Something is Smoldering in Nutrition Today

Health Controversies of the food we eat can be found throughout recent civilizations. Only a few decades ago some thought that smoking tobacco was actually good for them. Or take coffee. How many times have you heard the opinion that drinking coffee is bad for you? And how many times have you heard the exact opposite? Even the purest of all commodities, water, can come into the line of fire. This recent online article[1], for instance, reports that:

“(…) experts now warn that drinking eight glasses of water a day is not good for you after all – and could be harmful. …They say that scientific claims behind long-standing government guidelines are worse than ‘nonsense’. … A report describes the danger of dehydration as a ‘myth’ and says there is no evidence behind claims that water prevents multiple health problems.”

It is this kind of science that creates a lot of confusion in the nutritional debates of our day.

Consider also the connection between red wine to the so-called “French Paradox”, which describes that. The French, although their typical diet contains more fat and alcohol than that of other European nations are three times less likely to suffer from coronary heart disease than their neighbors. They eat a lot of saturated dairy products as well. One attempt to explain this phenomenon attributes it to the beneficial effects of drinking red wine – albeit in reasonable doses. Other experts, however, doubt that the French paradox exists at all. They cite a study by the WHO which concludes that the number of incidents of coronary heart disease in France was systematically underestimated in the past. Despite all tehse observations teh French are now obssessed with blaming palm oil for some of their ill health!

What these examples show is that in nutrition there is plenty of opportunities for speculative science and false information that confuses the consumer. In the on-going tussle, palm oil has often been used as the object of blame for CHD risk, despite volumes of evidence in the contrary. Thus it was refreshing when a group of scientists at the recent 41st National Congress of the Romanian Society of Diabetes, Nutrition, and Metabolic Diseases (May 2015) at Sibiu, decided to take a different stance.

Saturated Fat: Boon or Bane?

Dietary fats have been at the center of attention for almost 60 years now. Fat intake has been linked to detrimental health effects from clogging arteries to other cardiovascular diseases like high blood pressure and diabetes mellitus. Research suggests SFA increases plasma total (TC) and LDL cholesterol (TC). Further, it is assumed that increased levels of LDL lead to a higher risk of coronary heart disease. Thus, the link between SFA intake and coronary heart disease was established. As a consequence, health authorities the world over adopted the recommendation to limit the daily intake of SFA.

At the Sibiu conference mentioned above a dedicated session looked at precisely these issues under the title: “Controversies in Dietary Fat Intake”.

A presentation (“An update on dietary fatty acids in lipid management”) by Prof. Pramod Khosla of Wayne State University in Detroit, USA, showed that the traditional wisdom described above has been dramatically challenged in a series of studies published since the year 2009. As a direct consequence, a new thinking on the effects of SFA is spreading in nutritional circles. First, epidemiologic studies during the last two decades suggest that there is only one class of fatty acids that may lead to an increased risk for heart disease: trans. In his review, Prof. Khosla concludes that replacing SFA with PUFA may provide small benefits while the effects in the case of mono-unsaturated fatty acids (MUFA) are inconclusive. Furthermore, carbohydrates can also play a role. When they are the nutrients replacing SFA, the quality of the carbohydrate is important for subsequent health outcomes.

In a second presentation (“Cardiovascular risk potential of dietary saturated fatty acids: update and some implications”) Prof. Gerard Hornstra of Maastricht University in the Netherlands draws the attention to the fact that the intake of certain fatty acids not only increases levels of “bad” LDL cholesterol, but of cardiovascular risk-reducing “good” HDL cholesterol as well. This results in the ratio between these opposing risk factors to be hardly affected, and thus the link between saturated fat consumption and the risk of cardiovascular disease is weakened. The practical implication is that limiting the intake of saturated fat per se is unlikely to reduce cardiovascular risk. Prof. Hornstra further points out that since the commonly used dietary saturates (stearic-, palmitic-, myristic-, and lauric acids) have different effects on cardiovascular risk, the scientific community should reconsider the practice of addressing dietary saturates as one group. In conclusion, Prof. Hornstra states that:

“As part of a well-balanced diet, palm oil earned an established record in human nutrition because of its moderate effect on the cardiovascular risk. As such, it takes a valuable position between the available resources of the slightly more cholesterolemic, lauric, and myristic acids and the neutral stearic acid.”

Finally, the Romanian scientists Ciprian Constantin and Dan Cheta in their presentation (“Applied nutrition management power to control the lipid cardiovascular risk in type II diabetes mellitus patients”) point to the dangers of replacing SFA with carbohydrates. They maintain that such a replacement leads to lower LDL cholesterol and HDL cholesterol levels but does not change the total cholesterol ratio. There may be other negative effects of substituting carbohydrates for saturated fat. This is corroborated by other studies and advances in science having to do with biochemical markers including lipoprotein particle sizing and distribution. These studies also point to an association between the consumption of carbohydrates and the risk for cardiovascular disease. The link frequently is obesity through over-eating carbohydrates, which can lead to diabetes. And diabetes patients often have a higher risk profile regarding cardiovascular disease.

Overall a useful lesson in Nutrition: You cannot always load the burden of increased cardiovascular risk in humans on palm oil all the time. It is also timely to rethink which of our dietary components are really the probable culprits.

Article Credit: Dr. Kalyana Sundram and Mr. Uthaya Kumar, MPOC