Saturated Fats Part One: Great Britain’s Most Outspoken Cardiologist Sets the Record Straight.

Blog - S. Fat Picture.png
  • Saturated fat and cholesterol have little to do with the development of heart disease. Data shows two-thirds of people admitted to hospitals with acute myocardial infarction have completely normal cholesterol levels.
  • Fats that contribute to heart disease are primarily trans fats and highly refined and/or heated polyunsaturated vegetable oils (PUFAs), which are high in damaged omega-6.
  • For optimal health, seek to get 75 to 85 percent of your total calories as healthy fat, primarily monosaturated and saturated. Limit PUFAs to 10 percent and omega-6 fats to 5 percent.

Is saturated fat dangerous to your health?  Dr. Aseem Malhotra an interventional cardiologist consultant in London, U.K. seriously challenges the conventional view on saturated fats, and reviews how recent studies have failed to find any significant association between saturated fat and cardiovascular risk.

Malhotra reports that two-thirds of people admitted to hospitals with acute myocardial infarction have completely normal cholesterol levels.

“As an interventional cardiologist, we can do life-saving procedures with people who have heart attacks through heart surgery. What we can do in medicine is really quite limited at the treatment end and actually the whole ‘prevention is better than cure’ phrase is very true.”

Hospitals and Medical Personnel Are Far From Paragons of Health

Malhotra’s epiphany that something was wrong with the system came rather early. While working as a resident in cardiology, he performed an emergency stenting procedure on a man in his 50s who’d recently suffered a heart attack.

“Just when I was telling about healthy diet, how important that was, he was actually served burger and fries by the hospital. He said to me, ‘Doctor, how do you expect me to change my lifestyle when you’re serving me the same crap that brought me in here in the first place?’”

Looking around, he realized that a lot of healthcare professionals are overweight or obese, and hospitals serve sick patients junk food.

“The hospital environment should be one that promotes good health, not exacerbates bad health,” he says.

Diet and lifestyle changes are particularly important in light of the fact that medical errors and properly prescribed medications are the third most common cause of death after heart disease and cancer. Overmedication is a particularly serious problem among the elderly, who tend to suffer more side effects.

“Part of that is because there are very powerful vested interests that push drugs,” Malhotra says. “They even coax academic institutions and guideline bodies. People aren’t getting all the information to make decisions, whether or not they should take medications…

For Past 60 Years, the Wrong Fats Have Been Vilified

For the past 60 years, the conventional wisdom has dictated that saturated fat is dangerous and should be avoided. This flawed notion was originally promoted by Dr. Ancel Keys, whose Seven Countries Study laid the groundwork for the myth that saturated fat caused heart disease.

It’s true that heart disease rates began spiking in the beginning of the 20th century, and for the last 50 years, heart disease has been progressively increasing. It really wasn’t an issue prior to the 20th century. Saturated fat wasn’t the problem. It was all the other harmful fats people were eating.

In the 20th century, the average person probably had less than 1 pound a year of refined, processed omega-6 vegetable oils. By the 1950s, probably about 50 pounds a year, and by year 2000, it increased at about 75 pounds a year. It seems “fat” in itself isn’t the issue; it’s the type of fat that’s crucial.

This massive amount of highly refined polyunsaturated fat is far in excess of what we were designed to eat for optimal health.

In the United States, between 1961 and 2011, 90 percent of the calorie intake has been carbohydrates and refined industrial vegetable oils.

The heart disease epidemic peaked between 1960 and 1970. When we look at our data, it’s quite clear that the so-called fats responsible for that are trans fats and very likely polyunsaturated vegetable oils high in omega-6 fatty acids. We know now that they oxidize LDL and are pro-inflammatory.

What Are the Real Risk Factors for Heart Disease?

By failing to differentiate between trans fats and saturated fats, massive confusion has arisen. There’s also confusion about the relationship between saturated fat and cholesterol. Adding to the complexity, there are also different types of saturated fats, which may have different biological effects.

Many saturated fats will raise LDL, the so-called “bad” cholesterol. But LDLs come in various sizes. Large type A particles arelessatherogenic (form fatty plaques in the arteries) and are influenced by saturated fat. Saturated fat also increases HDL, the “good” cholesterol.

“What’s interesting is the saturated fat, even though it may raise LDL, your lipid profile may actually improve [when you eat more saturated fat], especially when you cut the carbs. On top of that, LDL has been grossly exaggerated as a risk factor for heart disease, with the exception of people who have a genetic abnormality (familial hypercholesterolemia),” Malhotra says.

So what is the major issue when you look at heart disease and heart attacks? Insulin resistance. The reason it’s being neglected is partly this flawed science on cholesterol. But, also because there’s never been any effective drugs that target insulin resistance.

Therefore, because [there isn’t a] big market around something to sell, there aren’t many people that know about it. As you and I know, if you target insulin resistance through the right kind of diet and lifestyle changes, stress reduction, right kind of exercise, that’s going to have the biggest impacts on your health.”

Check back next week for –

Saturated Fat Part Two: Gauging Your Heart Disease Risk:

  • Gauging Your Heart Disease Risk
  • The Connection Between Saturated Fats and Diabetes
  • Healthy Fat Tips
  • Why Statins Are a Bad Idea for Most People
  • Statins Are Associated With Serious Side Effects

Today’s Post has been condensed from: Great Britain’s Most Outspoken Cardiologist Sets the Record Straight on Saturated Fats

https://articles.mercola.com/sites/articles/archive/2016/06/05/saturated-fat-heart-disease-risk.aspx

Please see the original for the Footnotes and Citations for the scientific studies.

May you Live Long Healthy.

Yours truly,

Lydia Polstra

Email: lpolstra@bell.net

Facebook: https://www.facebook.com/2healthyhabits/

Blog: https://2healthyhabits.wordpress.com

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.

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise.

I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

To follow my Blog, 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.

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Cholesterol: The Standard Measure Of Blood LDL Cholesterol Is Inaccurate

For the last 5 decades, most medical and nutrition scientists have focused on low-density lipoprotein (LDL) cholesterol (“bad cholesterol”) as a primary cause of coronary heart disease. While cholesterol lowering therapy has become the standard of care for some individuals with well-defined heart disease risk, this focus on cholesterol in general – and LDL cholesterol in particular – remains very controversial.

Unfortunately the standard measure of blood LDL cholesterol is inaccurate, and when the various components of the blood LDL are measured they represent only a fraction of the lipid (fatty acids) and other biomarkers of heart disease risk.

A turning point in understanding the limitations of LDL and heart disease came with the publication of the Lyon Diet Heart Study. This randomized trial pitted a standard low fat diet against a Mediterranean diet for people with a prior heart attack. There was no difference in LDL cholesterol changes between the Mediterranean and low fat diet groups. The standard calculated LDL value did not seem to matter that much indicating that some very important drivers of coronary disease risk were going unmeasured.

In the recently published 1-year results from the IUH/Virta diabetes reversal study, they reported a small but significant rise in the average blood LDL cholesterol level in patients on a well-formulated ketogenic diet (WFKD). At the same time, however, they noted major reductions in a number of coronary disease risk factors including weight, blood pressure, and HbA1c.

The pattern of how these other risk factors change is independent of the changes in LDL.

In Figure 1, (please see the original post) the number of patients whose LDL went up was somewhat greater than the number whose LDL went down.

In the Figure 2, the 14 other risk factors with improved risk far outweigh those indicating a negative response. The heart disease risk factors indicate that a WFKD is much healthier than one might conclude by focusing on the single LDL risk factor.

Novel results from the IUH Diabetes Reversal Study:

Figure 2

Blog - July 26 actual numbers for each of the risk factors -3.png

Here is a table (figure 2) with the actual numbers for each of the risk factors shown in figure 1, plus HbA1c and weight. For each factor, there is a change between baseline and 1-year as a percent, the P-value indicating the chance this change might occur at random (i.e., the smaller the better), and then arrows up or down indicating how this change might influence overall heart disease and mortality risk.

These results are interesting for two reasons. First, none of the short term studies of ketogenic diets given to patients with type 2 diabetes lasting a few week to a few months have sustained these benefits without weight regain and/or rising HbA1c values after 1 year.

Second, no prior prospective outpatient low carbohydrate diet study has documented anything near this degree (0.6 mM at 10 weeks and 0.3 to 0.4 mM at one year) of sustained nutritional ketosis in such a large group past the first few months of treatment.

Note that only the arrow for calculated LDL cholesterol points up, whereas all of the other 16 point down. Also note that of these 16, only two have associated P-values that are non-significant or borderline. All of the others indicate a chance of random error of less than 1-in-ten-thousand. This means in turn is that these observations of reduced risk are statistically very strong.

This sustained nutritional ketosis may be a pivotal factor in risk reductions. The resultant beta-hydroxybutyrate (BOHB) is now understood to be a potent epigenetic signal controlling the body’s defenses against oxidative stress, inflammation, and insulin resistance.

What Blood Lipids Actually Do:

We have known for a long time that blood levels of both cholesterol and saturated fat tend to be independent of how much of these nutrients we eat.

But a completely different set of factors come into play when we eat less energy than we burn, which forces the body to dip into its energy stores and thus mobilize body fat. Similarly, when we restrict dietary carbohydrates, either body fat or dietary fat has to become the body’s principle source of energy. This is most profound in the keto-adapted state, where circulating lipids and blood ketones (made from fat in the liver) together provide 75-85% of the body’s energy. Lipoproteins play a critical role in the transport of lipid in the bloodstream, so changes in delivery needs in turn will impact lipoprotein lab results.

In response to the state of nutritional ketosis, humans can more than double their rates of fat oxidation (i.e., use for fuel) at rest and during exercise. So when you combine a doubling of fat intake with a doubling of fat use, clearly a lot more fat has to pass through the bloodstream.

We have spent a few decades studying how the body adapts to a WFKD, and have come to recognize a pretty consistent pattern for the changes in most blood lipids, but a quite inconsistent pattern for the calculated LDL cholesterol level in particular. The consistent changes are:

  • A dramatic reduction in serum triglycerides
  • A rise in HDL cholesterol and
  • The same or lower levels of saturated fats in serum triglycerides

The one inconsistent variable in this otherwise predictable pattern of change is the calculated serum LDL cholesterol level. For some people, following a ketogenic diet makes their LDL cholesterol go down and for some it does not change. But for a fair number of people the calculated LDL cholesterol value rises, in some cases quite a lot. Thus the key question is: How important is the calculated LDL cholesterol relative to the other risk factors that have been recently characterized?

Why LDL Cholesterol is Not a Single Number:

There are two important limitations of the commonly reported serum LDL cholesterol level.

First, the usual test procedure does not actually measure LDL – it reports a calculated value based upon measurements of serum total and HDL cholesterol and triglycerides, along with a number of assumptions. And in particular, when the triglyceride value undergoes a big change, it can skew the calculated LDL value considerably.

Second, the circulating lipoprotein particles classed as LDL are actually quite diverse in size, and it is now recognized that the smaller, more dense particles (which carry proportionately less triglyceride) are the sub-fraction that is associated with vascular damage and heart disease.

In Figure 2, only the calculated LDL cholesterol value went in the ‘wrong direction.’ But in this case, it appears that this was due to a shift to a greater proportion of the larger particles because the total particle number did not change, the average particle size increased, while the small dense particle number was significantly decreased.

Inflammation as an Independent Risk Factor for Coronary Vascular Disease:

Three decades ago, a number of mainstream investigators noted that the total white blood cell count and then c-reactive protein levels appear to predict coronary disease and mortality independent of cholesterol.

The key question as to whether this was a mere association or causal. This question was resolved with the recent CANTOS Trial, which reduced coronary risk by 15% without any effect on LDL cholesterol levels.

Unfortunately a side effect of the antibody used in this study (an increase in fatal infections) cancelled out the coronary disease risk reduction, so the CANTOS Trial answered an important question but did not offer a therapeutic solution. However this does offer an interesting insight into the mystery of why the Lyon Diet Heart Study reduced coronary disease risk AND mortality. In that study, blood anti-oxidant levels increased and granulocytes (aka white blood cells) decreased, suggesting that a dietary anti-inflammatory intervention can have potent benefits absent the dangerous side-effects of anti-inflammatory drugs.

Blood Saturated Fats and CVD Risk:

The key fact to keep in mind is that while a primary source of saturated fat in the blood is de novo lipogenesis (i.e., the production of fat from excess dietary carbohydrate), there is little if any relationship between dietary saturated fat intake and blood saturated fat content. And most importantly, because the keto-adapted state doubles the body’s ability to burn saturated fat for fuel while at the same time shutting down de novo lipogenesis, blood levels of saturated fats are reduced independent of dietary saturated fat intake.

There is a review of this topic in the blog, The Sad Saga of Saturated Fat. https://wordpress.com/post/2healthyhabits.wordpress.com/698

Getting Beyond Single Biomarkers of Cardiovascular Risk:

There is a wide range of processes that contribute to atherosclerosis and coronary artery disease risk. American College of Cardiology offers a 10-year heart disease risk predictor that includes the following inputs: age, sex, race, total cholesterol, HDL cholesterol, LDL cholesterol, systolic blood pressure, diastolic blood pressure, diabetes, smoking and medication use (statin, hypertension, aspirin).

Based upon this equation, the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score in the recent Virta study decreased -11.9% (P = 5×10-5). This is a large beneficial effect experienced by the participants in the Virta study despite the observed changes in calculated LDL values.

Continuous doctor’s care treatment including nutritional ketosis in patients with type 2 diabetes improved most biomarkers of CVD risk after the Virta one-year study. The increase in LDL-cholesterol appeared limited to the large LDL sub-fraction; whereas LDL particle size increased, total LDL-P and ApoB were unchanged, and inflammation and blood pressure decreased.

There so many different factors are associated with coronary risk we need to avoid focusing on just LDL.

This Post has been condensed from the Virta blog: Blood Lipid Changes With A Well-Formulated Ketogenic Diet In Context by Rich Wood, PhD, Amy McKenzie, PhD, Jeff Volek, PhD, RD, Stephen Phinney, MD, PhD on May 2, 2018. Please see the original for the Footnotes and Citations for the scientific studies. Here is the link https://blog.virtahealth.com/blood-lipid-changes-with-ketogenic-diet/

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise.

I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

To follow my Blog, 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.

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May you Live Long Healthy.

Yours truly,

Lydia Polstra

Email: lpolstra@bell.net

Facebook: https://www.facebook.com/2healthyhabits/

Blog: https://2healthyhabits.wordpress.com

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 and Ketogenic Diet FAQ

Part 1-1

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

FREQUENTLY ASKED QUESTIONS:

For the answers to these questions Written by Dr. Steve Phinney and the Virta Team, please copy and paste this link into your address bar https://blog.virtahealth.com/nutritional-ketosis-faq/

ALL ABOUT KETOSIS:

What is nutritional ketosis?

How do I get into nutritional ketosis?

How can I tell if I’m in nutritional ketosis?

What are ketones? What is ketogenesis?

What is keto-adaptation?

What does it mean to be fat adapted?

 KETOGENIC DIETS:

What is a ketogenic diet?

What can I eat on a ketogenic diet?

Why is sugar bad for you?

How many carbs can I eat on a ketogenic diet?

Should I count net carbs or total carbs?

Is a ketogenic diet healthy for everyone, not just people with diabetes or weight issues?

What is “keto flu” and how do I avoid it?

Should I take vitamins or supplements on a ketogenic diet?

How much sodium, potassium and magnesium should I have on a ketogenic diet?

How much protein should I eat on a ketogenic diet?

What are the best artificial sweeteners and sugar substitutes for a ketogenic diet?

Can I be vegetarian and still do nutritional ketosis?

Can I be vegan and still do nutritional ketosis?

Can I eat dairy on a ketogenic diet?

Can I eat gluten on a ketogenic diet?

Do I need to eat vegetables on a ketogenic diet?

Do I need fiber supplements on a ketogenic diet?

Can I eat whey protein on a ketogenic diet?

What can I eat at a Chinese restaurant on a ketogenic diet?

Can a ketogenic diet reverse type 2 diabetes?

KETOGENIC DIETS AND DIABETES:

Does a ketogenic diet reduce insulin resistance?

Can I reverse diabetic neuropathy, nephropathy, or retinopathy with a ketogenic diet?

Ketosis vs. Ketoacidosis: What’s the difference?

HEART HEALTH AND CHOLESTEROL:

Is a ketogenic diet safe for your heart?

What happens to your cholesterol on a ketogenic diet?

What happens to LDL cholesterol on a ketogenic diet?

What happens to triglyceride levels on a ketogenic diet?

Do statins decrease the production of ketones?

Is nutritional ketosis safe?

What is ketoacidosis?

Is it safe to increase salt intake on a ketogenic diet?

Is it safe to follow a ketogenic diet during pregnancy?

Is it safe to follow a ketogenic diet if you have no gallbladder?

Can I follow a ketogenic diet if I have no thyroid?

How does a ketogenic diet affect kidney stones?

Does a ketogenic diet increase your risk of gout?

Is fasting safe?

WEIGHT LOSS:

Does a ketogenic diet cause weight loss?

How do I break a weight loss plateau on a ketogenic diet?

Is dietary fat burned before stored fat on a ketogenic diet?

How can I lose belly fat on a ketogenic diet?

TROUBLESHOOTING A KETOGENIC DIET:

What causes muscle cramps on a ketogenic diet?

What do I do if I get diarrhea on a ketogenic diet?

How do I fix constipation on a ketogenic diet?

What causes keto rash and how do you fix it?

Why do ketone levels vary throughout the day?

What are the consequences of cheating or lapsing on a ketogenic diet?

How should I interpret and apply CGM data?

Fats and Oils:

Which fats and oils should I eat on a ketogenic diet?

Can I eat canola oil on a ketogenic diet?

What is the best ratio of MUFA, SFA and PUFA on a ketogenic diet?

Can I use olive oil as a cooking oil?

Is fat the most satiating macronutrient?

For the answers to these questions Written by Dr. Steve Phinney and the Virta Team, please copy and paste this link into your address bar https://blog.virtahealth.com/nutritional-ketosis-faq/ Have a question we haven’t answered? Email us your question at faq@virtahealth.com

To learn more please read the book the Dr. Phinney co-authored with Dr. Volek.    New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great Paperback – Mar 2 2010

https://www.amazon.ca/New-Atkins-You-Ultimate-Shedding/dp/1439190275/ref=pd_lpo_sbs_14_t_0?_encoding=UTF8&psc=1&refRID=32GFYZ6T1GBJA3TMR31G

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.

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

May you Live Long Healthy.

Yours truly,

Lydia Polstra

lpolstra@bell.net