31 Dec Is WHO fat out wrong?

WHO enters fat debate

Oh, these are cold and turbulent waters but I’m wading in anyway. I’m speaking, of course, about dietary advice, which as much as politics these days seems capable of provoking the most dire of debates.

Battle lines have been drawn and everyone seems to be partisan when it come to what foods to eat, or not eat. For every recommendation, for every new scientific study, an army of devotees seems to descend to demolish opposing views.

The most recent organization to face this wrath is the WHO, or World Health Organization, which you would think would be offering up the most evidence-based recommendations of any non-governmental body.

Their most recent guidelines, which include common-sense advice like limiting salt, sugar and alcohol also gets into slipperier terrain on the subject of fats. Here the esteemed organization claims we would all be better off replacing butter, lard and ghee with vegetable oils like soybean, canola, corn, safflower and sunflower products because of their lower saturated fat content.

Leading the opposition to this recommendation is Dr. Aseem Malhortra, a top British cardiologist who with some anger cites recent research showing that these oils are high in unhealthy omega 6 fatty acids, are pro-inflammatory and when heated for frying can become toxic.

In essence, the controversy swirls around how healthy saturated fats are, and how much we can safely consume. Many believe, and for good reason, that saturated fats contribute to obesity, heart disease and cancer. Many who consume diets high in saturated fats also have concerning levels of LDL, the so-called bad cholesterol.

But like all good arguments there are nuances to the stories told by each side that are far more complex than the initial rhetoric would suggest. From what I can see the research on saturated fats is mixed. Some people do indeed suffer when their diets contain a surfeit of saturated fats. Yet, many on Keto diets eat huge amounts of saturated fats while magically watching LDL levels go down. How is that possible?

While the biochemistry is beyond me, from what I’m able to glean from the likes of Dr. Peter Attia and his remarkable podcasts and articles, how our bodies respond to fats is to a large degree genetically governed and influenced by a variety of lifestyle factors including what fats are consumed with, i.e. processed foods and carbs as well as well as other life-style mitigators like age and exercise.

At this point WHO is still relying on the most conservative science and is based, they admit, on lipid levels and not disease outcomes. Do we need to say it again? Correlation is not causation. Plus, while their oil recommendations showed impact on LDL levels they did not show comparable benefits when it comes to HDL cholesterol and triglycerides, which are arguably even more significant.

In the meantime, a number of studies have shown that, for some people at least, unadulterated saturated fats can be a healthy diet addition.

Unfortunately, while many studies have been done the bottom line is that what works for you, may not be best for me. And the only way to know for certain is to work with a physician who is knowledgeable enough to give you the right kinds of tests and be smart and current enough to understand the results.

In the meantime, if you are not monitoring your lipid profiles with a deep understanding of what all the numbers mean, the most conservative approach is to take a wait and see attitude and not feast at either table.

Like you, I’d like to know more definitively what approach to take. Maybe I’ll have a better idea from my next blood test, if the right markers get measured. Regardless, I’m not dismissing the importance of the debate. Last year, according to WHO, over 15.2 million people died because of cardiovascular disease. And it remains one of the top three causes of death in the U.S. so this continues to be a vital topic for all of us.