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Can Fat be Healthy?

Guest Post: Why Dietary Fat is Healthy

A student and I originally wrote this post for my friend Laurel who writes over at Hickory Creek Lane.  We wanted to share some evidenced-based wisdom on some of the confusion that surrounds fat consumption. There is lots of confusion about which foods or fats can be “good” or “bad” and it gets complex. Sometimes it can even come down to our genetic make-up or gut microbiome! We are all individual but this is some general guidance on why we need some healthy fat in our lives! Enjoy! 

Why is Fat Healthy?

If you think the title of this blog entry seems a bit contradictory, you are not alone. Many of us have been told for decades that fat leads to high cholesterol, weight gain, heart disease and stroke. In the early 2000’s, food companies began labeling “0 grams of trans fat” in packages as the FDA granted a petition intended to help Americans follow appropriate diet recommendations.1 Today, many mainstream trends focus on low-fat diets to promote weight loss and improve cardiovascular outcomes. However, this shift does not necessarily make us healthier, likely because we are cutting back on healthy fats while also increasing the amount of foods high in carbohydrates and sugar.

But why is fat good for us?

Virtually all natural foods contain some fat. In fact, fat is contained in foods as it serves as the primary source for the body’s energy needs.  Fat (or triglycerides) from food is broken down into fatty acids and glycerol (a sugar alcohol intermediate) in a process called lipolysis.2 These fatty acids are again broken down for energy or used to make glucose (sugar) that is important for cellular respiration and functions of the human brain – which consumes 60% of blood glucose in fasting, sedentary individuals.3 All of this to say, our bodies were designed to intake fat!

Heart Disease and Fat

  • Myth: Heart Disease is caused by saturated fat intake
  • Fact: There is an inverse relationship between saturated fat and stroke

Historically, saturated fat received a bad name in 1953 when a paper was published comparing saturated fat intake and heart disease mortality.4 However, this theory was flawed for several reasons: Frist, the study surveyed 22 countries yet only included the results from 6 of the 22 countries, disregarding almost three-quarters of the data collected. Second, the results of the data collected from the select 6 countries simply indicated a correlation between saturated fat intake and heart disease mortality. It is important to note that correlation does not equal causation. For example, the number of Nobel Peace Prizes won by a country may correlate well with per capita chocolate consumption, but this does not equal causation. Newer studies indicate that the relationship between saturated fat and heart disease is little to none.5 In fact, there is an inverse relationship to saturated fat and stroke.6 This means that consuming saturated fat may be beneficial to your health!

Coconut oil is composed of 92% saturated fat. Roughly 50% of this fat content is made up of an ingredient called lauric acid.7 When coconut oil is consumed, lauric acid is converted in our bodies to monolaurin, which has anti-viral, anti-bacterial, and anti-protozoa properties.8 Because of this, coconut oil has demonstrated significant health benefits in areas such as immune system support, anti-inflammatory, and focus and mental performance. Additionally, coconut oil has added digestive support oral hygiene through fighting irritation and infection from Candida (yeast infection).9

Other natural and healthy sources of fat include:10-13

  • Tallow (beef/mutton fat) from grass-fed (pastured) animals
    • High concentration of conjugated linoleic acid (CLA) which is good for cholesterol levels
  • Lard (Unprocessed and un-hydrogenated)
    • Combination of saturated, monounsaturated, and polyunsaturated fats for heat stability
    • High in vitamin D
  • Pastured butter (emulsified if >250°F)
    • Rich in butyric acid, which can decrease inflammation
  • Pastured ghee (clarified butter)
    • Smoke point of 450°F; Does not contain lactose or casein
  • Avocados
    • High amount of monounsaturated fats, vitamin E, folate, and protein
  • Extra virgin olive oil
    • Demonstrated to reduce the incidence of heart attack and dying of heart disease
    • Not recommended for cooking at high temperatures; great for salad dressings
    • When purchasing:
      • Look for a seal from the International Olive Oil Council
      • Check the harvesting date on the label (avoid “light”, “pure”, or “blend”)
      • Opt for dark bottles to protect from oxidation

The underlying problem…

The gut immune system, the largest immune system in our body, actively responds to pathogens (invading microorganisms) while at the same time remaining relatively unresponsive to food (non-pathogenic) ingested.14 Essentially, cells in the intestine are exposed to bacteria and food breakdown products all the time.15Malabsorption means the failure of the Gastrointestinal (GI) tract, usually the small intestine, to absorb one or more substances from the diet (let’s say, fat). This is generally the result of some defect or damage to the mucosal lining of the small intestine, where most of our nutrient absorption takes place. Common causes of malabsorption include diabetes, bacterial overgrowth, past intestinal surgery, AIDS, radiation to the abdomen, lymphoma or motility disorders. 16,17

 What we eat and drink plays a huge role inInflammation

Inflammation is a defense reaction of the body against injury, and is traditionally characterized by redness, swelling, pain, heat, and impaired body function.18 However, chronic inflammation can lead to conditions such as inflammatory bowel disease, stroke, heart disease, Type 2 Diabetes Mellitus and more. Refined carbohydrates and sugars are high in glycemic load (the impact of a carbohydrate quality and quantity on blood glucose levels). This leads to high insulin levels followed by a plummet in blood glucose, encouraging low-grade inflammation.18.19

Foods that can cause inflammation are:

  • Grains (especially improperly prepared grains)
  • Sugar
  • Conventional Dairy
  • Other foods may contribute to inflammation once the gut is “damaged” and leaky and the immune system is overresponsive

Big picture:

When our gut is damaged or inflamed, healthy fat is not appropriately processed in our body. As a result, plaque builds up in the artery walls and makes it hard for blood to get through, ultimately leading to cardiovascular complications. (See leaky gut post for a more in-depth description)

The solution!

As you may be aware, there are a variety of fats in our food. Having a good understanding of how different fats affect our health is important to establish the concept of why fat is healthy. Some people have referred to these different types as “good fats” and “bad fats.” The types of fat that exist are:20-22

 

Unsaturated “good” Fats Saturated “in-between” Fats Trans “bad” Fats
Liquid at room temperature

Includes (mono-) and (poly-) unsaturated fats and omega-3,6

Naturally occurring, found in animal foods and certain plants Made by heating liquid vegetable oils via hydrogenation

Should be avoided

Sources: Peanut oil, avocados, high-oleic safflower and sunflower oils, most nuts, fish and flax seeds (omega-3) Sources: Red meat, coconut and coconut oil, cheese, whole milk and yogurt Partially hydrogenated vegetable oils are the foundation for fried and processed foods

Consuming fat does not directly make you “fat.” In fact, consuming fat is necessary for our body to function and have energy for daily activities. Instead, an imbalanced diet, malnutrition, bacterial imbalances, sedentary lifestyles and large portion sizes are the leading factors to excess weight gain. Unfortunately, a focus on fat intake alone distracts from the more appropriate focus on total energy intake and physical activity levels.

A healthy diet should include fat.

Looking at the literature

A recent study combined 21 studies with over 23 years of data looking at saturated fat intake in nearly 350,000 people. Despite popular belief, it was ultimately concluded that there is not enough evidence to claim saturated fat increases the risk of heart disease.23Additionally, the analysis also concluded that more data is warranted to determine if heart disease is related to other nutrients used to replace fat. In particular, one of these studies found that saturated fat consumption in 50 heathy men for 5 weeks had no effect on systemic inflammation markers.24

Another study focused on weight-reducing regimens through dietary interventions. It was found that the group of men receiving a diet high in monounsaturated fats saw significant weight loss and reduction waist circumference.25

As mentioned above, coconut oil is an example of a saturated fat. One of the main components of coconut oil is lauric acid. This saturated fat is a medium length fatty acid and has been shown in other studies to have an antimicrobial effect against certain bacteria (gram-positive) and yeasts.26 Even compared to other acids, lauric acid ultimately gave better results in fighting infections and inflammation.27

How do I choose which fats to eat?

 When it comes to cooking, there are many options to incorporate healthy fat into the diet.  Like all foods, however, fats contain calories and should be consumed in moderation in order to regulate calories to acceptable daily intake levels.

Using coconut oil is another great option. While unrefined coconut oil may be stable enough to resist mild heat-induced damage, it should still be used with caution and not cooked at elevated temperatures (350°F) due to oxidative stress, causing fragmentation and polymerization of the oil leading to damaging effects to the body.  Refined coconut oil can be used at a higher cooking temperature (400°F).28

A diet rich in monounsaturated fats has also been proven to improve the blood cholesterol profile.29 Monounsaturated fats are found often in foods like olive oil, nuts, avocados and whole milk. The most common monounsaturated fat found in food is oleic acid, a fatty acid that occurs naturally in vegetable and animal oils.

Best Monounsaturated Fats30

Some of the best sources of monounsaturated fats are:

  • Olive oil
  • Avocados
  • Almonds
  • Cashews

Eating polyunsaturated fats in place of highly refined carbohydrates reduces harmful LDL cholesterol and improves the cholesterol profile. It also lowers triglycerides.31 Additionally, our bodies require but do not produce these fats. Omega-3 fatty acids are involved in normal growth and development, play a role in the prevention of coronary and cardiovascular diseases, of diabetes mellitus, of arterial hypertension, arthritis and cancer.31.32 Common quality sources of omega-3 fatty acids include flaxseed, chia seeds, and fish. Additionally, current research suggests there may be beneficial effects of omega-3 fatty acids on athletic performance.33

Fat is necessary for a well-balanced diet.

Whether you are trying to lose weight, gain energy, or simply promote an overall healthy lifestyle, incorporating fat into your diet is essential to maintaining your health. Fat is necessary for many normal functions such as digestion, hormone function, and energy extraction. Staying away from greasy, fried foods high in trans-fat and oxidized fats and replacing these with naturally occurring sources such as avocados and coconut oil are great steps towards your wellness journey.

Thanks to Danielle Baker, PharmD Intern who wrote the majority of this post while on rotation with me in the fall!

References:

 

  1. Division of Nutrition Programs and Labeling, Office of Nutritional Products, Labeling, and Dietary Supplements in the Center for Food Safety and Applied Nutrition (CFSAN) at the U.S. Food and Drug Administration.
  2. Duncan, Robin E.; Ahmadian, Maryam; Jaworski, Kathy; Sarkadi-Nagy, Eszter; Sul, Hei Sook (August 2007). “Regulation of Lipolysis in Adipocytes”. Annual Review of Nutrition27(1): 79–101.
    doi: 10.1146/annurev.nutr.27.061406.093734.
  3. Berg JM, Tymoczko JL, Stryer L. Biochemistry. 5th edition. New York: W H Freeman; 2002. Section 30.2.
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  6. Cheng P, Wang J, Shao W, Liu M, Zhang H. Can dietary saturated fat be beneficial in prevention of stroke risk? A meta-analysis. Neurological Sciences: Official Journal Of The Italian Neurological Society And Of The Italian Society Of Clinical Neurophysiology. July 2016;37(7):1089-1098.
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  11. Kon SK, Booth RG. The vitamin D activity of butter: An attempt to elucidate the nature of the labile factor in butter antirachitic for the rat. The antirachitic potency of lard, olive oil, egg oil and the fatty acids of butters and lard. Biochemical Journal. 1934;28(1):121-130.
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  16. Williams AJ, Merrick MV, Eastwood MA. Idiopathic bile acid malabsorption–a review of clinical presentation, diagnosis, and response to treatment. Gut. 1991;32(9):1004-1006.
  17. Wake Gastroenterology. Malabsorption Syndromes.
  18. Kiecolt-Glaser JK. Stress, Food, and Inflammation: Psychoneuroimmunology and Nutrition at the Cutting Edge. Psychosomatic medicine. 2010;72(4):365-369. doi:10.1097/PSY.0b013e3181dbf489.
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  21. Remig V, Nece T, Street J, Kostas G, Franklin B, Margolis S. Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation. Journal Of The American Dietetic Association. April 2010;110(4):585-592.
  22. O’Sullivan T, Hafekost K, Mitrou F, Lawrence D. Food Sources of Saturated Fat and the Association With Mortality: A Meta-Analysis. American Journal Of Public. September 2013;103(9):e31-42.
  23. Mozaffarian, D., R. Micha, and S. Wallace, Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med, 2010. 7(3): p. e1000252.
  24. Hwalla N, Torbay N, Andari N, Adra N, Azar S, Habbal Z. Restoration of normal insulinemia and insulin sensitivity in hyperinsulinemic normoglycemic men by a hypoenergetic high monounsaturated fat diet. Journal Of Nutritional & Environmental Medicine. March 2004;14(1):29-38.
  25. Baer DJ, et al. Dietary fatty acids affect plasma markers of inflammation in healthy men fed controlled diets: a randomized crossover study. Am J Clin Nutr. 2004;79(6):969–973.
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  32. Hals P, Xiaoli W, Yong-Fu X. Effects of a purified krill oil phospholipid rich in long-chain omega-3 fatty acids on cardiovascular disease risk factors in non-human primates with naturally occurring diabetes type-2 and dyslipidemia. Lipids In Health & Disease. January 17, 2017;16:1-16. Available from: Food Science Source, Ipswich, MA.
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