Coconuts are Driving Me Nuts!

How does this headline sound to you?

“Newsbreak! We have no new information about Coconut Oil, but we have a news alert that we still think all saturated fat is bad for everyone.”

That is the real story behind the headline “Coconut oil isn’t healthy. It’s never been healthy” that has grabbed the attention of millions.

The American Heart Association released a statement that, to summarize, says:

  1. Coconut Oil is a saturated fat.
  2. Saturated fat can raise LDL.
  3. High LDL has been associated with increased risk of heart disease.
  4. Therefore, coconut oil will increase your risk for heart disease

Is there any direct proof that coconut oil is dangerous to our health?

No.

Is there any new evidence directly linking saturated fat to heart disease?

No.

Can we say that because “A” is true above that “D” has to be true?

No way.

But that sure is an attention-grabbing headline to try to connect the dots.

What Evidence?

Don’t get me wrong. It’s not like the AHA is making this up out of thin air. They are basing their opinion on decades of science. Decades of poor quality science. But since that was all the science we had for years, you can see why they came to the conclusion.

LDL cholesterol is an important part of the puzzle when it comes to your health. But it is exactly that. One piece of a very complicated puzzle.

What else does saturated fat do? It raises of HDL. For many, the total cholesterol-to-HDL ratio remains the same.  Does that increase the risk of heart disease? There is no good data to support that claim, but likely not.

Let’s look at it another way.

Is an LDL of 150 dangerous? That depends. Are you overweight, sedentary, have a diagnosis of metabolic syndrome, eating a high inflammatory diet, and have a strong family history of heart disease? Then an LDL of 150 likely is dangerous. And you likely also have a low HDL, high triglyceride level (TG), high blood sugar etc.

On the other hand, do you eat real food, mostly vegetables with appropriate portions of animal fats? Do you exercise, manage your stress, and have few if any other cardiovascular risk factors? Are your HDL, TG and glucose levels near ideal? Then that same LDL of 150 is likely not as dangerous for you.

It is misleading to suggest one size fits all.

(For more details on the saturated fat debate, and why the data is not as clear as most seem to think, see our prior article on the topic here.

Unfortunately, the American Heart Association discounts the evidence that shows no association between saturated fat intake and cardiovascular disease.  They continue to promote industrial, processed oils over natural fats. Again, rooted in decades of science. Poor quality science.

Both Sides Fail

In essence, the attention-grabbing news flash is simply restating the AHA’s longstanding position. There is nothing new.

To be fair, however, do we have good evidence saying coconut oil is healthy?

No, we do not.

Can we prove saturated fat reduces our heart disease risk?

No.

Can we believe Dr. Axe when he claims that coconut oil has 20 proven health benefits (including curing UTIs, protecting the liver and preventing osteoporosis)?

No way. That’s crazy talk.

If we are going to question the poor-quality evidence against saturated fat, we certainly have to question the horribly inadequate evidence supporting views like Dr. Axe’s.

So, what can we conclude?

We can conclude that nothing new was found for or against coconut oil.

Nothing new was found for or against vegetable oils.

Saturated fats (and by extension coconut oil) are not inherently bad, especially if they are a component of a real-foods, vegetable-based, Mediterranean style of eating.

Vegetable oils are highly processed, pro-inflammatory, fake foods that have evidence both for and against their use.

It’s all so confusing! I know. Trust me, I know.

What Can We Do?

What is someone to do in this sea of contradictory news?

Don’t believe the hype.

Focus on real, minimally processed foods.

When it comes to cooking fats:

  1. Olive oil is the best for low heat.
  2. Avocado oil is the best for medium heat.
  3. Higher heat gets tricky due to concern over smoke points.

    1. First, ask yourself, why are you cooking or frying in high heat to begin with? Can you get the same result with lower heat?
    2. If it’s something you have to do, you can choose from coconut oil, butter, ghee, and vegetable oil. Make you decision based on taste, or even better, mix it up.

Action Item: Do you want to know how cooking oils affect you, as an individual? Get your labs done (at a minimum check LDL, HDL, TG, TC, hsCRP, glucose. For more advanced testing try WellnessFX or other ways to get advanced lipid testing). Then switch to 100% coconut oil as your cooking oil for a month and recheck your labs. Review your labs with someone who has an open mind and looks at more than just your LDL number. LDL does not exist in isolation, but is part of the whole picture.  Now you know how it affects you. Individualized medicine beats general guidelines any day.

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com 

Herb-Crusted Roasted Salmon with Roasted Broccoli Steaks

Here is another great recipe from our friends at Whole30. Give it a try for a delicious twist on salmon. But don't stop with just broccoli for the veggie. Add cauliflower, zucchini, and sweet potato for an even greater array of colors and flavors!

Ingredients
1/2 cup fresh basil leaves
1/2 cup fresh parsley leaves
6 tablespoons extra-virgin olive oil
1 tablespoon fresh lemon juice
1 teaspoon salt
1 teaspoon black pepper
1/2 teaspoon grated lemon zest
1/4 cup almond flour
2 salmon fillets (6 ounces each)
3 small heads broccoli with the stems attached (consider adding cauliflower, sweet potato and other veggies here!)
1/2 cup sliced almonds, toasted

Instructions
Preheat the oven to 400°F. Combine the basil, parsley, 4 tablespoons of the oil, lemon juice, ½ teaspoon of the salt, ½ teaspoon of the pepper, and the lemon zest in a blender or food processor. Cover and pulse until smooth. Pour the herb mixture into a bowl and stir in the almond flour.

Place the salmon fillets in a large roasting pan or on a rimmed baking sheet. Pack the herb mixture on the top of each fillet.

Trim the broccoli stems to about 3 inches below the florets. Slice the broccoli heads lengthwise into 1-inch-thick slabs (two or three slabs per head), cutting from the bottom of the stems through the crown to preserve the shape of the broccoli. Brush both sides of each broccoli slice with the remaining 2 tablespoons olive oil and sprinkle with the remaining ½ teaspoon salt and ½ teaspoon pepper. Arrange the broccoli in a single layer in the pan around the salmon.

Roast the broccoli and salmon for 25 minutes, until the salmon just barely starts to flake when pulled apart with a fork and the broccoli is lightly browned, turning the broccoli once halfway through roasting. Sprinkle the broccoli with the toasted almonds before serving.

Text excerpted from The Whole30 Cookbook © 2016 by Melissa Hartwig. 

Breakfast Smoothies

I have posted a few times about my quick, easy and delicious veggie eggs that I eat at least three days per week. As a response, many of you who aren’t big fans of eggs have reached out and asked for other options. First, I encourage you all to explore intermittent fasting at least two days per week. Another option is to turn to smoothies. Smoothies are a great way to get your greens and veggies, plus you can easily add healthy fats and proteins to start your day with balanced nutrition. Just don’t fall into the trap of the “easy” bagel, muffin or cereal! You can do better. Here is a link to a delicious Strawberry & Kale smoothie from Amy Krasner at Nourished Balance. It’s easy and very tasty. Give it a try!

http://www.nourishedbalance.com/recipes/breakfast/strawberry-kale-smoothie/

Are Gluten-Free Diets Killing Us?

Gluten has come full circle in the eyes of popular media. It was initially portrayed as the cause of all our health concerns. Eliminating it was the quickest path to feeling better and living healthier. After all, how else can we explain Tom Brady’s Super Bowl prowess????

 

Now, however, avoiding gluten has been implicated in increasing our risk of heart disease and causing a harmful disruption of our gut microbiome (the bacteria in our digestive tracts and plays an integral role in our health).

 

So, which should we believe?

 

As with most health topics in popular media, the key is in the details. But first, a quick primer on gluten and gluten sensitivity.

 

Gluten 101

 

Gluten is a protein found in wheat, barley and rye, and in foods made with those grains, like bread, cereal, cookies, crackers and pasta.

 

In people with the medical condition of celiac disease the body sees gluten as a foreign invader and is unable to properly absorb it. Gluten causes an autoimmune response against the lining of the intestines causing intestinal damage and decreased absorption of necessary nutrients.

 

Symptoms of celiac disease include abdominal pain, bloating, and rashes. It can also cause anemia, bone problems, and malnutrition. Your doctor can diagnose celiac disease with a blood test and a biopsy of your small intestine.

 

Without question, those with proven celiac disease must avoid gluten. Fortunately, it is a rare medical condition.

 

More commonly, people may be sensitive to gluten even though they don’t have celiac disease. They simply find that they feel much better when they avoid gluten-containing foods. They have more energy, less bloating, clearer skin, and have improved concentration and mental clarity.

 

This is not a medical diagnosis. There is no way to objectively prove if this is the case or not. This is a subjective feeling. Do you feel better while avoiding gluten or not? It’s that simple.

 

This is similar to numerous other food intolerances that abound. Some people feel better avoiding dairy. Some feel better avoiding meat. Some feel better avoiding legumes. Gluten is no different. It just gets more attention lately given its popularity among celebrities and weight loss pundits.

 

If you feel better avoiding gluten, then you should avoid it. After all, our bodies do not require gluten for good health.

 

Our bodies need proteins and fats, vitamins and minerals. There is no physiological need for gluten. If it makes you feel poorly, there is no need to eat it.

 

Gluten Coming Full Circle

 

Now, however, people are starting to question the safety of gluten-free diets based on recent research.

 

An article published in May in BMJ (British Medical Journal) suggested that avoiding gluten increased our risk of heart disease.  What followed was a social media and popular media storm of gluten-free backlash with the end result being confusion and frustration.

 

Who do we believe and what do we do now?

 

Take A Breath, Then Dive Deeper

 

First, take a breath. Remember that health claims, good or bad, are rarely as extreme as portrayed by the media.

 

Next, dive deeper. Understanding the implications of the study depends on understanding the details of the study. I know that not everyone has the time/desire/resources to dig deeper into the studies, so we did it for you.

 

This study was an observational study that followed healthcare workers without heart disease (at the time of enrollment) for 26 years. There was no specific intervention, the researchers simply collected data over time on who had heart attacks and who did not, and also collected data on what they ate. By going back and statistically crunching the data, they tried to find an association between the amount of gluten eaten and the risk of heart attacks.

 

Here is the main conclusion to the study. There was no significant difference in heart disease risk between those who ate the most gluten compared to those who ate the least. No significant difference.

 

Why all the news reports that it increased the risk of heart disease?

 

Statistical massaging of the data showed that those who ate the least amount of gluten and the least amount of whole grains did have a small increased risk of heart disease.

 

So, what was the problem? Was it the missing gluten? Or the missing whole grains? This study does not prove cause and effect. It does, however, suggest it was the lack of whole grains, not just the gluten, that was associated with a very small increased risk of heart disease.

 

How small?  There was a 15% relative risk increase. The absolute increase was not reported, but looking at the numbers it was around 0.1%. The difference was 1 person out of 1000. Hardly earth shattering.

 

Said another way, if the subjects avoided gluten containing cookies, crackers and processed bread and substituted gluten-free cookies, crackers and processed bread, they were not any healthier, and may have increased their heart disease risk by 0.1%.

 

Yawn. That type of analysis wouldn’t sell many papers or get many clicks. Thus, the media did not report it as such. Yet that is what the paper found.

 

Gut Bugs

 

What about gut microbiota? Can gluten-free diet hurt our gut bugs?

 

A 2010 study suggested eating a gluten-free diet harmed our gut microbiome. This one should be an easy one to explain.

 

What helps healthy gut microbes flourish? Fiber. Specifically, fermentable fiber.

 

The most common gluten substitute is rice flour. Rice flour has very little fiber, thus very little ability to feed the healthy gut bacteria.

 

The result? A relative overgrowth of the unhealthy gut bacteria. The bacteria that like high-sugar and low fiber foods flourish while the fiber-eating bacteria die off.

 

Wheat on the other hand, tends to have more fiber. Especially whole grain foods. So once again, it is likely that limiting whole grains in favor of low-fiber, processed foods is not helping our health, whether we are talking about our guts or our hearts (and by extension, likely our brains as well).

 

Gluten- Guilty or Not?

 

Is there anything inherently dangerous about eating gluten free?

 

No.

 

The key is what are you eating instead. If you are eating low fiber, processed gluten-free foods, then you are not doing yourself any favors.

 

But if you feel better avoiding gluten, and you are replacing it with real food, fresh veggies (both starchy and non-starchy), fruit, seeds and nuts, then chances are you will feel better and be healthier.

 

What if gluten doesn’t bother you? Then there is no real need to avoid it as long as you are eating whole grains, minimally processed versions of gluten, and avoiding the processed and refined junk.

 

It’s that simple Let’s not over complicate it.

 

Action Item: Take two weeks to see how you feel without eating gluten. Do you feel any better? More or less energy? Can you think or focus better? Do you have fewer aches and pains? Did your weight change? If not, then eat what you want (as long as you continue to follow a real food, vegetable first, low sugar and low processed food way of eating). If you do feel better without gluten, then stock up on the foods listed below. Avoid gluten, but also be careful not to add processed, low-fiber, gluten-free alternatives. Just because it is gluten free doesn’t mean it is good for you!

 

Whole grain gluten-free foods:

Amaranth, buckwheat, brown rice, millet, quinoa, oats. 

 

Other fiber containing foods:

Legumes such as beans, lentils and peas

Green leafy vegetables

Starchy vegetables such as yams, sweet potatoes, carrots and other root vegetables

Apples, pears and berries

Nuts and seeds

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

A Healthier Grilled Cheese For The Whole Family

I know what you are thinking. Grilled cheese, healthy? What? I admit it may not be the healthiest choice, but sometimes you want to mix it up and your crave some comfort food. It helps to have a healthier go-to version of the old facorite. Plus, my kids love this. They love it so much that my 7-year old insisted that he film us making it for all of you. Enjoy!

https://www.youtube.com/channel/UCg6pXO7gfB2GapwRjMKEIbQ/videos

Why I Ate My Wife’s Chocolate Chips. All of Them.

I didn’t sleep at all Saturday night.

 

 In college, that may have been an exciting statement full of fun and intrigue.

 

In medical school and residency, it was a badge of honor and usually involved clinical challenges and valuable experiences.

 

This past Saturday, it involved consoling my son as he kept throwing up. Changing his sheets, wiping his head with a damp towel, and most importantly, just letting him know I was there and that he would be OK. It is a rite of passage all parents go through, more than once.

 

On Sunday, he was much better and slowly getting back to his usual self. Me? I was hungry and craving carbs.

 

I also almost never crave carbs. I practice intermittent fasting, I eat a “veggie first diet” with healthy fats, appropriate portions of animal sources, some fruit and almost no refined carbs. Through years of this practice, I have been able to drastically diminish my sweet tooth and control my hunger and cravings

 

A Different Story

 

Sunday was a different story. I had the carb cravings and munchies all day. Instead of eggs, veggies, and avocado, I had fruit and granola for breakfast. But didn’t stop there. I still had this crazy craving so I added toast and a banana.

 

Later in the day the cravings really hit. Chocolate.

 

I was craving chocolate like you wouldn’t believe. Fortunately, my wife had some chocolate chips in the freezer. Let’s just say I need to make a run to replenish the supply before she sees what I have done. Without thinking, I polished off what was left in the bag.

 

How could this be? This was all so unlike me. What could have happened?

 

Sleep.

 

Or more importantly, lack of sleep.

 

Sleep and Our Hormones

 

Sleep is intimately involved with our hunger and our cravings. As a result, sleep is intimately involved with our weight gain, weight loss and our health. It effects not only our ability to make decisions, but also alters our hormones, our cravings and our feelings.

 

That’s powerful stuff!

 

It turns out that inadequate sleep affects our hormones ghrelin and leptin. They sound like comic book villains, but they are hormones that control our feelings of being hungry or feeling full. Ghrelin, the “hunger hormone,” signals to your body that you’re hungry and need to eat. Leptin has the opposite effect, and signals that you’re full and don’t need to eat. Research consistently shows that poor sleep spikes ghrelin and suppresses leptin levels.

 

The result? Poor sleep leaves you feeling hungrier than usual regardless of what you eat or how much you eat. You eat more and expend less energy. Bad combination.

 

Leptin and ghrelin load the gun, our lack of mental clarity pulls the trigger (it’s a terribly violent analogy, but it makes the point none the less).

 

When we are sleep deprived we don’t think with the same level of clarity and with the same emotional control. We tend to react impulsively when we feel hungry. Impulse decisions rarely end in a well-balanced meal of veggies with healthy fats and proteins. More often, the result is standing in front of the freezer, door open, eating your wife’s stash of chocolate chips.

 

Guilty as charged.

 

Ripple Effect

 

Guess what else I did (or more importantly, didn’t do) in my sleep-deprived state on Sunday.

 

I didn’t go to the gym as I had planned.

 

I didn’t get out for a hike or nature walk.

 

I drove to the grocery store instead of riding my bike.

 

I sat and watched a movie with my son rationalizing that he wanted me there so it was OK to plant myself on the couch for an hour and a half.

 

Sound familiar? When we are tired and run down from poor sleep, the rest of our healthy lifestyle decisions suffer. It is the classic ripple effect.

 

And poor sleep can cause it all.

 

The solution?

 

Sleep better.

 

“No kidding. We already knew that. Thanks for nothing doc!”

 

Ok. We all know we need more sleep. And there is a laundry list of sleep hygiene techniques that I review in more detail in my book and elsewhere.

 

But life happens. We can’t always prepare for the night of consoling our children. Or the night before a big presentation when we are too excited/nervous/scared (take your pick) to get to sleep. What do we do then?

 

Be mindful and be aware.

 

Mindful Power

 

In this case, knowledge truly is power. Simply being aware that our hormones will be off kilter and our decision making will be impaired gives us the power to control our day.

 

You may need an extra reminder, or you may have to try harder than usual, but staying in the present and being mindful of your decisions is the skill you need to counteract the effects of poor sleep.

 

Instead of acting rashly, take a breath. Step back, breathe and realize you did not sleep well. Remind yourself that poor sleep alters your hormones and your perceived needs. And realize that you can still control these feelings and cravings. When you are mindful, you are in control.

 

It turns out, studies show mindfulness also helps you sleep better. When compared to a group of individuals given sleep hygiene education, individuals who practiced regular mindful meditation slept more and felt more refreshed. So not only does being mindful help you get through your day with minimal damage, it also helps you get back on track.

 

Once again, that’s a pretty powerful effect. If that were a pill you better believe there would be a multi-million-dollar marketing campaign behind it.

 

But it isn’t a pill. It’s free for anyone to do. It’s a skill anyone can try and everyone can improve. Being mindful is like exercising a muscle. The more you practice it, the stronger it becomes. The stronger it becomes, the easier it is to use.

 

You won’t be perfect and it may not always be easy. But I promise you this. Practice being mindful, practice your breathing, and you will be better.

 

Action Item:

Start recording your sleep. Activity monitors like FitBit Alta HR, FitBit Charge, Garmin Vivosport, Mio Slice, the Apple watch and many others all record sleep duration. Or simply record it yourself with a pen and paper (old school). When you get less sleep than usual, make a concerted effort to control your surroundings more. Make a concerted effort to practice your mindfulness techniques more. Treat yourself with more compassion and more love.  And make sure you get to bed a little earlier that night to help break the cycle. You can do this. You just need to be aware.

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

Whole30 Mexican Salmon Cakes with Mango Relish

I am a big fan of Melissa Hartwig and her Whole30 program. First there is the general concept that how and why we eat are just as important as what we eat. Then there are her recipes. Some people feel it can get boring eating real foods, no added sugars or grains or processed food. Melissa's recipes show us that it is anything but boring. Try these Mexican Salmon Cakes with Mango Relish and you will drop the word boring from your vocabulary. I'm a spice wimp so I did it without the cayenne pepper and jalopenos, and I served it with sauted spinach and some leftover broccoli/carrots/cauliflower I had in the fridge. Deliscious!

Rainbow Carrot and Brussels Sprout Salad with Pecans

Here is another one of our favorites from Dr. Hyman’s site. Rainbow carrotts, salad greens, cabbage, brussels sprouts, nuts and seeds. Yum! Great variety of colorful veggies and healthy fats. Delicious, nutritious and satisfying. Give it a try and let us know what you think.

Saturated Fat Kills! Or does it? Let the debate continue!

Dietary Saturated Fat Kills! Or does it? The Debate Rages On…..

 

A recent editorial publication in BMJ has once again stirred the raucous debate about dietary saturated fat. One subject with two completely opposing viewpoints, each one filled with ardent supporters who know in their hearts (pun intended) they are correct.

 

So……does dietary saturated fat directly cause heart disease, strokes and death? Or does it not?

 

Wait a second. This is science we’re talking about. Shouldn’t it be clear who is right? Shouldn’t the evidence prove one group right and the other wrong?

 

Nope.

 

Nutritional science is messy and rarely conclusive. That’s why we got into this mess in the first place.

 

Hooray for Debate

 

Before we get into the details, let’s all celebrate the debate itself. We should all be grateful that we can take part of an open and emotional debate among intelligent, successful and reputable individuals. Recent history has too many examples of some individuals trying to shut down debates in favor of declaring the “truth.” We all should know by now that isn’t going to fly.

 

Instead, we should celebrate every chance to debate the science and its impact on our lives. After all, we can still have free speech even if we can’t have free healthcare.

 

Bad Data

 

Here is the problem with nutritional science. It is really bad science.

 

Remember your science fair project as a kid? You were supposed to design an experiment that tested a hypothesis, controlled for one variable, and proved if that hypothesis was valid or not.

 

Nutritional science doesn’t work that way. Instead, most nutritional studies are observational studies. We observe how people live their lives, collect as much data as we can, and follow them to see who has heart attacks, who has diabetes, who lives and dies, etc. We can then see what habits each person had and try to draw statistical associations.

 

The problem is that this cannot prove anything. It can only suggest an association. When compared to your middle school science fair experiment, you can see the stark differences.

 

The observational study does not control any variables (they try to control for certain variables, but that is an impossible task especially since we can’t know all the variables for which we need to control), does not test a single hypothesis, and does not prove anything.

 

Why Does This Matter?

 

Here’s the problem. There are lots of studies that show an association between saturated fat intake (mostly animal products) and an increased risk of heart disease, strokes and death.

 

But here is the kicker. There are also lots of studies that show there is no association between saturated fat intake (mostly animal products) and an increased risk of heart disease, strokes and death.

 

Huh? How can that be?

 

There are many reasons why but here are the two big ones. 1- People are all different, and 2- Food is all different

 

People are Strange, I mean Unique

 

In the BMJ article, the authors propose that inflammation, not saturated fat, is the main cause of heart disease. There is definite sound evidence to support inflammation as a contributing causative factor in heart disease.

 

However, we need to acknowledge that inflammation is different in everyone. We are all unique. Our internal environments, from our degree of inflammation to our gut microbiome, are all different.

 

Therefore, how we respond to our external environment (i.e. the food we eat) is going to vary from person to person.

 

LDL cholesterol is a prime example. LDL is not inherently “evil.” Why would our bodies evolve to produce a substance whose job it is to kill us?

 

LDL is a necessary component in our cells, our brains and for making our hormones. We cannot live without it. Our internal environment, however, can alter LDL and turn it into an oxidized and inflamed structure that is more likely to cause heart disease. That may not be an inherent property of LDL, but rather, something our body’s environment does to LDL.

 

The same can be said of eating saturated fat. It is certainly plausible that introducing large quantities of saturated fat into an oxidized and inflamed environment can cause harm. But what if the individual exercises regularly, eats a veggie-first/real foods diet, practices mindfulness regularly, gets regular restorative sleep, and therefore has very low levels of inflammation and oxidation?  Chances are, the same amount of saturated fat in this individual is unlikely to cause damage (that’s my hypothesis, I haven’t don’t my science fair project on this yet).

 

Observational studies cannot tell the difference between these two types of people with different degrees of inflammation and oxidation. Instead, the trials try to reach a general conclusion that then is applied to everyone.

 

Does that sound like good science to you? I’d give it a C- in the middle school science fair (and that is being generous with extra points for their passion). Should we be making decisions about our health based on C- science?

 

We Don’t Eat Saturated Fat, We Eat Food!

 

Picture a big greasy burger on a huge bun, soaked in ketchup, with a side of fries and a coke. Observational studies call that a saturated fat eater.

 

Now picture a spinach and kale salad with beets, strawberries, walnuts, carrots and tomatoes topped with 4 ounces of grass fed steak. No fries. No coke. Observational studies also call this person a saturated fat eater.

 

I’ll say it once again. We don’t eat saturated fat. We eat food! It is crazy to think we can isolate one specific macronutrient and know all that it does. For starters, there multiple different types of saturated fat of highly variable quality with variable effects on our bodies.

 

Second, what we don’t eat (i.e. avoiding saturated fat) is just as important as what we do eat (instead, eating refined, processed, simple carbohydrates and sugar vs. veggies, fruit, nuts etc.). 

 

In the example above, the first person had a huge bun, fries and a coke. There wasn’t a veggie to be seen. Tough to pick just one villain in that so-called meal.

 

Don’t Throw It All Away

 

Don’t get me wrong. I am not about to suggest that we throw out all nutritional research. We still need it to guide future research and help us generate hypothesis.

 

I will suggest, however, that we need to be very careful about interpreting the research. Anyone who claims observational trials definitively prove anything must be seriously questioned.

 

And when they claim a “vast collection” of evidence, or an “overwhelmingly consistent conclusion” from the evidence, keep in mind that a vast collection of dog poop is still just a bunch a dog poop.

 

I respect and value ardent supporters on both side of the saturated fat aisle. But I also know that neither has the strength of evidence that their conviction conveys.

 

What Do We Do???

 

Be wary of anyone who claims they have the “answer” and the “conclusive” evidence. Try not to get caught up in all the debate if you don’t want. You can keep it simple and keep it healthy.

 

Eat real food. Mostly vegetables and some fruits with healthy fats such as extra virgin olive oil, avocados, nuts and seeds. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes.

 

If you enjoy the debate, by all means participate. It’s good for science. But here is the one and only thing I can say with absolute certainty.

 

I can’t prove anything that I recommended in this article.

 

There has never been a randomized study to prove my personal nutritional consensus. No one has done their middle school science fair project to prove my hypothesis.

 

Sometimes, we need to take a leap and say, “this makes sense.” We need to integrate all the evidence, combine it with clinical experience, and come up with our best solution.

 

That is why experts can be so passionate and so resolute in their position, and yet the positions can be so variable.

 

And that is why we need to find reliable voices we can trust. 

 

My voice? Keep it simple.

 

Eat real food. Mostly vegetables and some fruits with healthy fats such as extra virgin olive oil, avocados, nuts and seeds. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes. Take away the stress, be mindful in your eating, and enjoy!

 

Action Item:

Identify a belief you hold to be true about nutrition. Something that is ingrained in your core that must be true. Saturated fat is a perfect example, but there are plenty others. Salt? Carbs? Juicing? Whatever you feel is undoubtedly healthy or unhealthy. Next, search online for the exact opposite position. Keep an open mind and explore what the opposing side says. This will hopefully help you understand the complexities and uncertain nature of nutritional science.

 

Then, get back to the basics and (say it with me now….) eat real food. Mostly vegetables and some fruits with healthy fats. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes. Take away the stress, be mindful in your eating, and enjoy!

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

 

 

 

 

 

 

 

Bret Scher, MD FACC

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