The combination of these two words are enough to send shudders down the spine of most of us living in the developed world. Claiming the lives of over half a million Americans per year, many people are making drastic life changes to help avoid the risk factors. And truly, it would be foolish to not be concerned. According to the CDC, high blood pressure and cholesterol are two components that put you at the highest risk of developing heart disease, and the scary thing? About half of all Americans have at least one of them.
We live in one of the richest, most developed, most medically advanced countries in the world and yet our hearts are failing us at exorbitant rates. Why?
Fat is Bad
For the past 75 years, heart disease has remained the top killer of the American people, and in the 1950s scientists really began trying to tackle this problem with diet change. In 1953, one of the first scientists to launch this potential diet-disease link was physiologist Ancel Keys via his extremely controversial paper titled “Atherosclerosis: A Problem in Newer Public Health”. The paper compared the heart disease rates of 6 countries: Japan, Italy, England and Wales, Australia, Canada, and the US, and through this, Keys hypothesized that it was the saturated fat in the American diet that contributed to the development of heart disease. Saturated fat can most commonly be found in animal products, butter, and yes, coconut oil. Through his examinations Keys discovered that Japan, who ingested the least amount of dietary fat, had the fewest number of deaths due to heart disease whereas Americans, where the fat intake was the highest, were dropping like flies. And, while many became instantly skeptical of Ancel’s findings, he continuously insisted that no other countries could offer health statistics reliable enough for comparison. Two influential critics of Keys’ paper were Jacob Yerushalmy and Herman Hilleboe and four years later, in 1957 the study “Fat in the Diet and Mortality from Heart Disease: A Methodologic Note” was published. “Since no information is given by Keys on how or why the six countries were selected,” the paper criticizes “it is necessary to investigate the association between dietary fat and heart disease mortality in all countries for which information is available.” Using statistical data available from the Food and Agriculture Organization (FAO) and World Health Organization (WHO), the two conducted their own analysis on information for all countries available, 22 of them. The paper, which almost seems to be scolding Keys for his “indirect methods of study”, asserts that “no matter how plausible such an association may appear, it is not in itself proof of a cause-effect relationship.” After evaluating data, the pair determined that “the apparent association is greatly reduced when tested on all countries”, and “it is concluded that the suggested association between national death rates from heart disease and percentage of fat in the diet cannot be accepted as valid.”
Despite the unproven link between saturated fats and heart disease, the damage had already been done, and a country full of worried Americans boarded the anti-fat train led by Ancel Keys. “People should know the facts” he said in a 1961 interview with Time Magazine “Then if they want to eat themselves to death, let them.” By this point, Keys had become such an influential figure that he scored a spot on the magazine’s cover in January of that year. Notably, that same magazine in 2014, can be found reporting that “When researchers went back and analyzed some of the data, they found that what best correlated with heart disease was not saturated fat intake but sugar.”
A Shift in Diet – and Health
By 1976, heart attacks and disease had become so commonplace that scientists were almost panicking. Still, no one fully understood the reasons for the growing rates of heart troubles in the United States, and saturated fats seemed the most likely culprit, but the data to back it up just didn’t exist. Nonetheless, Congress had to do something, right? So in 1977 the first set of Initial Dietary Goals for Americans was released, and the message was quite simple: eat less fat, and more carbs. And thus, Americans were thrown into one of the largest experiments to ever take place. People dropped saturated fats, like meat, butter, and eggs, and replaced them with carbohydrates. Breads, pastas, and cereals, which take up the most room on the Food Pyramid, flew off the shelves in the supermarkets. At this time, ultra-processed foods, like chips, soda, frozen dinners, and breakfast cereal, skyrocketed in popularity. These foods, high in added sugars, became staples in homes all across America and the effects of these recommendations rippled for generations. Today, ultra-processed foods account for about 60% of the American diet and are responsible for 90% of the daily ingested sugar. Sugar addictions soared, fat intake continued to decline, and America just got sicker. Cases of obesity jumped from ~15% in 1971 to about 35% in 2006, and diabetes is quickly becoming an epidemic, with rates over tripling between 1975 and 2015. But, possibly the most concerning? Not only has this unproven recommendation caused unforeseen, and devastating, effects on the the health of the United States, but heart disease still remains the number one killer in this country.
So, What Does the Science Say?
The fat attack was controversial from the get-go, and many people set out to disprove these accusations. And when Americans not only weren’t getting healthier, but were actually even sicker than before, researchers and scientists started dumping millions and millions of dollars into understanding why. If the increase in carbs and sugar are the most likely culprit of our booming rates of obesity and diabetes, what was causing the heart disease?
Though over 60 years have passed since the burden of this nation’s declining health was unreasonably placed solely on the shoulders of fat, a stroll through your local grocery store will reveal that still, for the most part, a war rages on against fat. Products proudly display banners shouting low-fat, lite, and skinny. Ironically, many of these same products are latent with sugar and carbs (read: more sugar). But, what’s really important to remember here is that not all fats are the same. It’s true, some types of fats should be limited greatly, in the diet, but what’s the truth about saturated fat? This was the type of fat that Keys fought so hard against.
What’s the Lowdown on Saturated Fat?
So, there are four different types of fats found in the food we eat today: saturated, monounsaturated, polyunsaturated, and trans fats.
The classification requirements of fats has to do with the way the molecules are bonded together, and it’s super scientific, but the different types of bonds result in different temperatures in melting and solid points. Saturated fats are often solid at room temperature, and some of the highest sources of this type of fat include foods like beef, cheese and butter, coconut oil, and eggs. And, while there are huge differences among the separate types of fat, there are also extremely distinct disparities even among foods high in the same type of fat. Much of today’s conventional beef, for instance, can be seen with much higher-than-normal levels of saturated fats. As stated previously, both the type and amount of fatty-acid that can be found in a source help determine its beneficial or detrimental effects. Conjugated Linoleic Acid, or CLA, for instance has been proven to help tremendously with weight loss, blood sugar regulation, and even immune function. One study, examining the differences found in grass-fed vs. grain-fed beef discovered that the lipid profile of grass-fed is significantly more desirable, containing a higher number of CLA isomers, Vitamin A, and cancer-fighting antioxidants as compared to grain-fed contemporaries. These features made the grass-fed beef much more preferred, according to the nutritional community, because the overall fat content itself remains lower in grass-fed cows. Another study found that it’s not red meat, but in fact processed meats that contribute greatly to heart disease. Those who consume processed meats, like lunch meat and hot dogs, were found to have a 42% increased risk of Coronary Heart Disease, and 19% increased risk of diabetes. It sounds to me like if you’re going to get sick from meat, it’s because it’s crappy meat, not because animal protein, in and of itself, is bad for you. And, even if meat did pose a problem, it’s not in the saturated fat. As more time, money, and research has gone into investigating saturated fat and heart disease, the link has only gotten weaker and weaker. Study after study after study continues to bring the same results: saturated fat intake doesn’t clog your arteries or contribute to heart disease[18, 19, 20]. As stated by researchers, Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.
What’s Hurting Our Hearts?
Our good friend sugar could have something to do with the heart problems plaguing America.
In 2009, the University of California’s Robert Lustig, who specializes in pediatric hormone disorders and childhood obesity, issued a lecture (that has since gone viral on YouTube) entitled “Sugar: The Bitter Truth.” Much of Lustig’s research, and assertion that sugar is actually a poison stems from the 1970s efforts first introduced by Dr. John Yudkin, a leading nutritionist at the time. Since 1957, Yudkin investigated sugar, labeling it as a very likely cause of the heart issues faced by the nation. In his 1957 article, “Diet and Coronary Thrombosis: Hypothesis and Fact”, Yudkin finds “Relationships that do emerge, especially with sugar, suggest that coronary thrombosis is associated with higher living standards. There is a better relationship with intake of sugar than with any other nutrient we have examined.” Throughout the 60s, Yudkin continued to investigate the deadly effects cause by sugar. In 1964 he said “In the wealthier countries, there is evidence that sugar and sugar-containing foods contribute to several diseases including obesity, dental caries, diabetes mellitus, and myocardial infarction (or, heart attack).” And, while most health professionals tended to disagree with Yudkin’s findings, especially because he did not support the war raging against fat, today we’re really beginning to address the very serious concerns associated with sugar.
Just last year, an journal was published by the American Heart Association examining the potential link between consumption of added sugars in childhood, and risk of cardiovascular disease. The results were somewhat terrifying. While low doses of added sugars in the diet can be safely consumed, few children achieve such levels, in fact most kids in the United States eat way. too. much. And because of this, another generations of heart disease and stroke patients is on its way up. And the link between sugar and heart disease really isn’t surprising. Not only does the sugar itself impact your heart, but it greatly contributes to the development of obesity and diabetes, two huge risk factors to your heart. And, while Americans continue to consume more and more sugar, more studies are surfacing warning us of the very dangerous path we are on.
The Sugar Secret
While many scientists, like Yudkin, worked tirelessly to uncover the true risks contributing to the climbing heart disease rates, others were working behind the scenes to cover them up. Now, some 6 decades later, researchers are locating documents and evidence and realizing that much of the dietary guidelines put into place during the war on fat may have been severely skewed, thanks to the sugar industry. Through archival records, historical reports, and scientific debates, we are beginning to piece together correspondence and secondary motive between the Sugar Research Foundation (SRF) and Harvard School of Public Health.
In 1954, just one year after Ancel Keys’ paper was published, president of SRF, Henry Hass delivered a speech to the American of Sugar Beet Technologists devising a plan to increase sugar sales in the country. “Leading nutritionists are pointing out the chemical connection between this high-fat diet”, he began “and if sugar maintained its present share of the carbohydrate market, this change would mean an increase in the per capita consumption of sugar of more than a third.” he continued “At last people who never had a course in biochemistry are going to learn that sugar is what keeps every human being alive and with energy to face our daily problems.” The plan was simple, pounce on the research scientists are doing on heart disease and fat, and increase revenue. In other words, less fat, more sugar. And during the 50s and 60s, the industry dropped today’s equivalent of over $5 million to ensure that this recommendation made its way to all Americans.
As Yudkin’s research continued raising some very real concerns about the ingestion of sugar, Hickson and a subcommittee of the SRF began efforts to “counter Yudkin and other negative attitudes toward sugar.” In 1967 a research article led by Harvard University’s D. Mark Hegsted was published in the New England Journal of Medicine. This study concluded that there was “no doubt” that the only dietary change necessary for preventing heart disease was to drastically reduce saturated fat intake. It was a landslide study for the sugar industry, actual proof that sugar in no way contributed to heart disease. And any skeptic can review the list of those who helped fund the research to find that there were no conflicts of interest. And yet, that’s exactly what happened. Between July 1965, when the study first launched, and November 1966, just days before it was submitted for publication, numerous documents of correspondence between Hickson, president of the SRF, and Hegsted. About $50,000 of the study was also funded by the SRF. Just a few weeks into the study, one letter penned by Hickson reads “Our particular interest…had to do with carbohydrates. I will be disappointed if this aspect is drowned out in a cascade of review and general interpretation.” Another letter from Hickson addressed to Hegsted, penned November 2, 1966 – just a few weeks after Hegsted mailed the final draft to Hickson, prior to publication, read “Let me assure you this is quite what we had in mind and we look forward to its appearance in print.”
In the next decade, Hegsted went on to work with the staff Senate Select Committee for Nutrition and Human Needs, and actually helped draft the 1977 Dietary Goals for the United States. You know, the one recommending Americans eat more carbs and less fat.
So, What About Coconut Oil?
Recently, coconut oil has made the headlines again. Media outlets compare it to butter and steak (as if those were bad things) because of its high saturated fat content. It will make you fat! critics proclaim. It’ll clog your arteries! many doctors argue. But, what’s the real story behind this oil so raved about among the health conscious?
It’s true, coconut oil does have a high saturated fat content, in fact it is over 90% saturated fat. With the American Heart Association still raging war against saturated fats, and subsequently coconut oil, many people feel extremely confused about this topic. I feel that the American Heart Society has oversimplified this heart problem our country is facing, targeting all saturated fats as bad guys, without going into the whys of the heart issues we are facing. Because, most of the time, suffering a heart attack or stroke isn’t just eating one thing (in this case, saturated fat), and then having a heart attack. There are other issues, like blood pressure and obesity for instance, that greatly exacerbate your chances of suffering cardiovascular disease.
According to the CDC, about 70% of people who suffer their first heart attack already had high blood pressure. We know there are many factors that can raise blood pressure, like deli meat, pastries, and refined sugar, but what about coconut oil? Because of its high saturated fat content, it is assumed that coconut oil also raises your blood pressure, putting strain on your heart (even though continuous research reveals no link between saturated fat and heart disease). This is because just calling something ‘saturated fat’ and then demonizing it isn’t enough. One type of saturated fatty acids, lauric acid, is found in extremely high amounts in coconut oil. Coconuts and, subsequently, coconut oil is literally one of the best ways to get this rarely found fatty acid into your body. Interestingly, lauric acid has actually been proven, in the lab, to reduce blood pressure in rats with hypertension. Lauric acid is actually a type of medium-chain fatty acid (MCT), of which there are several types. While lauric acid is found in the most abundance the other types of MCTs also provide numerous heart benefits. All four types of MCTs, caproic acid, caprylic acid, capric acid, and lauric acid can be found in unrefined coconut oil.
Programs including consumption of MCTs have been shown to greatly enhance one’s likelihood to lose weight, even over olive oil[33, 34] . In another study, mice fed diets high in MCTs both lost weight, and had a better glucose tolerance than those who consumed long-chain triglycerides (LCTs), such as canola oil. According to the American Diabetes Association, supplementation with MCTs in the diet may “be beneficial for preventing obesity and peripheral insulin resistance.” Maintaining healthy weight, and healthy levels of insulin resistance is absolutely key when protecting your heart.
As a way to understand the potential link between saturated fat and heart disease, in 1981, researchers studied people living in two remote Polynesian islands whose energy intake primarily consisted of coconuts. Because their saturated fat intake was so incredibly high, it was suspected that their rates of heart disease would be higher than, or at least equal to, those living in developed, Western nations. Surprisingly, vascular disease remained virtually unheard of among their population.
Blanket statements against foods that are potentially extremely beneficial for the human body is, in my opinion, simply bad science, and has an eerie ring of the guidelines set into place in 1977 which had more roots in corruption than science. This “Presidential Advisory” released earlier this year, stating that coconut oil has “no known offsetting favorable effects” really makes you wonder where the AHA is getting their information. Hopefully, it’s not the sugar industry.
Until next time,
1. CDC Heart Disease Facts
2. CDC 75 Years of Mortality in the United States, 1935-2010
3. Keys, Ancel Atherosclerosis: A Problem in Newer Public Health
4. NBC News What if Fat isn’t so Bad?
5. Time Magazine Ancel Keys, Jan 13, 1961
6. Time Magazine 6 Facts about Saturated Fat that will Astound You
7. NCBI In the Face of Contradictory Evidence: Report of the Dietary Guidelines for Americans Committee
8. USDA The Food Guide Pyramid
9. BMJ Journals Ultra-Processed Foods and Added Sugars in the US Diet: Evidence from a Nationally Representative Cross-Sectional Study
10. The BMJ Saturated Fat is Not the Major Issue
11. Oxford Academic Trends in Carbohydrate, Fat, and Protein Intakes and Association with Energy Intake in Normal-Weight, Overweight, and Obese Individuals: 1971-2006
12. CDC Long-Term Trends in Diabetes
13. Oxford Academic Conjugated Linoleic Acid Supplementation for 1y Reduces Body Fat Mass in Healthy Overweight Humans
14. Belury, Martha Pilot Study: Conjugated Linoleic Acid Reduces Fasting Blood Glucose and is Inversely Correlated with Leptin in Subjects with Type 2 Diabetes Mellitus
15. NCBI Effects of CLA Supplementation on Immune Function in Young Healthy Volunteers
16. BMC A Review of Fatty Acid Profiles and Antioxidant Content in Grass-Fed and Grain-Fed Beef
17. NCBI Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus: A Systematic Review and Meta-Analysis
18. The American Journal of Medicine Dietary Fat is not a Major Determinant of Body Fat
19. Annals of Internal Medicine Association of Dietary, Circulating, and Supplement Fatty Acids with Coronary Risk: A Systematic Review and Meta-Analysis
20. Oxford Academic Meta-Analysis of Prospective Cohort Studies Evaluating the Association of Saturated Fat with Cardiovascular Disease
21. BMJ Saturated Fat does not Clog the Arteries: Coronary Heart Disease is a Chronic Inflammatory Condition, the Risk of which can be Effectively Reduced from Healthy Lifestyle Interventions
22. The Lancet Diet and Coronary Thrombosis: Hypothesis and Fact
23. Cambridge University Carbohydrates and Nutrition
24. Circulation Added Sugars and Cardiovascular Diseases Risk in Children: A Scientific Statement from the American Heart Association
25. Circulations Consumption of Added Sugars and Indicators of Cardiovascular Disease Risk Among US Adolescents
26. JAMA Internal Medicine Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents
27. The American Society of Sugar Beet Technologies Proceedings Eighth General Meeting
28. The New England Journal of Medicine Dietary Fats, Carbohydrates, and Atherosclerotic Vascular Disease
29. Oxford Academic D. Mark Hegsted, Ph.D
30. CDC High Blood Pressure Facts
31. PLOS One Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Fatty Acids in Palmitoleic Acid in Adults with Metabolic Syndrome
32. NCBI Acute Treatment with Lauric Acid Reduces Blood Pressure and Oxidative Stress in Spontaneously Hypertensive Rats
33. NCBI Medium Chain Triglyceride Oil Consumption as Part of a Weight Loss Diet Does Not Lead to an Adverse Metabolic Profile When Compared to Olive Oil
34. NCBI Weight-Loss Diet that Includes Consumption of Medium-Chain Tricylglycerol Oil Leads to a Greater Rate of Weight and Fat Mass Loss than Does Olive oil
35. American Diabetes Association Enhancement of Muscle Mitochondrial Oxidative Capacity and Alterations in Insulin Action are Lipid Species Dependent
36. NCBI Cholesterol, Coconuts, and Diet on Polynesian Atolls: A Natural Experiment: The Pukapuka and Tokelau Island Studies
37. Circulation Dietary Facts and Cardiovascular Disease: A Presidential Advisory from the American Heart Association