr. Phinney’s Answer: Insulin resistance is the hallmark of type 2 diabetes and manifests as carbohydrate intolerance. Like other food intolerances, the most logical and effective approach to managing carbohydrate intolerance is to restrict sugars and starches to within the individual’s metabolic tolerance. A well-formulated ketogenic diet can not only prevent and slow down progression of type 2 diabetes, it can actually resolve all the signs and symptoms in many patients, in effect reversing the disease as long as the carbohydrate restriction is maintained.

For complete answers to this and the other questions please copy and paste this link into your address bar

Q: Appreciated your article on the concerns about prolonged fasting. Could you comment on the utility and safety of shorter durations of fasting (i.e. 16 hrs of fasting/8 hrs of eating or 20 hrs of fasting/4 hrs of eating over a period of 1 day)? —Anonymous

Q: Can you achieve this on a vegetarian diet too? A lot of people I know from India, including my wife, are vegetarian and prediabetic or T2D. I am a T1 and now on keto diet, but I am not able to convince the vegetarians to eat meat. —Anonymous

Q: Does the amount of fat I eat in a ketogenic diet interfere with my ability to burn body fat? —Marcos C.

Q: Why are blood ketone values lower in the morning than in the afternoon/evening? —Nikola S.

Q: When I started my cholesterol was fine. Now my glucose has dropped 40%, but my cholesterol is 241. Should I be worried? —Kerry J.

 Q: Since families often (and should!) eat together, is there any concern about children who are eating high fat diets at breakfast and dinner with their ketogenic parents, but higher carb foods at lunch/snacks at school? —Tera N.

 Q: What are your inflammation biomarkers? —Tekla B.

 Q: Can long-term keto diet contribute to hypothyroidism? —Sonia Z.

 Q: Why some people’s LDL goes sky high on keto diet? —Sonia Z.

Dr. Phinney: The changes we see in total and LDL cholesterol levels are much less predictable than the changes in triglycerides and HDL cholesterol. For the full answer click the link below.

Q: There is a lot of concern about protein intake and gluconeogenesis kicking people out of ketosis. As stated in your book, moderate protein is .6-1 gram/pound of lean body mass. As long as you stay within that protein range is GNG something to be concerned about? —James F.

 Q: Does Diazoxide helps in the ketone production? Thanks a lot for sharing your knowledge. Your influence is bigger than you think. —Salomon J.

 Q: Does athlete fat oxidation rate vary continuously with carb intake? Or is keto the only way to get it above 0.5g/min?—Norman T.

 Q: My daughter has high uric acid on KD, we don’t know if she did before KD, have you seen this before?—Justine L.

 Dr. Phinney: Yes, blood levels of uric acid usually double in the first week of a ketogenic diet or with fasting. This is because there is a competition between ketones and uric acid for excretion by the kidneys early in adaptation. As the adaptation process proceeds over a few months, the uric acid level comes down to normal levels even as nutritional ketosis continues, Thus this is a process of clearance (i.e., excretion), not over-production from dietary protein, and this temporary elevation in uric acid is usually harmless unless one is prone to gout. That said, the precursors of uric acid are pretty high in organ meats like liver and kidney, so if these are part of one’s diet, they should be eaten in moderation. You can learn more about keto-adaptation here.

Q: Thoughts on patients suffering from depression and/or hypothyroidism and keto diets? Also, interested in your thoughts on “The Fast Metabolism Diet” by Haylie Pomroy, which encourages a 5x/day eating plan, which includes a couple days of a keto-like diet after some carb and protein-heavy days each week over the course of a month. Thank you for what you do, sir. Appreciate your work. —Tyler S. 

Q: Love your and Dr. Volek’s low carb performance book – amongst the ‘good’ fats you talk about high-oleic safflower being acceptable (better PUFA ratio). Are high-oleic SUNflower oils OK and can you cook with them? —Chris B.

 Q: Could blood ketones, along with blood sugars, be used to fine-tune insulin dosing? Too little insulin with someone with type 1 and we get DKA. With too little insulin ketones disappear. Could we use ketone levels are consistently below 0.3mmol/L as a signal that we have too much basal insulin? —Marty K.

 Q: Does Virta know the benefit of whey protein for diabetes? Not sure in the context specifically of DM, but it is a very high quality protein source – BCAA, immunoglobulins —Salomon J.

 Q: Why NOT eat certain oils, such as safflower and sunflower oil? Do these oils impact ketosis or is it for other reasons? —India K.

Q: Can you please explain hair loss on Keto? —Jessy G.

Q: Thanks for all you do!! There are groups that advocate the potassium to sodium ratio at 4 grams to 1 gram per day. Does that fit into your view of those two. Also, is 400 milligrams of Magnesium appropriate? Thank you! My ketone level ranges from .3 to 1.2. —Mark K.

 Q: Are you looking at Cardiac Calcium Score? —Lincoln C.

 Q: Hi Dr. Phinney. I have chronic pain and take a lot of medications. Also have controlled type 2 diabetes. Do you think taking 4400mg of gabapentin a day could be why I am not losing weight that easily. I am eating under 30 grams of carbs a day and I don’t eat a lot of fat. I eat just twice a day, and only around 950-975 calories. Thank You! —Teresa R.

 Q: While someone pursuing a therapeutic ketogenic diet for the management of cancer, epilepsy, Alzheimer’s or dementia may want to reduce protein to achieve elevated ketone levels, do you think someone trying to manage diabetes or lose weight needs to consciously worry about “too much protein” or can they just follow their appetite when it comes to protein intake? —Marty K.

 Q: If you are trying to reduce saturated fat but maintain ketosis, what fat sources do you recommend? —Gail K.

For answers to the questions above please copy and paste this link into your address bar

For more information please refer to the book that Dr. Phinney and Dr. Volek co-authored the New York Times Best Selling “The New Atkins for a New You” published in March 2010. Available at

Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.

If you are interested in following my postings, please click the Follow button to receive an email when the next posting is available. Hint: You may have to click the Accept and Close button before follow is available.

If you wish to contact me by Email, please email using this form.

As always, I am interested in your thoughts on these topics.

May you Live Long Healthy.

Yours truly,

Lydia Polstra


Ketogenic Diet – Dr. Jong Rho, MD – How Ketones Affect Whole Body Metabolism and Inflammation.

The connection between the Ketogenic Diet and the Gut and Psychology Syndrome (GAPS) has fascinated me.  Dr. Rho supports that connection in this very informative interview. Sit back and relax while Dr. Rho tells you how you can improve your health by diet.

Dr. Rho’s Elevator Pitch: The primary lesson from the ketogenic diet is that a simple alteration in the type of foods we eat is the basis for preventing disease, treating disease and is something that can be done pragmatically without billions of dollars and the decades needed for drug development. Fats are not bad. Through the unfounded philosophy that fats are bad, we have created a health problem throughout the world.

Continue reading “Ketogenic Diet – Dr. Jong Rho, MD – How Ketones Affect Whole Body Metabolism and Inflammation.”
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