Fat Is Good For You

I recently read the following:

“Pharmacotherapy can assuage the symptoms but can’t alter the pathophysiology. Doctors need to embrace prevention as well as treatment. The greatest improvements in morbidity and mortality have been due not to personal responsibility but rather to public health. It is time to bust the myth of the role of saturated fat in heart disease and wind back the harms of dietary advice that has contributed to obesity.”

British Medical Journal

For a chiropractor, seeing these words published in the British Medical Journal (BMJ) is refreshing; as is the mention of the over-prescription of statin drugs and the lack of support for use of statins in the prevention of heart disease. A very important number to look at when considering treatment options is the Number Needed to Treat (NNT). This article reports the following:

“A meta-analysis of predominantly industry-sponsored data reported that in a low-risk group of people aged 60–70 years taking statins, the NNT to prevent one cardiovascular event in one year was 345. The strongest evidence base for statins is in secondary prevention, where all patients after a myocardial infarction are prescribed maximum-dose treatment, irrespective of total cholesterol, because of statins’ anti-inflammatory or pleiotropic (coronary plaque stabilising) effects. In this group, the NNT is 83 for mortality over five years. This doesn’t mean that each patient benefits a little, but rather that 82 will receive no prognostic benefit. The fact that no other cholesterol-lowering drug has shown a benefit in terms of mortality supports the hypothesis that the benefits of statins are independent of their effects on cholesterol.”

British Medical Journal

Though I do enjoy reading this in the BMJ, the primary focus of the article was not statin usage, but saturated fats. For years, people outside of the AMA and USDA have had issue with the recommendation to lower fat intake in order to reduce the risk of heart disease. These recommendations are not supported by research and lack positive results so I am pleased to see them come under attack in a peer-reviewed medical journal.

Fat is good for you and it tastes good, too. Not only is fat good for you, but removing it from our diets has led to a general increase in carbohydrates and trouble with insulin resistance. The source of fat does matter; this goes back to the whole vs. processed discussion which will be the focus of another blog post, as will my nutritional recommendations. In short, when choosing your fat sources, go straight to the source; the less processing involved and the shorter the ingredient list, the better. (Note: Everyone agrees trans-fats are bad for you.)

In regards to my nutritional recommendations, I will take the easy way out in this blog post. What works for one person will not necessarily work for another. If I’m using well-known terminology, I’d say that a blend of Mediterranean and Paleo is a good place to start. Remember, a good nutrition plan that you stick to is better than a perfect plan that you don’t. (That quote is stolen from someone clever, but I don’t remember who.)

I’d like to thank a well-read patient and friend, Tim B., for sending me this article. I may have otherwise missed it. If any of you have anything interesting regarding health and life that comes across your desk, please share it with me.

Read the article for yourself here.