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08th November 2013

Fat – A controversial issue?

A recent commentary in the influential British Medical Journal suggested that government advice to eat less saturated fat for better heart health was flawed.

This was picked up widely by the media, along with headlines such as 'Is a high-fat diet GOOD for the heart?' Not only are such reports confusing, but  they could undermine public confidence in making  lifestyle changes that have health benefits. A further damaging consequence of such media reports would be for people to actively increase the saturated fat content of their diet.

So what should we make of this?

It is important to understand that this was an opinion piece -  a commentary based on limited cited evidence, and not new science. UK dietary guidelines on the other hand, based on interpretation of a large body of scientific evidence, supports advice to reduce saturated fat in order to reduce the risk of heart disease. These guidelines are in line with European (EFSA), US (IOM) and International (WHO) assessments, and should not all be debunked on the basis of an opinion piece.

Perhaps part of the issue is that studies on diet and disease often produce conflicting results. Unlike drugs trials, it is difficult to carry out highly controlled randomised studies into human diets. We never eat a single nutrient; we eat a variety of nutrients in a matrix of foods. Furthermore, heart disease is complex and the risk can be influenced by other dietary factors, as well as physical activity, alcohol, tobacco and medication use.

Obsession with one single nutrient may be unhelpful, and the focus should be on eating well. Effort therefore needs to be made to consider whole dietary patterns.  Broader changes to the diet including reduction in added sugar and salt intake, an increase in fruit and vegetables and wholegrain consumption and maintaining a healthy weight will reduce the risk of chronic disease, and incidentally would also be likely to moderate saturated fat intake.

If the only consideration is to cut saturated fat, we may find that we do not replace this with a healthy alternative. Studies have shown that the health effect of reducing saturated fat may be dependent on what the replacement energy-providing nutrient is. Replacing calories from saturated fats with refined carbohydrates may actually be detrimental to heart health, but beneficial if some are replaced by unsaturated fat.

Reduction in saturated fat still remains important in the context of a healthy, balanced diet. And another good lesson – whilst the plethora of populist press reports on diet continue to simplify complex scientific debate to sound-bite headlines,  its best to source current recommended dietary advice from the Department of Health or ourselves, the British Nutrition Foundation

Ayela Spiro, British Nutrition Foundation - QCS Expert Nutrition Contributor


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