The skinny on fats

Beginning more than a half-century ago, fats got a bad reputation in the medical world. The thinking: Ingesting fats led to high levels of cholesterol, which led to an increased risk of heart attacks. More recent research, however, shows little link between fat intake and cardiovascular disease mortality. Instead, higher carbohydrate intake was linked to higher mortality rates.

Fats aren’t exactly off the hook, and like all studies, this one is hotly debated. But perhaps a keener focus should be on carbohydrates.

“For me, putting all the pieces together, it seems logical that a highcarb diet puts people at greater risk,” said Dr. Sarah Goodpastor, with Mercy Internal Medicine.

A large, recent study published in The Lancet, a renowned, peer-reviewed medical journal, offered somewhat surprising results. In the study of 135,000 people in 18 countries, those eating high-carb diets had a nearly 30 percent higher death rate than those eating low-carb diets. Meanwhile, those eating high-fat diets had a 23 percent lower death rate during the study period.

The study will challenge those setting nutritional guidelines, said Goodpastor, who is a doctor of both internal medicine and obesity medicine. And if fats actually lower death rates, as the study in The Lancet indicated, people are bound to ask, “So what fats do you want me to eat?”

One answer to that question is to focus on a Mediterranean diet, one that is high in unsaturated fats. Although eating saturated fats (animal fats, butter, whole milk) may be OK in moderation, unsaturated fats (olive oil, cashews and other nuts, many types of fish) are healthier.

A good rule, Dr. Goodpastor said, is to eat foods that are minimally processed or not processed at all. That applies to both fats and carbs. For fats, that means to stay away from processed meats, hydrogenated oils, and trans fats (scheduled to be banned in the U.S. next year – sorry, Twinkie lovers). For carbs, that means to ease off the boxed and bagged foods that Americans typically dive into for snacks and meals.

The truth is that as far as medical researchers and professionals have come in their understanding of cardiovascular disease in the last half-century, no one has all the definitive answers. The recent Lancet-published study is “so large it’s hard to ignore,” but its results will certainly be bandied about, discussed and debated for years to come, Dr. Goodpastor said.

“We should be doing our best to eat as many quality fruits and vegetables as possible,” she said. “It’s not the fruits and vegetables that are going to get you in trouble. It’s all of the processed stuff.”


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