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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Tuesday, April 15, 2014

THE LINK BETWEEN SATURATED FAT AND HEART DISEASE IS QUESTIONED

One of the consistent nutrition messages in the last 50 years is that saturated fats found in dairy and meat raise blood cholesterol and therefore increase the risk of heart disease.  However, this time honored recommendation is now being called into question.  A recent editorial arguing limiting saturated fat does not curb heart disease risk by cardiovascular disease researcher Dr. DiNicolantonio  and a review of the current research by Dr. Siri-Tarino and colleagues have been generating a reexamination of the evidence on this subject.

 Dr. DiNicolantonio points out that the original findings that linked saturated fat and heart disease were based on epidemiologic (population) studies in which researchers cherry-picked the evidence for groups that matched their hypothesis while excluding populations for which there was contrary evidence.  And, the 2010 Siri-Tarino review of existing epidemiologic studies on the relationship between saturated fat and heart disease found no significant evidence saturated fat intake increases cardiovascular disease rates.  Another reason saturated fat has been linked to heart disease is the evidence that it raises LDL cholesterol levels but, increasingly, it is being recognized that LDL cholesterol is made up of a combination of artery damaging small dense LDL particles and comparatively benign light large LDL particles and it appears that saturated fat mostly increases the light large LDL rather than the dangerous small LDL in the blood.  Dr. DiNicolantonio argues the real drivers of increases in the small damaging LDL particles is over-consumption of carbohydrates especially in the form of sugars and refined grains.

Additionally, one of the chief reasons saturated fat has been linked to heart disease is the finding that diets high in red meat, which is generally high in saturated fat, are linked with higher heart disease rates.  This is especially true for processed meat.  In the past few years researchers have been uncovering other ways that meat may be contributing to heart disease.  It appears that the nitrites in processed meat can damage arteries and increase metabolic problems linked to diabetes.  Also, it has been found carnitine which is especially rich in meat may be metabolized into a substance that increases arterial damage by small LDL particles.

What to do:  While new questions are being raised about the role of saturated fat in heart disease risk, it is too early to make a definitive conclusion.  Stay tuned.  In the meantime, there is stellar epidemiologic evidence that a traditional Mediterranean diet rich in olive oil, nuts, fish, beans, fruits, and vegetables does help to prevent and improve cardiovascular disease.  At the same time there is also good evidence diets high in processed carbohydrates such as refined flour and sugar do increase the risk of cardiovascular disease.  

Adapted from articles available at:
http://www.sciencedaily.com/releases/2014/03/140305191429.htm
http://www.medicalnewstoday.com/articles/273528.php

Sources:
DiNicolantonio JJ. The cardiometabolic consequences of replacing saturated fats with carbohydrates or omega-6 polyunsaturated fats: do the dietary guidelines have it wrong? Open Heart. 2014;1. doi:10.1136/openhrt-2013-000032.

Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke and diabetes mellitus: a systematic review and meta analysis. Circulation2010;121:2271-83.  Available at: http://ajcn.nutrition.org/content/91/3/535?ijkey=2755fae85a1e0c716ad5d4419af2cd89c40e3388&keytype2=tf_ipsecsha&linkType=ABST&journalCode=ajcn&resid=91/3/535&atom=/bmj/347/bmj.f6340.atom


Siri-Tarino P, Sun Q, Hu FB, Krauss RM.  Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.  Am J Clin Nutr 2010; 91: 535-46.  Available at: http://circ.ahajournals.org/content/121/21/2271.full.pdf+html

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