What You Don’t Know About Saturated Fat That Could Harm You
By Paul RogersWhat you probably do know is that most dietary recommendations say that you should keep your consumption of saturated fat and cholesterol in food low in order to lower your blood cholesterol and consequently your risk of heart disease.
The usual recommendations are that saturated fat should be no more than 10% of total calories and cholesterol less than 300 milligrams each day – and for people with existing signs of heart disease, less than 7% saturated fat and under 200 milligrams of cholesterol each day.
If you read widely of internet health and nutrition sites, you may also be aware that fringe movements exist that say this is not true; that it’s a government conspiracy and so on, and that saturated fat and cholesterol are as harmless as soft fruit. You can read one of my responses to that. It’s surprising how many otherwise knowledgeable pundits get taken in by this stuff.
What you may not know is that too much saturated fat in the diet has other adverse effects beyond how it raises blood cholesterol. Here is a short summary.
Saturated Fats Cause Dementia
Here is what one research team has to say about saturated (and trans) fat and cognitive function.
“Diets high in fat, especially trans and saturated fats, adversely affect cognition, while those high in fruits, vegetables, cereals, and fish are associated with better cognitive function and lower risk of dementia. While the precise physiologic mechanisms underlying these dietary influences are not completely understood, modulation of brain insulin activity and neuroinflammation likely contribute.” (Ann N Y Acad Sci. 2007 Oct;1114:389-97.)
And another:
“Moderate intake of unsaturated fats at midlife is protective, whereas a moderate intake of saturated fats may increase the risk of dementia and AD, especially among ApoE epsilon4 carriers. “ (Dement Geriatr Cogn Disord. 2006;22(1):99-107. )
Saturated Fats Cause Insulin Resistance
This conclusion provides a pointer to findings from several similar studies:
“A change of the proportions of dietary fatty acids, decreasing saturated fatty acid and increasing monounsaturated fatty acid, improves insulin sensitivity . . . ” (Diabetologia. 2001 Mar;44(3):312-9.)
And:
“Therefore, prevention of the metabolic syndrome has to be targeted . . . and . . . to improve insulin sensitivity and associated metabolic abnormalities through a reduction of dietary saturated fat, partially replaced, when appropriate, by monounsaturated and polyunsaturated fats.” (Clin Nutr. 2004 Aug;23(4):447-56.)
Saturated Fat Slows Blood Flow in the Arteries
Here is what recent studies found about how saturated fat essentially clogs the arteries. (The endothelium is the layer of cells lining the inside of blood vessels and arteries. It is important in regulating blood flow.)
“High SFA (saturated fat) caused deterioration in FMD (flow-mediated dilation) compared with high PUFA, MUFA, or CARB diets. Inflammatory responses may also be increased on this diet.” (Arterioscler Thromb Vasc Biol. 2005 Jun;25(6):1274-9.)
And:
”Consumption of saturated fat reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function. In contrast, the anti-inflammatory activity of HDL improves after consumption of polyunsaturated fat.” (J Am Coll Cardiol. 2006 Aug 15;48(4):715-20.)
And:
“Consumption of an SAFA-rich meal is harmful for the endothelium, while a MUFA-rich meal does not impair endothelial function in subjects with type 2 diabetes.” (Diabetes Care. 2008 Dec;31(12):2276-8.)
Overall, you should be able to see that the case against too much saturated fat in the diet is convincing – one way or another — and it’s not just about cholesterol. Bear in mind that vegetable sources of saturated fat are not inconsequential. Olive and soy oil are about 15%, corn and sunflower about 12% and peanut oil around 20%. However, consuming saturated fat and cholesterol together in animal foods may present the greatest combined risk, and whole nuts or seeds, even with some saturated fat, the least risk.
- Parrott MD, Greenwood CE. Dietary influences on cognitive function with aging: from high-fat diets to
healthful eating. Ann N Y Acad Sci. 2007 Oct;1114:389-97. Review.
- Laitinen MH, Ngandu T, Rovio S, et al. Fat intake at midlife and risk of dementia and Alzheimer’s disease: a
population-based study. Dement Geriatr Cogn Disord. 2006;22(1):99-107.
- Morris MC, Evans DA, Bienias JL, et al. Dietary fats and the risk of incident Alzheimer disease. Arch Neurol. 2003 Feb;60(2):194-200. Erratum in: Arch Neurol. 2003
- Vessby B, Unsitupa M, Hermansen K, et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia. 2001 Mar;44(3):312-9.
- Riccardi G, Giacco R, Rivellese AA. Dietary fat, insulin sensitivity and the metabolic syndrome. Clin Nutr. 2004 Aug;23(4):447-56. Review.
- Keogh JB, Grieger JA, Noakes M, Clifton PM. Flow-mediated dilatation is impaired by a high-saturated fat diet but not by a high-carbohydrate diet. Arterioscler Thromb Vasc Biol. 2005 Jun;25(6):1274-9.
- Tentolouris N, Arapostathi C, Perrea D, et al. Differential effects of two isoenergetic meals rich in saturated or monounsaturated fat on endothelial function in subjects with type 2 diabetes. Diabetes Care. 2008 Dec;31(12):2276-8.
- Nicholls SJ, Lundman P, Harmer JA, et al. Consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins and endothelial function.J Am Coll Cardiol. 2006 Aug 15;48(4):715-20.
Food for Life, Fit for Life - Lifestyle Training Course Released
Food for Life, Fit for Life - Prevent Diabetes, Heart Disease and Cancer is a set of training modules in lifestyle preventive health. It took me 12 months to write and it’s now available for licensing. You can download a free ebook version that describes the content. Here’s what’s included:
- Training and evaluation manual for course presenters
- 120 PowerPoint slides with notes and contemporary references
- Sample learner assessment questions for each module
- Fact sheets that can be used as handouts to clients/students
- Risk evaluation self-assessment handouts for nutrition, physical activity, diabetes, cardiovascular disease, and cancer
- Case studies for workgroups and workshops
- Glossary of terms
- Regular newsletter
- US and UK/Australia versions (spelling and units)
- Evidence based information, fully referenced
- Flexible licence conditions and regular, free updates for one year
- Access to a membership web site for support, updates and extra resources.
Background
I started writing this over 12 months ago as a tool to use for talks to clients and groups in fitness and personal training. Rather than the limited training course I had in mind at that time, it has now morphed into something more like a training ‘environment’ with support tools like handout risk assessments and case study tasks. I have plans to add more of these tools and content within the context of the course. For example, a basic ’sports nutrition’ module is near completion.
As a trainer-presenter, your options are varied. You could select various slides or modules for presentations ranging from 2 hours to 2 days to groups or even individual clients. The target audience could include lay people or professionals in various support roles in preventive health. Presenters could include dietitians, nutritionists, fitness trainers, practice nurses, physios, diabetes educators and any support professionals working in preventive and lifestyle health. Some skill in delivering an appropriate language and idiom to audiences with variable knowledge bases would be required by the presenter.
I’ve summarised the essential elements of lifestyle disease, meaning the risks with which we burden ourselves because of our behaviour in relation to food, nutrition and physical activity. Although I mention the roles of environment and genetics, this is not the focus of the program at this time, but I do have plans to add modules that address basic issues in environmental safety in relation to food quality. Any additional modules added are included in the updates available in the licence for one year.
The core elements are:
- Type 2 Diabetes
- Cardiovascular disease
- Cancer
- Obesity
- Motivational and behavioural change
- Nutrition
- Physical activity and exercise
For example, I’ve summarised the complete content of the WCRF/AICR Expert Report: Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective so that the essential points are clear.
Licences
At present, only one licence option is available. This locks the headers and footers and PowerPoint attributions to me and no changes are permissible. I will probably also offer a ‘professional licence’ under which the licensee has the right to modify the content and replace attribution and headers etc with their identity. This would allow the licensee, with some restrictions, to modify the content and to adjust any particular aspect that did not suit their purpose or premise.
Availability
I’ve created a free ebook (pdf) version of the course, featuring the PowerPoint slide headings with content from the notes of each slide. This delivers a summary version and illustrates the content quite successfully. Not everything is fleshed out of course.
The best way to get this is to fill out the email form on the front page of the web site — or on this blog at the top right. This will redirect to a download page after confirmation. You will then get an email advising when content is updated or added, including new web and blog articles. This would be no more frequent than once each week.
I hope you take a look at the free ebook and let me know what you think. Suggestions, comments and admonitions are, of course, welcome.
When Aerobic Fitness is Not Aerobic Conditioning
By Paul Rogers
Photo: Ernst Moeksis
Aerobic fitness is measured by the volume of oxygen you can process in any given time. This is called your VO2 maximum or VO2max. It’s mostly measured in millilitres of oxygen used per kilogram of bodyweight per minute.
An elite marathon runner might have a VO2 of 80 and an obese, sedentary and very unfit person of the same age around 35.
You mainly get very high VO2 by doing aerobic or cardio training for lengthy sessions, usually in one block; say, an hour or running, cycling or similar activity. But . . . you can also get a reasonably high VO2 — but not as high as a marathon runner — by doing higher intensity exercise for less time. This might involve sprints or middle distance intervals at high intensity, or even workouts like this one in the gym without running at all. Training for team sports can provide this sort of aerobic fitness. Typical VO2 in elite athletes in sports like football (soccer) might be around 60 to 65, with some individuals even higher.
Why You Need Cardio for Health
‘Cardio’ like walking or slow jogging on treadmills is often recommended in heart rehabilitation programs or for the very unfit in order to build up heart and lung fitness. This is much less stressful than doing higher intensity intervals for a shorter time. And regular, moderate-intensity, sustained aerobic exercise conditions other aspects of your body other than your ability to to get fitter faster, which is perceived as one benefit of interval training.
Aerobic conditioning of the longer, slower type builds the small blood vessels called ‘capillaries’, in muscles, — the heart is a muscle — and these are encouraged to grow throughout muscle tissue to facilitate oxygen supply at times of high demand. With this sort of conditioning, your heart has extra blood supply and it gets bigger and stronger as well. For example, in one study, two groups were trained, one doing continuous, cardio type exercise, and the other shorter intervals of higher intensity. The longer, slower cardio group added twice as much capillary capacity as the interval trainers.
This might even be important if you were unfortunate enough to suffer a heart attack. The extra blood supply, called ‘collateral supply’ could save your life.
You will get some of this capillary conditioning with interval training, but the big benefits mostly come from regular, sustained aerobic type exercise — jogging, running, cycling swimming for 30 minutes or more at a session. Naturally, the higher-intensity interval type exercise will improve your anaerobic performance if you need this for sports.
If you’re training for health and fitness, don’t put all of your eggs in the weight training and high-intensity interval training baskets. Find time to fit in some good, old-fashioned cardio.
Effect of interval versus continuous training on cardiorespiratory and mitochondrial functions: relationship to aerobic performance improvements in sedentary subjects. Daussin FN, Zoll J, Dufour SP, et al. Am J Physiol Regul Integr Comp Physiol. 2008 Jul;295(1):R264-72. 2008
How the Cholesterol Skeptics Can Harm You
By Paul Rogers
Pic courtesy jslander
Do a search for ‘cholesterol and heart disease’ in Google and you will see that many of the results in the first few pages are from sites that dispute the current medical view that cholesterol is a major factor in causing heart disease.
Some of the advocates of this position are well known ‘alternative’, or at least fringe movements that have a particular dietary barrow to push. Many belong to the low-carb brigade, indigenous diets advocacy, Paleo nutritionists, and sadly, some bodybuilders and weight trainers and men’s health advocates. And, of course, it should be said that many reputable people within these movements do not accept the ‘cholesterol myth’ line.
Cholesterol is a factor in heart disease and these people are dangerously wrong. They rely on dumbing down a complex scientific issue to impress a gullible audience. I could write a long review of this issue, fully supported by references, but I won’t waste my time, or yours. Here are a few crucial points to consider.
It’s the Cholesterol, Stupid!
- In the condition familial hypercholesterolemia (FH), individuals have naturally very high cholesterol levels as a result of a genetic abnormality. If undiagnosed, or without treatment, such people can die of heart attacks in childhood or in early adulthood depending on the severity of the condition. Brown and Goldstein won the Nobel Prize for their work on cholesterol, HF, and how cholesterol causes cardiovascular disease. The science of HF alone, should be enough to send the cholesterol skeptics packing — but still they persist.
- Although I am no promoter of pharmaceutical company interests per se, there is little doubt that statin medications improve heart disease conditions and fatal outcomes in people with high cholesterol by a combination of lowering LDL cholesterol and probably raising HDL cholesterol. The evidence is just too overwhelming. In fact, in recent years, the cholesterol skeptics have subtly shifted their attacks from “cholesterol does not cause heart disease” to, “saturated fat does not cause heart disease”, which is a softer target for them considering the complexities of different chain length saturated fats and the interactions of mixed diets.
- The skeptics like to juggle the medical literature to try to show that there is no valid evidence linking high cholesterol to heart disease. However, it’s not in dispute that heart disease is dramatically low in healthy populations with total cholesterol levels under 150 mg/dL or 3.9 mmol/L. Cardiovascular disease rises with increasing total cholesterol, and especially LDL cholesterol, in most populations.
- Even so, some populations in some countries seem to defy this trend, and these are the people the skeptics concentrate on when delivering their message. The thing to remember is that heart disease is multifactorial — that is, cholesterol may only be one factor among several, even though it is a major factor. Some populations will, through genetics or lifestyle, defy the atherogenic effects of higher cholesterol to some extent. This seems to be the case with the ‘French paradox’, in which French populations have much lower heart disease than other country groups with similar cholesterol levels. That does not mean that cholesterol is not a major factor in heart disease for most populations.
Overall, considering the established science of familial hypercholesterolemia, and the evidence from statin drug trials, including regression of plaque with cholesterol lowering, the evidence is so overwhelming for a dominant role of blood cholesterol in heart disease, and the influence of poor nutrition in raising blood cholesterol, that one can only assume the cholesterol skeptics have another agenda. I don’t know what it is, but it doesn’t take too much thought to come up with a list of industrial food interests that might benefit from this hogwash. Believe them at your peril.
10 Ways Exercise Prevents or Manages Diabetes
By Paul Rogers
Trials in the US, Finland and China have shown that moderate weight loss combined with an exercise program can ward off impending type 2 diabetes by getting blood glucose (sugar) under control and generally improving markers for this disease of glucose, fat and insulin metabolism. Diagnosed diabetics also benefit from regular exercise in a similar way.
Here’s how exercise helps:
- Physical activity helps you manage weight. You need to include a sensible eating program, but weight loss improves your ability to process glucose and ward off diabetes.
- Exercise uses glucose stored in muscle and, over time and with increased fitness, enhances the amount of glucose you can store, lowering blood glucose in the process.
- Weight training uses muscle glucose more than fat, as does other high-intensity exercise. Regular sessions of weight lifting lower your blood glucose and open up the “gates” for glucose transport.
- Weight training also builds more muscle. More muscle provides additional storage capacity for glucose.
- Glucose transport to muscle during exercise does not require insulin. In fact, insulin goes quiet during exercise in people with normal metabolism and not injecting insulin.
- Physical activity enhances insulin sensitivity even when you’re not exercising. Insulin sensitivity is the ability of insulin to store glucose.
- Day to day, exercise gives you improved glucose storage when you’re exercising, and improved glucose storage when you’re not. You get a synergy of effect when you exercise.
- Cardiovascular fitness is a result of aerobic conditioning. Cardio type exercise is best for this. Heart and lung fitness is associated with protection against diabetes and heart disease. The fitter you are, the better your chances — even allowing for some excess weight.
- Faulty fat metabolism and high levels of fat (triglycerides) in the blood raise your chances of getting diabetes. Exercise of any sort can help normalize blood fat levels. Look to be under 150 mg/dL or 1.69 mmol/L. When you’re really fit and healthy and have low overall body fat, this number will be closer to 100 mg/dL (1.1 mmol/L). You should aim for this.
- Regular exercise, especially higher-intensity exercise, increases your metabolism when you’re not exercising. This not only helps lower blood fats and glucose, it helps you reach and maintain normal weight.
Tim Russert’s Heart Attack - What Went Wrong?
By Paul RogersAccording to a New York Times article, Tim Russert, the well-known NBC news and current affairs television journalist who suffered a fatal heart attack, did not have any prior warning even though he did have some ominous signs in his cardiovascular risk profile.
The essence of many articles about Tim Russert since his death have emphasized his compliance with doctors’ recommendation and prescription — exercise, lower cholesterol, lose weight, healthy diet and so on. How could someone, presumably doing the right things, still have a fatal heart attack?
The New York Times article points out that even allowing for these positive things, he was quite overweight and had low high-density cholesterol and high blood triglycerides. This constellation of measures is known to some practitioners as the “metabolic syndrome”, although not all recognize this term or if it is a syndrome at all. Either way, it means greater risk of a heart attack.
Waist Circumference and BMI
It’s risky business when you’re over 40 and have these markers of cardiovascular risk. And there are no guarantees that technology can reduce your risk to zero. Even people with very low risk markers still fall over dead with sudden heart attacks. It’s all about numbers, percentages and how you improve your chances.
Getting that waist to below 38 inches or 95 centimetres for men, and 32 inches or 80 centimetres for women, is a good place to start. Alternatively, a waist to hip ratio of 0.9 for men and 0.8 for women, or less, is also a good guide to healthy weight. Divide your hip measurement at the widest by your waist measurement at the narrowest, usually around the naval.
The body mass index (BMI) scale is less useful because it gets distorted for relevance by how much muscle you carry. Bodybuilders, weightlifters and athletes are often unfairly placed in the overweight categories, which are at BMI 26 or more. BMI can be measured by dividing your weight in kilograms by your height in metres squared.
Does Coffee Kill or Cure?
By Paul Rogers
Coffee, Java, Joe, Mud, Beans, Cafe — whatever you call it — coffee is the most popular drink on the planet, in international terms. Even so, in “natural health” circles it was, and perhaps still is, regarded as just about as evil as alcohol. Natural health people don’t like substances that either stimulate or depress the nervous system like coffee and booze do respectively. A naive evaluation for sure.
But what if coffee turned out to be just about as health-giving a herb as you can get? Wouldn’t that be a surprise?
Here’s what recent research has discovered about coffee. Keep in mind that the coffee industry is enormously powerful and no doubt some scientific work is sponsored by the industry. However, enough reputable and independent scientists are involved in this research to suggest there is something to take note of.
Diabetes Prevention
Coffee consumption seems to lower the risk of type 2 diabetes significantly, and this association turns up in research as far afield as Europe, Japan and the USA in at least 12 different studies. Caffeinated and decaffeinated coffee seem to have similar effects and some component of the coffee bean other than caffeine is suggested as the protective compound. Chlorogenic acid is one such natural chemical compound, perhaps acting as an antioxidant.
Surprisingly, caffeine studied by itself seems to impair insulin sensitivity and glucose tolerance, so one might expect coffee to have the opposite effect. It doesn’t seem to be so. Most authorities suggest limiting coffee consumption to around 3 cups each day to be on the safe side.
Parkinson’s Disease and Liver Disease
Similarly, there is reasonable evidence that coffee drinking protects against liver disease like cirrhosis, and also the debilitating Parkinson’s disease, a disease that affects the brain’s production of dopamine, a chemical neurotransmitter required for coordinated movement. There is some consistency to this evidence as well.
What’s Wrong with Coffee?
Heart disease
You may be aware that in the past, coffee and caffeine were assumed to be bad for the heart: raised blood pressure, increased heart rate, cholesterol and so on. People with heart disease and those recovering from heart bypass surgery were urged to avoid coffee and even tea, with the stimulant caffeine being the most problematic agent. But now, cardiologists are not so sure. It seems that the coffee/caffeine and heart disease risk may have been overestimated and that some aspects of coffee drinking could even be beneficial.
Distinctions are made between the effects of boiled and filtered or instant coffee. Boiled coffee is traditionally a Scandinavian method of brewing with coffee grinds subjected to hot water with no filtering. Filtering with paper or metal filters is supposed to take out the potentially harmful chemicals cafestol and kahweol, which are reported to raise cholesterol. Some studies show that boiled coffee could be more hazardous than filtered coffee for heart disease, but I think this needs more follow-up to be certain. While for some people blood pressure seems to adjust to coffee consumption, others seem to have a genetic tendency for increased blood pressure with coffee consumption.
Overall, moderate consumption of filtered or instant coffee — up to 3 cups daily — seems to have little effect on heart disease risk.
Osteoporosis and Miscarriage in Coffee Drinkers
I’ve put both of these long-held beliefs, or at least suspicions, related to coffee together because they mainly affect women directly. The most recent research suggests that caffeine may increase your risk of miscarriage when you drink more than about one cup of coffee or 100 milligrams of caffeine a day. Some research also points to marginally lower birth weights in higher caffeine consumers.
Moderate consumption in the range of up to 3 cups of coffee daily probably has little effect on osteoporosis or bone fractures according to the most recent studies.
Summary
As the epidemiologists like to say, more work is needed to confirm these associations, but overall, moderation is the way to go — around 3 cups a day is unlikely to be harmful and may even be beneficial in some respects — with perhaps a reduction of consumption when pregnant. Coffee is a stimulant and some people do not deal with the caffeine hit as well as others. I can drink coffee before bed and it won’ t keep me awake. But that’s not for everyone. If you get heart palpitations or sleeplessness, drinking less coffee, cola drinks or strong tea is worth a try.
Heart Disease on the Increase for Women
By Paul Rogers
While breast cancer is often a health focus for women, disease of the heart and arteries is the leading cause of death among men and women in most developed countries, accounting for about half of all deaths and associated illness.
In recent years, cardiovascular disease and deaths from it, in some groups of women, has been rising faster than for men.
An increase in type 2 diabetes, which is especially potent in women, may be the cause according to a new study in the American Journal of Lifestyle Medicine — and most of it is preventable with diet and exercise — a message that is already widespread.
Apparently, in the Nurses Health Study — a long-running evaluation of the health of nurses — 82% of coronary heart disease cases and 91% of diabetes cases in women could be prevented by avoiding smoking, eating a healthy diet, maintaining normal body weight and exercising regularly. Not much to ask, surely . . . and the story is much the same for men.
In fact, it is a lot to ask of many people. The message is understood, the implementation is much more difficult. Finding a way around this impasse can be a personal challenge and a public one.
Vitamin D Deficiency May Cause Heart Attacks
By Paul Rogers
As reported by Reuters health, a new study by Harvard University health researchers has found that men with the lowest blood levels of vitamin D are more susceptible to heart attacks, especially fatal heart attacks.
Vitamin D improves calcium absorption and is important for bone health and to prevent osteoporosis. In addition, adequate vitamin D seems to offer protection against other diseases such as cancers of the colon, breast and perhaps pancreas. The lower level of normal is 30 nanograms per millilitre of blood. The men with the greatest risk in this study had levels as low as 15 nanograms.
What you need to know
Vitamin D is formed in the skin from sunlight exposure — and is available in fortified milk and margarine products and fatty fish like salmon and sardines. Sunscreen will block vitamin D absorption so it’s important to ensure a balance between sunlight exposure and the skin cancer risk of overexposure and sunburn. Supplements are an option, but you need to get medical advice because too much can be toxic.
Personally, I try to get as much gentle sun exposure in the early hours in summer or in winter when sunburn risk is least. I do this at the beach or by training outdoors. Tanning booths are not recommended and can be dangerous.
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