FAT LOT OF GOOD

Does saturated fat really deserve its bad rep?

For Maddie Jackson, it started with cheese on toast. The 25-year-old product analyst from Eastbourne had been vegan for five years – a dietary pivot she’d made in pursuit of optimising her health – when she began to feel like this way of eating was no longer working for her. ‘I wasn’t one of those “fast food” vegans – I loved cooking, and everything I ate was made using fresh whole foods – but it didn’t seem to satisfy me any more. I started to feel way more lethargic, my exercise routine became pretty much nonexistent and I was always hungry, no matter how much food I ate.’

She started sneaking cheese and butter into her diet during late night fridge raids, but consuming small amounts of dairy didn’t seem to make a difference. When a battery of blood tests revealed that some of her vitamin levels were dangerously low, she decided to take action. ‘That same day, I called my boyfriend and told him to buy two steaks and some St Agur cheese for dinner – and it was heaven on earth,’ she recalls. And while she was nervous about the optics of admitting to eating meat again – eventually ‘coming out’ via a Facebook post explaining her reasons – she didn’t look back. ‘I just felt better. My energy came back, and I started to feel more confident in my body again. Now, I’m three years back into eating a balanced diet that includes animal fats and proteins, I’m training for a triathlon and I’ve never felt fitter or more energetic.’

While the cultural politics that surround such a switch are inescapable, a dietary U-turn like Maddie’s is made all the more complicated by the fact that scientists can’t tell us for sure which approach is healthier. Central to the debate is saturated fat, which is commonly associated with animal proteins – and whether eating too much of it is dangerous. It shouldn’t surprise you that books, podcasts and documentaries can draw on countless studies about meat and saturated fat but come to opposite conclusions; nutritional science is less absolute than you might imagine, and warring camps have been accused of exploiting this uncertainty to promote polar-opposite agendas. While NHS guidelines conclude that ‘most people in the UK eat too much saturated fat’, official advice is to cut down on all fats, and to focus on replacing the saturated fat in your diet with the unsaturated kind. Some argue that this directive lacks nuance, while others complain that it doesn’t go far enough. The pressure is mounting on scientists and healthcare professionals either to absolve or to decry animal fats once and for all. But who makes the strongest case?

GREASE FRIGHTENING

Until the 1940s, few worried about whether certain foods would expand their waistlines or clog up their arteries, says Adrienne Bitar, a food historian and the author of Diet And The Disease Of Civilization. Dietary advice primarily focused on eating more to avoid malnutrition, rather than eating less to avoid illnesses of excess. Then, in the 1950s, Ancel Keys, a physiologist at the University of Minnesota, noticed that the wealthy were well fed, but suffered from a higher rate of heart disease than those with more restrictive diets. Keys believed that saturated fat was to blame. He concluded that if people ate less of it, they’d reduce their blood cholesterol levels and, therefore, their risk of heart disease. In 1955, US president Dwight Eisenhower had a heart attack. ‘That’s when public attention cohered around the idea that heart disease was an epidemic,’ says Bitar. Eisenhower adopted a low-fat diet. Not long after, the federal government started raising concerns about the levels of fat in the average American diet.

During the 1970s, a new theory emerged: that it was sugar, not rib-eye steaks and brie, that was largely responsible for the Western world’s worsening health. This theory was pioneered by scientists in the south of England, including physiologist John Yudkin, whose anti-sugar gospel Pure, White And Deadly was published in 1972, and surgeon Thomas Cleave, who wrote The Saccharine Disease. A paper in The Lancet asked that the cure ‘not be worse than the disease’ – that the animal fats that were then the staples of the British diet not be replaced with what they perceived to be unhealthier, low-fat alternatives. Nevertheless, Key’s findings eventually became the foundation on which nutrition lore was built. In 1983, the UK government issued its first set of national dietary guidelines, based on the American model. In both countries, these guides were underpinned by the idea that reducing saturated fat intake would lower incidence of coronary heart disease and save lives. This recommendation has been unchanged ever since.

BONES OF CONTENTION

Journalist Nina Teicholz, 56, was ‘something of a vegetarian’ for 25 years. She was constantly trying to lose weight and always felt tired. Then, around 2005, she began researching and writing The Big

Fat Surprise: Why Butter, Meat and Cheese Belong In A Healthy Diet. And when she started eating more animal products, she noticed that her health improved. ‘Saturated fat has been the rate-limiting factor in the consumption of animal foods,’ says Teicholz. ‘Meat and dairy are principally foods that we depend on for essential nutrients and vitamins for human health. They’re the most calorifically efficient way to get the vitamins and nutrients you need.’ Teicholz says there’s evidence that these foods are healthy even at twice the current guideline recommendation. Suggesting that people avoid saturated fats, she argues, steers people away from whole foods such as red meat.

Teicholz is now the executive director of The Nutrition Coalition, a non-profit group in the US, supported by donations and grants, whose principal goal is advocating for a review into the process by which the country’s dietary guidelines are set. Presently, they’re assessed every five years, with the latest update published in December 2020. The Nutrition Coalition has argued that recommendations to avoid saturated fats are based on weak scientific evidence. ‘In order to continue the limits on saturated fat, health officials must show ample and consistent evidence that these fats damage health,’ the coalition has stated. It points to some 20 review studies showing an inconsistent link between saturated fat and heart disease. Critics of the Nutrition Coalition point to a lack of credentials among some of its members; some of those in prominent positions there have ‘no formal training in nutrition,’ says Dr David Katz, founding director of Yale University’s Yale-griffin Prevention Research Center. But while some scientists within the field have written The Nutrition Coalition off, others in nutrition are becoming sympathetic to the idea that animal products aren’t as bad as science has made them seem.

CATTLE-GROUND

In September 2019, a group of researchers published a series of six papers in the Annals Of Internal Medicine, one of the most influential nutrition journals, reviewing the science on red and processed meats. The team found that study participants who ate about four to seven servings of red and processed meats per week had approximately the same risk of cancer, heart attack or death from any cause as those who ate one to four servings. The difference between the two groups meant that for every 1,000 people who reduce their meat intake, only two would benefit from a lower mortality risk. Based on these findings, the group

‘I told my boyfriend to buy two steaks and some St Agur cheese for dinner – and it was heaven on earth’

published its own dietary guidelines: you enjoy beef and bacon, so continue eating it. It was controversial, to say the least. ‘If they’d just published the [data] and not the guidelines, it would have been a yawn from us,’ says Dr Katz. ‘But to devise guidelines directly at odds with your own findings and pretend like that’s business as usual… This is a provocation.’ There’s yet another complicating factor to all of this: though the saturated fat debate centres around red meat, the nutrient is found in many other foods. ‘It’s not possible to eat saturated fat in isolation. Therefore, you have to question the significance of studies that study saturated fat, as opposed to the foods that contain it,’ says Dr Marion Nestle, a food and nutrition researcher at New York University.

Perhaps the strongest statement suggesting a rethink on the guideline caps on saturated fat was published in The BMJ in 2019. Nineteen scientists concluded that the established guidelines ‘fail to take into account considerable evidence that the health effects vary for different saturated fatty acids and that the composition of the food in which they are found is crucially important’. A team of Norwegian scientists took this sentiment a step further in January this year, noting that saturated fats occur naturally in a wide variety of foods, and concluding that there is ‘a lack of a logical biological and evolutionary explanation’ for why they should then make us ill.

Lumping together all sources of saturated fats, some scientists now believe, may steer the foodmarketing industry towards advertising foods that are low in fat but high in refined starch and sugar. This is often the effect when broad recommendations are made based upon single nutrients, says Trevor Kashey, a former cancer researcher who now runs his eponymous nutrition coaching business. It’s happened in the recent past: the recommendation to eat more fibre is meant to encourage people to get that nutrient from whole-food sources such as fruits and vegetables. ‘But then,’ Kashey says, ‘bakeries started making bran muffins.’

IN THE BALANCE

It’s estimated that less than a third of the saturated fat we eat comes from proteins and dairy, with the majority of it coming from multiingredient foods, including pastries, pies and desserts. That meat and cheese are grouped together in the UK’S official Eatwell Guide with cake and ice cream is ‘stupid’, says Martin Macdonald, a clinical performance nutritionist and director of Mac-nutrition. ‘Meat and cheese have essential nutrients, such as zinc, magnesium and iron – all of these things that are important for hormonal health.’ He points to studies examining dairy intake, which consistently show that switching from

‘Meat and cheese have essential nutrients, like zinc and magnesium’

full-fat products to low-fat alternatives doesn’t lead to a reduced risk of cardiovascular disease. But though UK guidelines still advocate for reducing the amount of saturated fat you eat, the existing limit of 30g a day

– or 10% of your calorie intake – isn’t especially restrictive.

It’s equivalent to an 8oz rib-eye steak and three large eggs. When this number was reviewed by Public Health England in 2019, it concluded that there was ‘no need to change current advice’.

This is not, by any means, the equivalent of a dietary blank cheque. While it’s unlikely that we’ll ever have an infallible set of guidelines, the majority of the scientists and dietitians interviewed for this article suggested limiting yourself to four weekly servings of red meat. But the experts also agreed that the best diet for optimising your health isn’t nutrient focused – it’s one that’s food focused. The best diet takes into account food preference, variety and enjoyment, as well as the social and environmental footprint of the food you eat. And the best diet, they all agreed, isn’t carnivorous; it isn’t vegan, either. It’s where the warring sides of nutrition’s infighting can’t often meet: somewhere in the middle.