May 1

More saturated fat nonsense

10  comments

Sometimes I feel like King Canute trying to hold back the tide. It seems as if there is a never-ending stream of idiocy emanating from the ill informed washing in just to aggravate me. In today’s case it is a non-medical columnist for the Wall Street Journal who is in my sights. Normally I’ll give non-medical people a pass because most of them are simply parroting what they read in the papers and hear on TV, but in this case I feel the need to strike because this person actually writes a health column and, horror of horrors, answers medical questions.
I sat down this weekend to catch up on my reading and came across the following Q & A in the Health Mailbox section of an issue of the Wall Street Journal published last week.

Q: Is it true that less than a gram of partially hydrogenated oil per serving is bad for you? My wife has been cooking with more butter and less margarine in an effort to reduce trans fat. She also uses liquid oil anytime it can be substituted for a shortening or margarine. Biscuits and cookies just don’t work well with liquid oils. Is it reasonable to use shortening sometimes if it’s done within a diet that is not excessive in fat overall? –D.T.

You can read between the lines here that the guy asking the question has been brainwashed by the anti-fat establishment, who, remember, were the folks who foisted trans fats off on us in the first place by their constant whining about saturated fat. As we’ve discussed in other posts, nothing shortens like shortening made from a saturated fat–soft oils just don’t hack it. So, thanks to the anti-saturated fat bozos everyone starts using shortening made from trans fats, all the while patting themselves on the back for eating in a more healthful way. Problem is, of course, that trans fats are much worse for us healthwise than even the most vocal anti-saturated fat fools claimed saturated fats to be. Ah, the law of unintended consequences. It seems to always jump up and bite do-gooders in the you know where. So, getting back to our questioner, the poor guy is in a quandary. How does he minimize the fat in his cooking, avoid trans fats, and still make biscuits and cookies that look and taste like biscuits and cookies are supposed to? (As you might imagine, I would have answered his question a little differently. Uh, you don’t need shortening of any kind if you don’t make biscuits and cookies, and you shouldn’t be eating biscuits and cookies. Problem solved.)
The Wall Street Journal’s dietary guru answered a little differently:

A: Trans fat is bad for you, and there isn’t any known safe level of it. As a result, you should work hard to eliminate it from your diet completely. But while it’s a good idea to keep trans fat from creeping into your diet, a big concern today is how many consumers are now switching to foods high in saturated fats to avoid trans fats. Butter is high in saturated fat, so it isn’t a good alternative. [my italics]

The better plan is to find a trans-free-margarine. Margarines in the past were high in trans fat, but today some tub margarines are trans-fat-free. You have to read the label to make it doesn’t contain “partially hydrogenated oils.” Crisco, the shortening that was synonymous with trans fat, now makes a trans-fat-free version. But the label is confusing because the new version of Crisco is made with fully hydrogenated cottonseed oil. Trans fats are created when oils are partially hydrogenated to thicken them up. Fully hydrogenated oils don’t contain trans fat, but they are too hard to cook with, so the new Crisco is softened up by blending it with liquid oils. A trans-fat-free shortening is still a fat, but it’s an improvement, and a reasonable alternative.

The best way to avoid trans fat without increasing saturated fat is to choose liquid vegetable oils [my italics] or olive oil. Reduce intake of commercially prepared baked goods, most of which still contain trans fat. Avoid deep-fried foods at restaurants; most still use trans fat to fry foods. And avoid fats from animal sources, except for fish. [my italics]

Jesus wept.
If you’ve been reading this blog for long, you can imagine my reaction to this clap trap. First, who is this woman, Tara Parker-Pope, who is answering nutritional and medical questions for the Wall Street Journal, the daily newspaper with the second largest circulation in the country? Due to the tone of her answers I figured her for a Registered Dietitian, but nope, it turns out that she has a degree in Sociology from the University of Texas, and has spent her post graduate years working as a journalist. During her time in that profession she has been a city hall reporter in Austin, a transportation reporter for the Houston Chronicle, a European stringer for the Wall Street Journal, and has covered the television beat for the Wall Street Journal. She was part of a group that won a press club award for coverage of the federal standoff with the Branch Davidians in Waco, and she has written a book on the cigarette industry. All in all, not what I would consider an appropriate background for someone dispensing medical and nutritional advice in the country’s second most read paper. Other people must feel the same way. A couple of weeks back, I found the following question from a reader:

Q: How are you allowed to address medical questions of any kind? You are not a physician. –G.C.

Well put, G. C. Let’s see what she has to say.

A: Like other health writers, I don’t dispense medical advice to readers about their personal health situations. Instead I provide readers with medical information they can use to talk to their doctor and make decisions about their health. One of the biggest challenges of being a patient usually isn’t finding answers. It’s figuring out what questions need to be asked in the first place. The Internet and media reports can be excellent places to help patients figure out what those questions are.

In writing about health issues and answering reader questions I turn to some of the top doctors and most recognized experts in the field. I also rely heavily on information published in peer-reviewed medical journals. Anyone can search the medical literature through the PubMed search engine, provided by the National Institutes of Health, at www.pubmed.gov. Often I look for review articles and meta-analyses, which take a comprehensive look at all the research on a particular topic. Large randomized clinical trials or major ongoing observational studies are also reliable sources. [my italics] National advocacy groups often are excellent sources of information on specific health issues.

The Archives of Internal Medicine last year noted what it called a “tectonic shift” in the way patients consume medical information, with more patients looking for information online and in the media, even before talking with their physicians. The Health Information National Trends Survey tracks the online health activities for nearly 6,400 U.S. adults. The December 2005 analysis showed that although 62% of those surveyed said that their doctors were their most trusted information source, nearly 50% noted that they go online first with health questions. Only 11% go to their physicians first.

Sounds like a bunch of gobbledygook telling us she really doesn’t have the credentials to be answering such questions. But, answer them she does. As I highlighted with italics in her answer, she writes that she relies on clinical trials and major observational studies to support her answers. I wonder why she didn’t rely on a study from a major institution (Harvard) and published in a top tier scientific journal (American Journal of Clinical Nutrition) not long ago.
The study entitled Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women is just the kind of study I like, and not solely because it agrees with my biases. I like it because it measures an actual outcome–the progression of coronary artery disease–not simply whether or not some activity, say, diet, for example, increases or decreases a particular risk factor, which, in most cases, isn’t even a risk factor in the minds of many knowledgeable people.
Researchers followed 235 postmenopausal women with angiographically proven coronary artery narrowing for an average of 3.1 years and looked at the degree of progression (or lack thereof) as a function of diet. The changes in the diameter of the coronary arteries were evaluated using quantitative coronary angiography; the nutritional data was obtained–and here is the weak part of this study–using Food Frequency Questionairres.
Among the other things found when the data were analyzed:

A higher saturated fat intake was associated with a more favorable lipoprotein profile, including higher HDL, HDL2, and HDL3 cholesterol; higher apoprotein A-I; lower triacylglycerol concentrations; and a lower ratio of total cholesterol (TC) to HDL cholesterol (TC:HDL cholesterol).

These findings all fall under the heading of ‘putative’ risk factors, i.e., assumed risk factors. But even these putative risk factors improved as saturated fat intake increased.
What about actual changes in coronary artery diameter?

Among postmenopausal women with established CHD [coronary heart disease], greater saturated fat intake was associated with less progression of coronary atherosclerosis over an average follow-up of 3 y, whereas polyunsaturated fat and carbohydrate intakes were associated with greater progression.

As it turns out, the more saturated fat these women reported eating, the less their coronary disease progressed. Those who ate the most polyunsaturated fats, i.e., the vegetable oils Ms. Parker-Pope is so enamored of, had the greatest rates of disease progression. Same with carbohydrates.
It’s interesting to read the contortions the writers go through in trying to rebut this paper. (Click here for full text) The first line of this rebuttal sums up the predicament of all the low-fatters out there, including, I’m sure, our Ms. Parker-Pope:

It is an article of faith that saturated fat raises LDL cholesterol and accelerates coronary artery disease, whereas unsaturated fatty acids have the opposite effect .

An article of faith, indeed, because it is definitely not proven.
The take-home lesson of this post is to not believe everything you read in the newspaper, not even a venerable, prestigious paper such as the Wall Street Journal with mega circulation figures. I’m quite sure that before long I’ll receive a copy of this Q &A on saturated fat along with a letter from a reader asking how MD and I can reconcile what we wrote in our books with Ms. Parker-Pope’s response. I’ll be ready for them.


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  1. Dr Mike I appreciate your comments on this writer, but are you saying a question on sat fats is a medical question? You I trust, but that’s the exception, not the rule, even among bariatric MDs.
    In my personal experience, MDs treat illness and injury only with meds and surgery, and refer out for diet and exercise experts.
    To say MDs are the ones to ask about nutrition? Aren’t MDs as a group, no more qualified than that writer, and they read the same things she does?

  2. I am certainly not saying that only physicians can comment accurately about nutrition. William F. Buckley once famously said that he would rather be governed by 100 names pulled at random from the Boston telephone book than by the faculty of Harvard. I feel the same about physicians and nutrition: I would rather get my nutritional advice from 100 people gathered at random than from a consensus of all the physicians at any medical school.
    But, that doesn’t mean I think it’s just peachy keen for someone who has zero nutritional background to be answering nutritional questions at a major newspaper. I don’t know how I would feel about it if Ms. Parker-Pope were a low-carb zealot, but she’s not, so I guess I’ll never find out.
    You make a valid point, however. The truth is the truth, no matter who utters it.

  3. “On the large scale, history shows that an uncritical and misinformed populace is a breeding ground for all manner of intolerant beliefs and practices. The discovery that truth has to fight for its survival is not a pleasant one, but is an essential realization in maintaining civilization. And in a society as open and susceptible to fraud as ours is, truth needs all the help it can get.” — Anthony Garrett

  4. Dr. Mike, if she was a low-carb zealot, then she would most likely be writing based on experience rather than dogma, which in my opinion, is much more valuable.
    You become a low-carb zealot by watching it happen, and by experiencing exceptional health improvements after going against that which has been beaten into your brain for the last 30 years. You become a low-carb zealot after eating this way and feeling great.
    If she could defend her position by saying “after battling my weight for X years, I finally followed a strict low-XXX diet and lost X pounds. Since then I’ve kept it off for X years by staying on my plan and have had these health improvements…” Of course, it’s hard to make that claim if you try to follow a low-fat diet. 😉

  5. Dr. Mike, instead of (justly) railing against this writer, wouldn’t it be an enormous coup d’etat to get her over to the low-carb way of thinking? Or at the very least, to have her begin to mention some of the lastest studies that justify it. I wouldn’t even mention it except for the circulation of the WSJ, making it a particularly worthwhile effort. Or am I just being naive?

  6. It would indeed be wonderful to woo her over to the low-carb way of thinking (and based on her pictures I found online, it would do her some good), but it would be difficult to do for a couple of reasons.
    First, in my research into who she is I found that her “love of animals almost led her to turn her back on journalism and become a veterinarian.” Makes me wonder if she isn’t a vegetarian, at least a beady-eye vegetarian. (A beady-eye vegetarian is one who will eat animals with beady eyes, i.e., chicken and/or fish, but avoids animals with non-beady, more human shaped eyes.) I know that all animal lovers are not vegetarians, but something tells me she is. Those folks are hard to convert, even if they need converting.
    Second, in her profile that I was able to track down, it points out that Ms. Parker-Pope dislikes being contacted unless it is in reference to a call she has first placed herself.

  7. I can testify that this budding Jane Brody doesn’t like being contacted. I’ve several times sent her information about fats to correct something she’d said but have never gotten back so much as an acknowledgment. Sometimes she’ll acknowledge that there are two schools of thought on a subject – which is why I wrote her – but she’s gun shy on fats.

  8. “(A beady-eye vegetarian is one who will eat animals with beady eyes, i.e., chicken and/or fish, but avoids animals with non-beady, more human shaped eyes.)”
    LOL! I’ve never heard that description before but it is priceless! I’ll have to remember that one.

  9. The “beady-eye vegetarian” thing is amusing, I’ve never heard it before. I frequently eat the flesh of animals I find “cute” with no problem. (IE: ducks and cows.)
    “And avoid fats from animal sources, except for fish.”
    ARGH WHY WHY WHY WHY *bangs head on desk*
    According to her article, I should have dropped dead by now. I pretty much only eat fat. Saturated, of course.
    Anyway. Keep up the good work, Doctor.

  10. Came across a blog post by Fred Hahn that said that he went on a an all meat/fat diet.
    http://slowburn.typepad.com/my_weblog/2006/06/me_and_my_stres.html
    He also said he talked to you about it. Did you give Fred any advice about such a diet besides the book recommendation?
    Hi Imsovain–
    I did talk to Fred about an all meat diet as recommended by Blake Donaldson, M.D. in his book Strong Medicine (from my collection of old diet books) written forty of fifty years ago. I didn’t really give any advice aside what was in the book.
    Best–
    MRE

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