Wednesday, March 06, 2013

After all those warnings about saturated fat being unhealthy for hearts... Stop feeling guilty! That juicy steak is good for you

There is no good evidence that saturated fat is bad for you.  Ancel Keys thought it was bad but he looked at heart disease only.  Follow-up studies showed that overall mortality is not affected

Saturated fat has become public enemy number one for heart health, the one food type guaranteed to clog arteries and raise the risk of a heart attack.

But emerging evidence suggests not all saturated fat should be tarred with the same brush — one type of saturated fat, known as stearic acid, may actually protect the heart against disease.

Stearic acid, which is found in beef and pork, skinless chicken, olive oil, cheese, chocolate and milk, is one of many saturated fatty acids found in food. Others include lauric, myristic and palmitic acids.

However, unlike other saturated fatty acids, repeated studies have shown stearic acid has no adverse effect on blood cholesterol levels or other risk factors for cardiovascular disease.

Indeed, it appears to be beneficial — suggesting that red meat and chocolate are not the heart-health disaster zones we assume they are.

When one study published in a recent edition of the American Journal of Clinical Nutrition revealed that eating lean beef on a daily basis improved cholesterol levels, it was the stearic acid in the meat that was said to be responsible for the positive changes.

After five weeks on the diet of daily lean beef, the participants in the study experienced a 5 per cent drop in total cholesterol and around a 4 per cent drop in ‘bad’ LDL cholesterol — almost the same as those on a diet high in fish, vegetable protein and poultry.

Both groups also kept their weight steady. Dr Michael Roussell, one of the study authors from Pennsylvania State University, said that, unlike processed meats such as sausages and ham, unadulterated red meat ‘brings a unique, heart-healthy blend of fats to the table’.

In the UK, the Government’s recommended upper daily limit for women is 20g of saturated fat, while for men it is 30g.
The stearic acid findings mean that so-called 'bad foods', such as cheese and meat, are not as harmful as thought - the key is moderation

The stearic acid findings mean that so-called 'bad foods', such as cheese and meat, are not as harmful as thought - the key is moderation

However, many nutrition scientists agree that myths and misconceptions have led to consumers wrongly thinking that all saturated fat is bad when, in fact, they can eat sensible amounts of foods rich in stearic acid, such as red meat, without fearing for their heart’s well-being.

‘There are different forms of saturated fat, and stearic acid isn’t linked to heart disease,’ explains Glenys Jones, a nutritionist at the Medical Research Council’s Human Nutrition Research Department in Cambridge.

‘Other forms of saturated fat, such as the fat in butter, have a much stronger association and, of course, too much of any fat will result in obesity, which is a risk factor for heart disease itself.’

The confusing twist in the science of saturated fatty acids was recognised as early as 1957, when it was shown that cocoa butter — the fat obtained from the cocoa bean and used to make chocolate — did not raise blood cholesterol as much as butter fat.

And almost 25 years ago, a major study at the University of Texas clearly demonstrated that all saturated fats don’t have the same ill effects.

Scientists reporting in the New England Journal of Medicine found that saturated fats such as butter and coconut oil, which contain negligible amounts of stearic acid, had far more damaging effects on blood fats than red meat or chocolate.

Then, in 2011, the British Nutrition Foundation published a major report that challenged conventional wisdom about the effects of saturated fat in red meat.

In the document, Dr Carrie Ruxton, an independent dietician, confirmed there is ‘no conclusive link’ between cardiovascular disease and red meat that contains some fatty acids, such as stearic acid, that protect the heart.

She added that modern farming methods have cut overall fat levels in red meat.  ‘There is less saturated fat in a grilled pork steak than in a grilled chicken breast with the skin left on,’ she said.

‘Studies have shown favourable effects of lean red meat consumption on blood pressure and cholesterol levels.’

The amount of stearic acid varies from food to food, but cocoa beans and red meat have among the highest proportion.

Of course, the findings are not a green light to gorge on bacon sandwiches and Easter eggs.

On average, our intake of saturated fat is one-fifth more than the upper limit set by the Government, and we still need to heed established dietary advice surrounding heart health.

However, the stearic acid findings mean that so-called ‘bad foods’, such as cheese and meat, are not as harmful as thought — the key is moderation.

‘There is definite evidence that stearic acid has a neutral effect on cholesterol and cardiovascular risk,’ says Dr Emma Williams, a BNF nutrition scientist.

‘However, in many foods stearic acid is lumped together with other saturated fatty acids which are less beneficial and can contribute to a rise in risks.

‘The truth is that no one has ever said people should cut out animal fats completely. Just eat them sparingly.’


Elderly British patients diagnosed with 'acopia' - a disease that does not exist

Elderly patients often do not receive proper treatment because they are subconsciously 'written off' and diagnosed with 'acopia', a condition that does not exist, a former Government adviser on the elderly has said.

Professor David Oliver said that subconscious ageism within the NHS often meant the elderly are not correctly diagnosed and instead sent to care homes for treatable illnesses.

One study found serious conditions such as strokes, heart disease and Parkinson's were being missed. Patients were instead diagnosed with 'acopia', which only means 'failure to cope'.

Patients from the wartime generation typically do not want to "make a fuss", he said, and so do not demand better care.

"Writing ‘acopia’ is basically saying ‘We’re not going to make a proper diagnosis. There’s that subconscious decision-making,” Professor Oliver, who has recently stepped down as National Clinical Director for Older People, told The Times.

Older people are “sometimes being written off and sent to care homes when they had perfectly treatable problems," he said.

He added: “It’s easy for someone to come into hospital, they’ve got some dementia, they’re struggling to walk, and if you don't really say, ‘Right let’s see what we can do to get you back on your feet’ in very short order they’re heading towards a nursing home, and sometimes it needn’t have happened.”

But older patients are often too willing to settle for inadequate care, he said.

“Often older people themselves in this country will be saying, ‘Not at my time of life doctor’, or ‘I don’t want to bother you doctor’.

"With the wartime generation they remember the NHS being founded, and what there was before, and they’re still generationally very grateful for the welfare state, they’re still respectful of professional and authority figures and they don’t generally like to make a fuss.”

He urged doctors to see past common occurrences in old age such as falls and confusion and conduct proper geriatric assessments.


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