Anti-Fat Hysteria Is Fading — You Can Bank On It

A dietary shift is definitely happening. Here’s how I know that for sure:

The big-money bankers are on board.

In case you didn’t see it in the comments section of my most recent post, Credit Suisse just published an 84-page report titled Fat: The New Health Paradigm. I skimmed it and was impressed, but my initial response was why is a bank publishing this?

The answer (echoed by a handful of readers) is that Credit Suisse is an investment bank, and their reports are intended to inform investors of economic trends. If there’s a big movement among consumers to embrace natural fats and cut back on grains and vegetable oils, that will of course have an economic impact. Probably not a good time to invest in General Mills.

Two of the bullet points from the document’s summary section make that clear:

• What is the outlook? Globally, we expect fat to grow from the current 26% of calorie intake to 31% by 2030, with saturated fat growing the fastest and going from 9.4% of total energy intake to 13%. This implies that fat consump¬tion per capita will grow 1.3% a year over the next fifteen years versus a rate of 0.9% over the last fifty years. We expect saturated fat to grow at 2% a year versus a historical rate of 0.6% a year; monounsaturated at 1.3% a year versus 1.0%; polyunsaturated omega-6 to decline 0.2% a year versus a 1.3% past growth rate and polyunsaturated omega-3 to grow at 0.7% a year versus 1.6% a year over the last 50 years.
• Among foods, the main winners are likely to be eggs, milk and dairy products (cheese, yogurt and butter) and nuts with annual rates of growth around 2.5-4%. The losers are likely to be wheat and maize and to a lesser extent solvent-extracted vegetable oils. Meat consumption per capita should grow at 1.4% a year and fish at 1.6% supported by a fast expanding aquacul¬ture industry.

But there’s waaaaay more to the report than predictions of what consumers will be buying or not buying in the near future. There are explanations of the various types of fats, a history of fat in the human diet, and a history of the anti-fat hysteria that took hold in the 1960s and became official policy in the 1980s. There’s a lovely, concise section that looks at the evidence (more like lack of evidence) that fat causes heart disease and obesity. There’s a similar section on the health effects of red meat. And of course, there are sections on the recent shift in consumer attitudes about fat.

I’m still reading the thing (since I have a full-time job and all that), but here’s a sample of other bullet points from the opening summary:

• Triangulating several topics such as anthropology, breast feeding, evolution of primates, height trends in the human population, or energy needs of our various vital organs, we have concluded that natural fat consumption is lower than “ideal” and if anything could increase safely well beyond current levels.
• The 1960s brought a major change in the perception of fat in the world and particularly in the U.S., where saturated fat was blamed for being the main cause behind an epidemic of heart attacks. We will see that it was not saturated fat that caused the epidemic as its consumption declined between 1930 and 1960. Smoking and alcohol were far more likely factors behind the heart attack epidemic.
• Saturated fat has not been a driver of obesity: fat does not make you fat. At current levels of consumption the most likely culprit behind growing obesity level of the world population is carbohydrates. A second potential factor is solvent-extracted vegetable oils (canola, corn oil, soybean oil, sunflower oil, cottonseed oil). Globally consumption per capita of these oils increased by 214% between 1961 and 2011 and 169% in the U.S. Increased calories intake—if we use the U.S. as an example—played a role, but please note that carbohydrates and vegetable oils accounted for over 90% of the increase in calorie intake in this period.
• A proper review of the so called “fat paradoxes” (France, Israel and Japan) suggests that saturated fats are actually healthy and omega-6 fats, at current levels of consumption in the developed world, are not necessarily so.
• Doctors and patients’ focus on “bad” and “good” cholesterol is superficial at best and most likely misleading. The most mentioned factors that doctors use to assess the risk of CVDs—total blood cholesterol (TC) and LDL cholesterol (the “bad” cholesterol)—are poor indicators of CVD risk. In women in particular, TC has zero predictive value if we look at all causes of death. Low blood cholesterol in men could be as bad as very high cholesterol. The best indicators are the size of LDL particles (pattern A or B) and the ratio of TG (triglycerides) to HDL (the “good” cholesterol). A VAP test to check your pattern A/B costs less than $100 in the U.S., yet few know of its existence.
• Based on medical and our own research we can conclude that the intake of saturated fat (butter, palm and coconut oil and lard) poses no risk to our health and particularly to the heart. In the words of probably the most important epidemiological study published on the subject by Siri-Tarino et al: “There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.” Saturated fat is actually a healthy source of energy and it has a positive effect on the pat¬tern A/B.
• The main factor behind a high level of saturated fats in our blood is actually carbohydrates, not the amount of saturated fat we eat.

Wow. Great stuff … from a bank.

In case you had any doubts that most doctors don’t keep up with the latest diet and health research, the report includes this finding:

We conducted two proprietary surveys of doctors, nutritionist and consumers to understand better their perception of the issues we mentioned previously. All three groups showed superficial knowledge on the potential benefits or risks of increased fat consumption. Their views are influenced significantly more by public health bodies or by WHO and AHA rather than by medical research. Even on the “easy” topic of cholesterol, 40% of nutritionists and 70% of the general practitioners we surveyed still believe that eating cholesterol-rich foods is bad for your heart.

Go figure. The nutritionists are more likely than doctors to know that cholesterol has been found not guilty of causing heart disease.

In term of macronutrients, 45% of the doctors surveyed said that their perception of protein has improved, versus only 5% saying it has worsened; 29% of the doctors said that their perception of fat has improved versus only 7% saying it has worsened; and 15% only said that their perception of carbohydrates has improved versus 26% saying it has worsened.

Answering what makes you fat if eaten in large quantities, the doctors correctly pointed to sugar and carbohydrates (32% and 26%); fat and saturated fats are not as bad (23% and 16%) and protein collected only 2% of the responses.

However, the doctors believed that the best diet for weight loss is a low calorie one (65%), followed by low carbohydrate (36%) and low fat (7%). Among nutritionists, 42% prefer the low carbohydrate diet, against 30% for the general practice group.

Let’s focus on the positive. Yes, nearly two-thirds of doctors surveyed believe low-calorie diets are best for weight loss, but only 7% recommended a low-fat diet, versus 36% who recommended a low-carb diet. I’d wager a large sum that 15 or 20 years ago, more doctors would have been recommending a low-fat diet than a low-carb diet. It’s progress. And I was pleasantly surprised to see that 42% of the nutritionists recommend a low-carb diet.

I plan to read the entire report when I can. If anything jumps out at me as particularly interesting, I’ll post about it.

In the meantime, I see this report as another sign that the arterycloggingsaturatedfat! paradigm is dying out. The American Heart Association doesn’t want it to happen, The Guy From CSPI doesn’t want it to happen, the USDA Dietary Guidelines Committee doesn’t want it to happen, and countless makers of low-fat and low-cholesterol food-like products don’t want it to happen. But it’s happening.

And you can take that to the bank.