What’s with all of the confusion about saturated fat?

Confused Nutrition Action readers have been asking me how we could have gotten it so wrong on saturated fat. Why didn’t we see that the villain in the heart disease story isn’t saturated fat, but sugar? And how could the American Heart Association and the National Heart, Lung, and Blood Institute have missed that too?

The chorus of those claiming our position is wrong includes:
New York Times food columnist Mark Bittman (“Butter is Back,” ran his headline),
• journalist Nina Teicholz, author of The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet, and
• the author of TIME magazine’s June 23rd cover story (“Eat Butter. Scientists Labeled Fat the Enemy. Why they were wrong”).

I want to highlight a few points that have contributed to the confusion.

The debate over which is worse, sugar and white flour or saturated fat, has been percolating for years. But the pot boiled over in March, when an “exhaustive new analysis” (as The New York Times put it) was published in the Annals of Internal Medicine.

The meta-analysis reported that people had the same risk of heart disease whether they ate a diet high in saturated fat (in meat, dairy, and tropical oils) or one high in polyunsaturated fats (in foods like soybean oil, mayo, salad dressing, and fish). Newspapers, magazines, and talk shows just couldn’t resist a man-bites-dog story line like that.

Since then—and you haven’t read about it in TIME or the Times—that study has been blasted by leading heart disease researchers.

In a letter published in the Annals, these researchers and CSPI’s Bonnie Liebman pointed out a crucial flaw in the meta-analysis, which combined the results of clinical trials that replaced saturated fat with polyunsaturated fat: it included a trial in which some of the saturated fat was replaced with high-trans margarine. Trans fat increases the risk of heart disease. (The authors buried the trans detail in a supplement to the article available only online.)

Removing that one trial from the meta-analysis reverses the results and shows that people who replaced saturated fat with polyunsaturated fats had a lower risk of heart disease. (Those trials and other controlled studies, not the 1950s Seven Countries Study that Teicholz dwells on in her book, are the evidence that experts rely on.)

Dog bites man. No story. Some contrarians also argue that America’s obesity epidemic was caused by those who advocated a low-fat diet. Food companies—and consumers—they maintain, replaced fat with sugar, which is what made us fat.

There’s just one problem: we didn’t replace fat with sugar. Most low-fat or fat-free foods on shelves contain no more sugar (or carbs) than their higher-fat counterparts. What’s more, over the past 40 years, we’ve been eating more fat, not less.

Looking for a culprit for the obesity epidemic? Blame it on the billions spent on ads for sodas and fast food, on the 1,000+-calorie restaurant meals, and on the 24/7 availability of cheeseburgers, fries, shakes, pizzas, burritos, fried chicken, movie theater popcorn, muffins, nachos, soda pop, etc.

It doesn’t take an exhaustive new analysis to see that.

Michael F. Jacobson, Ph.D.
Executive Director
Center for Science in the Public Interest

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