How Saturated Fat Affects Heart Disease Risk
I’m writing this addendum to last week’s article because I think it’s really important to understand why I and most doctors who recommend cutting saturated fat intake argue the way we do. Knowledge is the best defense against erroneous arguments, and you’re almost certain to encounter other health professionals who have eloquently argued that you can eat as much saturated fat as you want. When we’re stuck in the middle between two paradigms, we frequently opt to simply remain the same. If you have heart disease, remaining the same is probably not optimal!
We can’t directly study how saturated fat affects heart disease like we can study how statins lower cholesterol or ginger affects headaches. With statins and ginger, we can enroll participants in double-blind, placebo-controlled trials which allow for reasonably certain conclusions to be drawn about the effect statins or ginger have on outcomes. With saturated fat and heart disease, this would be nearly impossible.
With saturated fat and heart disease, such a trial would need to be tens of years in length and ingeniously designed in such a way that participants and researchers alike had no idea the saturated fat content of the food the participants were eating. Not only would the timeframe required be challenging to the point if impossibility (heart disease takes years to develop), but most people in the United States are at least vaguely aware of whether a food contains saturated fat or not. We know the red meat is higher, chicken lower. How you would go about feeding individuals real food that they are completely unaware of the saturated fat content is beyond me.
Of course, we’ll never see a double-blind, placebo-controlled “what causes heart disease” trial, but that’s not really too important. We don’t need this sort of trial to make observations about the types of people who develop heart disease or don’t. As such, we can use observational research. While it won’t tell us for certain whether a factor like heart disease is actually playing a role (and is not just a confounding factor), we can still observe that populations with high saturated fat intake tend to develop more heart disease.
I’ve collected a non-exhaustive list of trials such as the observational one I described above and published within the last 4 years—this time frame is important for the same reason you wouldn’t rely on a book from 1978 to learn how to navigate today’s job marketplace. I won’t describe each trial in detail, instead I’m going to tabulate the results on what each study’s evidence suggests about the role of saturated fat in heart disease. Afterwards, I’ll discuss the results and my own conclusions.