Thursday, November 14, 2013

The saturated fat myth has had its day

For more than 20 years, there have been one or two medical commentators in newspapers, such as the Telegraph's great James Le Fanu, who have rejected the cholesterol theory of heart disease. Dr Le Fanu has always maintained that (most) people should stick to the boiled eggs and buttered soldiers for breakfast and avoided margarine as if their lives depended on it. But the mainstream view for 40 years, as dished out to the public in health campaigns and via the NHS has been – cut down saturated fat to lower your risk of cardiovascular disease. That has meant that butter, full-fat milk and cheese were ruthlessly demonised, while oil-based spreads and low-fat products flew off the shelves.

But this is changing – and if you doubt it, consider that we have a leading young cardiologist, Aseem Malhotra, writing in the British Medical Journal today, saying quite plainly: "If you have a choice between butter and margarine, have the butter every time."

The evidence is pretty persuasive. The essence of it is: recent studies have failed to support any significant association between saturated fat intake and cardiovascular risk. Indeed, saturated fat has actually been found to be protective – though it should come from natural sources, not processed food where it's mixed with harmful chemical additives. That is to say, steak is all right, but an Ulster Fry – sausage slice, black pudding, bacon etc – should be for special occasions only.

What has happened over the past four decades is that public health campaigns have relentlessly hammered home the "cut fat" message. The general public has responded, egged on by the food companies flogging "low-fat" processed snacks and meals. The trouble is, fat makes substances palatable to eat, and if you take it out the food will taste bland.

Here is where the industry stepped in – replacing all that fat with sugar to provide a substitute kick. And did obesity decline in this period? It did not. In fact, over the past 30 years in the US, as the proportion of energy derived from fat in the diet fell from 40 per cent to 30 per cent, obesity rocketed. And there's increasing evidence that sugar could be an independent risk factor for the metabolic syndrome that was discussed in a blog the other day.

All this is in Malhotra's report and I recommend reading it in full. It has implications for me because like thousands of others I take a daily statin – a tiny dose of atorvastatin in my case. I was prescribed it for raised cholesterol and some family history of blocked arteries and heart problems. I'm now seriously considering ditching the little white pill and carefully following Malhotra's advice on diet instead. He says consuming a Mediterranean mixture of foods – fresh vegetables, olive oil, complex carbohydrates – is "almost three times as powerful in reducing mortality as taking a statin", citing the Predimed study.

He does seem to accept that statins have an important role in treating patients who have already had heart attacks, but "the benefits of statins are independent of their effect on cholesterol". I still have a feeling that statins are a bit of wonder drug. But it seems that, as with aspirin, they exert their beneficial effect in mysterious ways not yet fully understood.

The saturated fat/cholesterol theory of heart disease resembles the serotonin model of depression in that it's a gross simplification of complex and poorly understood mechanisms. But at least Malhotra's message is clear, and it should be listened to: the saturated fat myth has had its day.



Organic ISN'T better than factory farmed: Why caged chickens have 'less stressed' lives than free-range

For consumers with a  conscience, they are top of the shopping list.  But it seems free-range eggs may not be all they are cracked up to be. According to researchers, hens kept indoors in cages lead happier lives.

A study found birds raised in ‘enriched cages’ enjoyed lower levels of stress and mortality, and were less likely to suffer from bone fractures or pecking than free-range chickens.

Demand for free-range eggs, which cost almost double the caged equivalent, has risen steeply as a result of high- profile campaigns.

But Professor Christine Nicol, who led the research at the University of Bristol, said although free-range farms had the potential to offer birds a better quality of life than their caged counterparts, many had poor welfare standards.

As a result, shoppers concerned about the well-being of birds should opt for eggs from caged hens, or those from free-range flocks that are part of a farm assurance scheme.

‘Caged hens are more comfortable than people think and have higher welfare as standard than free-range hens,’ she said.

‘It would be nice to think the current free-range system gave the birds the best welfare, but the problem is that the management of free-range systems in the UK is so variable. Although you get some brilliant farms, you get some that are really not good.’

Prof Nicol added: ‘The challenge for the industry is realising the potential of the free-range system... so that they actually do what consumers think they do, which is provide all hens with good welfare.’

Battery farming of chickens, which involved five or six birds living in cramped conditions in a small cage, was outlawed in 2012.

It was replaced by ‘enriched cages’ – flocks of 70 or 80 birds living in stacked enclosures with access to food, water perches and scratching posts.

Half of all eggs produced in Britain come from caged hens. But the majority of eggs sold in British supermarkets are free range.

A carton of 15 cage eggs from Tesco costs £1.75, or less than  12p an egg. For a dozen medium free-range eggs, the price is £2.50, or 21p each.

A spokesman for Compassion in World Farming said consumers should still opt for free-range eggs.

She added: ‘Only in free-range (or organic) farms can hens fully perform all their important natural behaviours, like stretching and flapping their wings, perching up high, foraging, scratching, dust-bathing and laying their eggs in a comfortable nest.’


No comments: