Dr. David Katz, Preventive Medicine: Saturated fat as click bait

Dr. David Katz

Dr. David Katz

The pattern of provocations, proclamations and click bait innuendo related to saturated fat is fairly clear to anyone who reads past the headlines. It’s entirely clear to anyone who actually reads the studies that are blithely cited, and routinely misrepresented, in a show of pseudo-erudition. Just about every missive inviting you to eat more bacon-cheeseburgers and pepperoni pizza or douse yourself with butter is a bait and switch, and those that are otherwise are simply wrong.

What do I mean? Here’s a short list of the bait that draws you in, and the inevitably divergent truth reserved for the fine print.

1) Sugar is the problem, so saturated fat is not.

While there are many articles that pertain here, including some that have been massively misinterpreted, and some subjected to revisionist history — the two most often invoked are meta-analyses from 2010 and 2014. Leaving aside the details, what both papers showed is: rates of heart disease were just about identical at the lower and higher end of the saturated fat intake ranges assessed. If the epidemiology that’s good for the goose is good for the gander, these papers can only be interpreted to show: excesses of sugar and saturated fat appear to be all but exactly, commensurately harmful.

2) Butter is back.

In some ways, looking for the harms of just butter, or any one food for that matter, is like attempting to indict the culpable snowflake in a deadly avalanche. Every snowflake is innocent; but together, they did it.

There is no evidence that butter is beneficial to health. There is some evidence that butter, per se, may increase the risk for some chronic diseases but not others. Contrast this with olive oil, for instance, where there is compelling evidence of actual benefit. So, while we get headlines like “butter is back,” what they actually mean is: butter, by itself, may confer only some of the harms formerly associated with it.

3) Full-fat dairy is better.

Claims about dairy fat, like those about butter, beg the oft-neglected question: compared to what? There is evidence in the context of the prevailing American diet, where go-to beverages include Coke, Pepsi, and psychedelic sports drinks incubated in chemistry experiments — that there may be satiety (appetite control) benefits of full-fat dairy. That makes sense. But is there any evidence that full-fat dairy produces better health outcomes in the context of decent dietary patterns, where foods are wholesome and filling, and water is the default response to thirst? None that I can find. But we have perfectly clear evidence that the fat in nuts, seeds, olives, and avocado is actually good for us. So I get mine there, preferentially.

4) Low-fat diets fail.

To be blunt, the “low fat” rubric doesn’t interest me much. The world’s best diets range from very low fat, to very high; it’s a poor discriminator. That said, “low fat” has commonly served as a convenient flag for plant-predominant and plant-exclusive diets that are, in fact, low in total fat either by design, or by the macronutrient happenstance issuing from food choice. Vegetables, fruits, whole grains, beans, and lentils are very low in fat, so diets in which these predominate are apt to be as well.

Almost every study claiming to show the failings of low-fat diets is itself an egregious failure when viewed objectively. As a matter of routine, diets are called “low” fat but are nothing of the sort, and while “lower” in fat, may not otherwise be designed to be good diets. In other words, the “low fat” comparison diets are routinely straw men, designed from the outset to go up in smoke.

5) Saturated fat is not the cause of heart disease.

There is no single cause of heart disease, of course. The criteria for indictment as “the” cause are rather different from those for “a” cause. Beware conflation of the two.

What do we know? All of the diets most decisively associated with the health outcomes that matter most, longevity and vitality, are low in saturated fat. That doesn’t prove a diet high in saturated fat can’t produce such outcomes, but it does prove that those who are peddling such diets to you in the absence of evidence are blithely gambling with your life.

So, most of what you read in headlines or hear in sound bites about saturated fat and health is really just click bait. Why should you care? Quite simply: because you are the fish in this scenario, and you know what happens to them when they take the bait.

Dr. David L. Katz; www.davidkatzmd.com; founder, True Health Initiative.