“Urging people to follow low-fat diets is having “disastrous health consequences”, a health charity has warned”. This quote is taken from a recent article on The Guardian website stating that official dietary guidelines on fat consumption are in need of a “major overhaul” and are “failing to address Britain’s obesity crisis”.
In truth, this matter is very rarely out of the news, and there is a constant controversy surrounding fats in our diet – what is ‘good’ and what is ‘bad’.
Recently, this has been more in the public eye than usual as a result of a recent report by The Public Health Collaboration – titled “Healthy Eating Guidelines & Weight Loss Advice For The United Kingdom” (you can download the full report here) – which questions the healthy eating guidelines recommended in ‘The Eatwell Guide’, with the topic of fats (i.e how much we should be eating) at the forefront of the report.
‘The Eatwell Guide’
You can find the official healthy eating guidelines for the UK in ‘The Eatwell Guide’, and they are summarised as follows:
- Eat at least 5 portions of a variety of fruit and vegetables every day
- Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates; choosing wholegrain versions where possible
- Have some dairy or dairy alternatives (such as soya drinks); choosing lower fat and lower sugar options
- Eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily
- Choose unsaturated oils and spreads and eat in small amounts
- Drink 6-8 cups/glasses of fluid a day
- If consuming foods and drinks high in fat, salt or sugar have these less often and in small amounts.
According to the report (which cites this reference for the following statistics) the latest National Diet and Nutrition Survey from 2014, show that adults in the UK have been eating 383 calories below the recommended daily amount as well as eating just below the recommended 35% for total fat consumption.
The report concludes that, “this seemingly paradoxical situation of following healthy eating guidelines yet having dire health statistics brings into question the very guidelines that the UK population is being asked to follow.”
A good point? Well it would be hard to argue on the contrary, because if the majority of us are following these ‘healthy’ eating guidelines then why is there an obesity prevalence in The UK of 25% (1 in 4)? And why has the number of people living with type 2 diabetes doubled since 1996?
Indeed, the report goes as far to say that “the advice to follow current healthy eating guidelines has resulted in 25% of adults being obese, the prevalence of type 2 diabetes doubling in 20 years, 35% living with pre-diabetes and 20% living with the early-stages of non-alcoholic fatty liver disease.”
So what are the main concerns with the guidelines that we are being set in ‘The Eatwell Guide’? The Public Health Collaboration narrows it down to three main points, comprising:
- The avoidance of foods because of saturated fat content.
- The dietary reference value of no more than 35% total fat.
- The quality and quantity of carbohydrates.
In reference to point 2, the report claims:
“The main concerns that the NHS and the BDA seem to have in regard to eating more than 35% fat are the possible increased risk of heart disease and becoming overweight.
However, in February 2016 an analysis was published in the British Journal of Nutrition finding that “Compared with subjects on low-fat diets, subjects on low-carbohydrate diets experienced significantly greater weight loss, greater triglycerides reduction and greater increase in HDL-cholesterol after 6 months to 2 years of intervention.”
Therefore, according to the most up to date analysis of the scientific literature eating a low carbohydrate diet, which contains much greater than 35% total fat intake, is more effective for weight loss and reducing heart disease risk than eating a diet with less than 35% fat, as The Eatwell Guide recommends.”
Indeed, the recommendation of less than 30-35% fat in your diet has now become so unconvincing that Dietary Guidelines For Americans the Department of Health and Human Services no longer places any restrictions on the intake of fat in your diet.
However, the problem in this country is that the ‘fats’ message that is often portrayed by the media is a negative one, with pictures of processed foods such as cakes, biscuits and pies. These high fat foods often contain undesirable types of fat and are high in sugar/refined carbohydrates and low in nutrients.
The report suggests that the UK should remove the recommendation to eat no more than 35% of total calorie intake from fat (as a lot of this then steers towards recommending unnatural man-made low fat foods), and instead focus on encouraging people to eat food in it’s most natural form, regardless of how much fat it contains.
So what role does fat play in our body? And what types of fats should we be including in our diet?
Fats don’t just provide us with energy – they perform numerous, essential functions in the body.
For example, fats are used as structural components in cell membranes and hormone-like substances called prostaglandins. Every human cell has a protective permeable membrane composed of phospholipids (fats), cholesterol and proteins.
Omega-6 and omega-3 fats are also used to synthesise hormone-like substances called prostaglandins. Different prostaglandins can act to increase or decrease inflammation in the body.
In general, omega-6 fatty acids result in more inflammatory prostaglandins and omega-3 in more anti-inflammatory prostaglandins. Thus the high proportion of omega-6 in the Western diet is pro-inflammatory. Inflammation is a critical component of virtually every degenerative disease from heart disease, to diabetes, to arthritis, to obesity, to Alzheimer’s.
Despite the vital roles of fat, many people are ‘fat-phobic’ as a result of the bad press fat has received and the Low Fat Diets heavily promoted in the 1980s and 1990s.
Types of fat
Fats come in many different forms. The nature of the fat depends on the predominant type of fatty acids it contains. All fats contain both saturated and unsaturated fatty acids (mono-unsaturated, poly-unsaturated) but are sometimes described as saturated or unsaturated according to the proportions of fatty acids present.
For example, olive oil is often described as a mono-unsaturated fat because a high proportion of the fatty acids are mono-unsaturated.
Found in animal products (meat, full fat dairy products), coconut oil and palm oil. Some forms of saturated fat, for example the kind in coconut, are very healthy.
The Public Health Collaboration report refers to various pieces of research stating that the idea of saturated fat increasing your risk of heart disease and obesity is in fact misplaced:
“In March 2010 an analysis published in The American Journal of Clinical Nutrition by the Harvard School of Public Health followed 347,747 people over 5-23 years and concluded that “Intake of saturated fat was not associated with an increased risk of coronary heart disease, stroke, or cardiovascular disease.”
Following that in July 2012 a review published in the European Journal of Nutrition concluded that “observational evidence does not support the hypothesis that dairy fat or high-fat dairy foods contribute to obesity or cardiometabolic risk, and suggests that high-fat dairy consumption within typical dietary patterns is inversely associated with obesity risk.”
Finally, in March 2014 the University of Cambridge published an analysis in the Annals of Internal Medicine looking at a total of 643,226 people concluding that “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”
It was reported in the ‘Harvard Health Publication’ in February 2015 that “for every 2% of calories from ‘trans fat’ consumed daily, the risk of heart disease rises by 23%.”
An incredible statistic and one that begs the question; if this is the case, why are we still consuming them?
‘Trans fats’ are a form of unsaturated fat that act more like a saturated fat because of their chemical structure. They are uncommon in nature but became a common choice for food manufacturers for use in margarine, snack food, packaged baked goods and frying fast food from around the 1950’s.
Artificial ‘trans fats’ go through a process called ‘hydrogenation’ which solidifies the oil. ‘Trans fats’ are frequently used by the food industry because they ‘improve’ flavour stability and the shelf life of food.
Please note that natural ‘trans fats’ can be found in nature but are not common. Conjugated linoleic acid is the only known ‘trans fat’ that is profoundly beneficial to health and is present in meat and butter.
The danger of trans fats
‘Trans fats’ alter the configuration of cell membranes and also block the essential enzymatic processes necessary for the metabolism of fats. Medical professionals consider ‘trans fats’ to be one of the most unhealthy compounds found in today’s food.
They are manufactured when an oil is heated to a point that changes its chemical structure. Extra hydrogen atoms are bubbled into the hot oil in order to make it more stable for food preservation. Although these fats look chemically similar to their natural fat counterparts, they are not natural at all, and this confuses the body.
It has been reported that cutting commercial ‘trans fat’ intake from 2.1% of daily energy intake to 1.1% could potentially prevent 72,000 cardiovascular deaths.
Please follow this link to read our blog on The Truth about ‘Trans Fats’.
These have a single carbon-to-carbon double bond. Because of this they have two fewer hydrogen atoms than a saturated fat and a bend at the double bond. This structure keeps monounsaturated fats liquid at room temperature. Mono-unsaturated fats are heart healthy.
For example they lower bad cholesterol (LDL) and raise good cholesterol (HDL) and lower blood pressure. Monounsaturated fats are linked to reduced risk of cancer and diabetes.
Good sources of mono-unsaturated fats include avocado, olives, most nuts and olive oil. However, it is important to use Extra Virgin oils and avoid heating to high temperatures (best used for salads or added at the end of cooking).
Poly-unsaturated fats (omega-6s and omega-3s)
Linoleic acid (omega-6) and alpha-linolenic acid (omega-3) are essential in the diet in the correct ratio. However, most Western diets contain too much omega-6 and not enough omega-3. The Western diet ratio is estimated to be between 10: 1 to 15:1 in favour of omega-6. Traditionally our diet would have included a much lower ratio of between 3:1 and 1:1.
The reason for the omega-6 dominance is because Western diets include large amounts of sunflower and corn oils (and processed foods containing them), grain-fed meat and margarines. These foods are all high in omega 6.
Other important omega-3 fats, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), are found in oily fish like wild salmon. The body can make DHA and EPA from alpha-linolenic acid but it doesn’t always do a good job of it.
That’s why it’s important to obtain these important fats from fish such as wild salmon, sardines and mackerel or vegetarians can take an algal based EPA/DHA supplement. Flaxseeds and flaxseed oil is also a good source of the parent omega-3 fatty acid, alpha linolenic acid.
And of course we all know that the fats to avoid include: deep fried food, meat pies, sausages, pastry, cakes and biscuits, margarine, sunflower and corn oil – these foods are highly processed, inflammatory and lacking in nutrients.
The truth is, when it comes to addressing the many health problems that this country faces now and for many years to come, the argument of fats – What is good? What is bad? How much should we be eating? – really is just the tip of the iceberg.
Which ever way you look at the problem, whether our attitude as a population is to blame or the official advice that we are being set, it is hard to get away from the statistics that have the potential to haunt the United Kingdom for many years to come:
- The United Kingdom has one of the highest prevalences of obesity in Europe
- The cost of obesity to the NHS will double to £12 billion by 2030
- Type 2 Diabetes already costs the NHS £10 billion a year
- Ill health in general costs our economy around £47 billion a year
I leave you with a quote from the Public Health Collaboration report that sums up the issue that the United Kingdom faces:
“At this very moment in time we are at a crossroads for improving public health in the United Kingdom. We can either carry on recommending current healthy eating guidelines and weight loss advice, which have not made any progress for the past 20 years, or we can accept that what was previously thought to be true is no longer so. In order to make progress we must accept that mistakes have been made and move forward with the lessons learned.”
If you have any questions regarding the topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.
firstname.lastname@example.org, 01684 310099
Amanda Williams and the Cytoplan Editorial Team: Joseph Forsyth, Simon Holdcroft and Clare Daley