Saturated Fat Misconceptions: Separating Fact from Fiction | Dr. Carvalho | The Proof Podcast EP 243
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- Опубликовано: 19 июн 2024
- In Episode #243, Dr Gil Carvalho joins me to analyse a controversial new study on saturated fat, offering a definitive conclusion on what the science says.
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As we settle into 2023, there are still loose ends to reflect on and assess from last year. In today’s episode, Gil Carvalho, MD PhD returns to break down a controversial study released in late December. Focusing on saturated fats and having been well circulated online, this study positions saturated fats as a 'bogeyman' not to be feared - but how does this claim stack up against the general scientific consensus?
Gil Carvalho, MD PhD is a physician, research scientist, science communicator, speaker, and writer. He has been a member of the Genetics Society of America and the American Society for Neuroscience and has achieved accolades including a Delill Nasser Award for Professional Development in Genetics and a Mathers Foundation award. With a career spanning both medical practice and research, Dr Carvalho offers a rational, practical, and actionable perspective on this topic.
In Episode #243, we examine the aforementioned study with a researcher’s eye, breaking down analysis techniques in a way that is applicable to most scientific papers. We expand on the topic of saturated fat, reconciling the difference between cardiology guidelines and isolated studies, saturated fat, and bio-individuality. We also cover common misunderstandings, genetics, and the principles of saturated fat consumption.
Specifically, we discuss:
00:00 Intro
17:20 Saturated fat misunderstandings: Is saturated fat bad?
22:07 Principle 1: Dose matters? - How much saturated fat is too much?
30:12 Is no saturated fat the goal?
31:54 Principle 2: Replacement nutrient matters
45:53 Principle 3: Source matters
50:48 Mechanisms: Saturated fat and heart disease
55:47 Saturated fats and genetics
59:40 Target ApoB level
1:03:02 Importance of lifetime exposure
1:08:53 Statins and heart disease risk: Are statins bad for you?
1:10:52 Mendelian randomization studies
1:15:59 The totality of evidence
1:17:46 Saturated fats and total mortality
1:19:51 Saturated fat and liver health
1:20:43 Gaps in the research
1:23:52 Common arguments against lowering saturated fat
1:38:36 Outro
It was great to have Dr Carvalho back on the show to round out what the science says about saturated fat. Dr Carvalho’s communication style balances evidence with accessibility, and I hope you found this episode clarifying and useful.
Connect with Dr Gil Carvalho
• RUclips - / @nutritionmadesimple
• Twitter - / nutritionmades3
• Facebook - / drgilcarvalho
• Our previous conversation in Episode #207 - theproof.com/making-sense-of-...
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Enjoy, friends.
Simon
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A huge problem with the guidelines is - the usda subsidize the opposite - they should put the money where their mouth is and subsidize vegetables, leafy greens, whole grains, legumes and fruits. And maybe then eating would improve. If I could get 5lb of apples for $5 instead of 5 fast food hamburgers... lol (a fast food hamburger would cost 3X as much or more without government aid)
AMEN. My garden is down for the winter due to some yard grading and organic Kale is breaking the budget.
When vegetables and fruit cost more than meat and junk foods we know it's lost.
so true
Have a look at the Canadian dietary guidelines - there's no biases there.
It's a very different beast with little refined grains, lots of fruit and veg, and no dairy food group..
As I am watching this, I would add that I earned a degree in biochemistry in 1977 (no doubt before you were born) and what is being said here and the current state of the views on dietary fat is consistent with the things I was learning back them in university. Certainly, there are some tweaks but at the time, my professor was teaching us that too many saturated fats are problematic, PUFAs are good. Butter is better than margarine due to trans fatty acids* (I do realize today's margarines are made using naturally saturated plant fats vs. industrial hydrogenation of unsaturated fats which leaves you with a mix of isomers, so things are a bit different today - but of course, the palm oil plantations bring their own challenges from an environmental and societal standpoint), and that dietary cholesterol is not generally absorbed into the bloodstream. It is very alarming that people are saying ANY linoleic acid is bad for us, since it is an essential fatty acid.
*At the time they were also talking about the anomaly of naturally occurring trans fats in ruminants, I gather CLA, but unclear of where that was going. Having gone down a very different career path, I never followed up but it is an interesting topic.
I wonder what people did with their potatoes a few thousand years ago? I doubt it was drowned in butter!?!?
@@WFPBFORLIFEthousands of years ago, only native north Americans had them, same as corn and tomatoes and many other things. It's amazing that it took under a hundred years or Ireland getting the potato to half the population getting starved out because of the potato famine.
I love when great minds find each other. I’ve been following you both for quite some time.
@Bladerunner2049 It's funny. I ain't a vegan but I take B12 supplements because I know I will develop deficiency eating meat and fish only once or twice a month.
but it seems some "smarter buffoon" have a better idea: Taking statins so they can eat a steak while enjoying very "not so good" side effects from statin pills.
What a graceful display of buffoonery 👏
a Vegan who loves other Vegans? shocking!
in other news: a "2021 study found that the average American believes that the U.S. could go completely plant-based by 2039."
When people are told to put oils that will turn rancid in the blink of an eye into their body, and they happily do it, if these are not great minds, I wonder who are?
Gil is awesome, I liked the mutual-love-fest at the end. I wonder if Chris at "Plant Chompers" would fall under what Gil calls a "nutrition" podcast or a "diet" podcast -- I'd categorize him with the former, as well. Just another that comes to mind as a truly helpful voice.
yeah, he's pretty based.
@@TheProofWithSimonHill aww thanks mate
So happy to see someone give Chris over at plant choppers some credit! Such a wholesome guy who shares such great information 🔥👏❤
@@TheProofWithSimonHill It's interesting that plant chompers 3 videos on health influencers, the ones he hand picked that lived the longest and in the best health with awards and honors in their name ate animal products 3 times per day along with a balanced diet in moderation and kept super fit.
@@TheProofWithSimonHill Simon and Gil are my heroes. To be mentioned with them is an honor.
Just look at how healthy you both look. Your face says it all. You're both so generous of your time and dedication to presenting the science.
Dr. Chaffee and Paul Mason both look very healthy, and they are pure carnivores .
@@gerardklauner902Almost anyone can tolerate toxins for awhile. It's longterm exposure that causes the problems. Carnivores seldom live a long time.
@@gerardklauner902 Paul mason dont look very good for his age.
27:33 the S curve of sat fat and cvd.
28:00 ice cube analogy.
35:05 sat fat replacements and cvd.
44:02 study says that adherence to guidelines reduces cvd and mortality.
55:03 linear curve between sat fat and LDL or apo-b, but (57:25) it's probs more nuanced.
55:14 linear curve between apo-b and risk, so he wonders why the sat fat to cvd curve is an S.
58:29 same apo-b, different outcomes.
1:00:25 apo-b ranges: a pretty good but pretty permissive number for general prevention is below 80 mg/dL, while some experts say below 60 mg/dL. if one is at high risk (like if one has already had a cvd event), then under 50 or 30 mg/dL. however, work with ur doctor or cardiologist to decide ur ideal range.
1:01:23 ldl range for general prevention: 70 mg/dL if he remembers correctly.
1:01:40 non-hdl is a good alternative to apo-b, but they don't mention ranges for non-hdl.
You don't have to listen to anyone. Simply take your own markers at blood panel, C-RP, TRG/HDL and LDL. C-RP measures your chronic inflammation. If you control carbs in your diet and then increase unrefined medium chain saturated fats, your C-RP and TRG/HDL ratio will fall, and if you have been on seeds oil, your LDL which is the firefighter will take some time to reduce because the wall of your arteries has been built PUFA and MUFA, they are highly unstable and after some time LDL will lower by itself.
Nice summary
Stop spreading nonsense.
None of this data has ever been proven with science, it's made up hogwash to defend their dietary choices.@@wilsont1010
@@wilsont1010those claims cannot be supported by RCTs. However, the opposite claims can be supported by a great number of RCTs.
Guys, this was so much density of information that I have already watched more than 10 times! Kudos
One of your best episodes. The root cause of confusion with diet is in an incapacity to think critically. Critical thinking should be required at the public school level especially in our era of social media and misinformation. But the work you guys are doing really is important. Much appreciated to both of you.
A huge amount of respect for how Gil Carvalho approaches analysis and discussion of nutrition topics. First and foremost he wears his scientists hat, rather than advocacy of particular dietary approaches for ethical reasons. I like that. That's how it should be. What does the science say, especially supported by RCT's seems to be his raison detre.
i think gil gives too much importance to this subject (saturated fat)...All cause mortality going from 0.90 to 1.02 is nothing....basically if you overeat saturated fat you have a 2% greater chance to die...c'mon...lets get serious...
All I'll remember is I can eat all my saturated fats from dark chocolate. 😅
I am so grateful for the knowledge….and the sharing of that knowledge by these two men. I learn something every time I watch either of them. Thank you gentlemen.
Dear Dr. Gil: When some influencer discovers they can get rich telling people they can get thin/healthy by eating Twinkies, it will become a thing.
Maybe you won’t be surprised but someone has done exactly that. It wasn’t all Twinkies but included salads and a multivitamin. The idea was to show the validity of calories in calories out. I think it can be found searching for Twinkie diet.
Yep, and that's why keto works. Appetite suppressant at first, and the weight lost is what makes you feel better. Could have done it a healthier way with low saturated fat and sugar, more whole foods diet as well. It's really bloody hard to overeat oats, beans or baked potato with an absence of added fat.
Keeping people confused = PROFITS!
Thank you for a most informative discussion.
Hi Simon, I found you through Gil’s channel and watched this wonderful video! I’ve just subscribed to your channel and want to buy your book. Just wanted to add it’s never too late to reverse a lifetime of-a high cholesterol diet. I was diagnosed with peripheral artery disease and changed my diet, high blood pressure and numbers change drastically and my disease appears to have stopped in its tracks ! I’m still working on other aspects of health, so I am so grateful for both your channels. I’m 73 and planning to live much longer. Aloha.
Excellent video. Thank you gentlemen.
Get this. I'm 55 perfect health 12% body fat. Blood pressure 120/75. Lift weights my whole life and cardio exercise 5 days a week. I eat only on average 15 grams of saturated fat which is less than 5% of my diet and I keep cholesterol intake very low. Just had my ApoB checked and it's off the charts high 185 so I went and had a CAC scan and that too is a Hugh 550 score. Off to the cardiologist. I have terrible genetics I guess. Oh well I heard nobody is getting out of here alive.
That's really wonderful you were able to know ApoB was a more accurate test and get useful results. That's wonderful! What did your cardiologist say? I wish you well.
That seems weird, APOP usually follows ldl
Not saying anything is bad with ldl, but seems if cholesterol is low, seems like APOB would be normal
@Primetime_dads I keep my cholesterol intake low but I always had really hi ldl cholesterol so I went on a statin and it dropped my apob to less than 80 and my ldl is now about 75 before it was always pushing 200. My body for some reason makes a ton of cholesterol. I think I'm one of the few people that really does need a statin. I also stopped eating processed Carbohydrates and sugar.
@@TheSavior888 ok cool I understand now, we’ll just make sure you do what ever works for you. That’s end goal anyway, listening to as much research as possible and finding what works for us.
Good luck and wish you the best 🫡
Carbs cause calcification.
I so appreciate the depth and detail of your information. Might I just mention that “consulting my health care provider” has not, over decades, helped much in my decision making process re CVD prevention. (eg. Two months ago advised to stop eating eggs by my board certified cardio.) Thank you both.
Perhaps you have a cardiologist because you need secondary rather than primary prevention? Different target levels of apoB needing to include every little difference.
The advice to stop eating eggs or at least reduce consumption is sensible. Here in the EU several health institutes that are not infiltrated by the egg industry (unlike so many institutions on the US) have recommended keeping egg consumption to below 3 per week for decades.
Top-notch episode, so informative.
I found this presentation interesting, and quite credible relative to other studies/presentations I've seen. For us non-medical-professionals, we are typically not in a position to read published research papers and easily detect flaws in the study (e.g. dose, replacement, timeframe, significance of relative risk metrics, etc.). So we do rely on credibility and trust. This video was credible for me because they include explanations about the flaws in studies which seemingly contradict what they are presenting. In my case, as a 71-year-old who has been hearing both sides of the statin-for-primary-prevention debate, I have been hesitant to draw any conclusion, and have hence avoided taking them. The reason: both sides I listen to so often tend to be dogmatic and not acknowledge and address the evidence cited by their opponents. Gil talks about the relative-risk-absolute-risk question and addresses it. I still have lots of questions about this, but at least in terms of the perceived controversy about saturated fat consumption I feel I understand better now and it makes sense. Thanks for this video-interview-presentation!
I am ten minutes into this video. He acknowledges that there is a differentiation between saturated fats in heavily processed foods vs foods like grass fed red meat. I am not interested in any “findings” that lump all saturated fats together any more than I am interested in vilification of seed oils because they are chosen as the oil used in junk food products
@@dondajulah4168 but what makes a food junk food ? Neither the carnivores, the vegans or the omnivores can get in accord to that.
@@classicgameplay10high calorie density, high sugar, salt, and fat foods, ideally that don't go bad quickly, full of palm oil, high glycemic..
Thanks for another interest and helpful video! Surprised that it is so difficult to keep saturated fats down below 2% even if on a whole plant based diet with no added oil or nuts. Yet we ideally want to keep our saturated fats intake at 8% or lower. This doesn't leave much room to play with.
People are trying to increase saturated fat for a healthier body instead.
Two of the most knowledgable people
Thankyou for sharing this discussion ❤🔥👏
Here's what surprises me; in the studies done on the benefits of EVOO they generally point towards a daily intake of 6 Tbs. (3 oz.) as optimal within a so-called Mediterranean Diet and that adds 11 grams of Saturated Fat. Since as you say almost all foods contain some sat. fat Oatmeal for instance per oz. Walnuts have about 1.5 gms. and even a 200 calorie serving of Oatmeal has 0.6 gms. Rice, & Beans add a little as well. Using Cronometer I find it challenging to stay below 7% of calories from Sat. Fat. I'm going to have to tweek my diet again.
"People love to hear good news about their bad habits.” - Dr. John A McDougall
Yes … bad habits like junk food and Veganism .
@@stevebuss69 Yeah and other bad habits like you don't have to do much exercise just buy his McDougall packaged food products that are made in an industrial plant and consume his diet that no long healthy populations or cultures including Okinawa centenarians have ever consumed.
McDougall is in serious cognitive decline at early-mid 70's.
Convince me why i should listen to him ???
@@pbpb253 for someone who ate bacon and eggs everyday and suffered a massive stroke at the age of 18. The fact that he's alive is quite respectable enough ♿
@@beepbeepnj2658 and u with your obsession with Okinawa. They ain't a blue zone now, their life expectancy declined badly.
The only place worth mentioning is now Loma Linda, I wonder why u never mentioned it
too inconvenient for your stand eh?
cute
Dude, you ask the best questions in these space!! Great job!!!
Dear Simon, please have a conversation with Dr. Paul Mason (low carb Downunder) about this paper and all-about-cholesterol. He is just around the corner (Sydney)
Please also ask him about why the longest-lived nutrition guru so far is Ancel Keys? 🤔
In would be also fantastic if you had a conversation with Dave Feldman of all-about-cholesterol.
Please also chat with both about the flaws/correctness of the risk calculators using blood lipid measurements and Coronary Calcium Scores.
Or Paul saladino, yes he should have some people on here that see it differently.
The fact that doctors/scientists studying the effects of a high saturated fat diet don’t (won’t) perform studies that require participants to eat that kind of diet because it’s a KNOWN detriment to health, tells me everything I need to know about satfat
This saturated fat thing is nonsense....if you overeat saturated fat based on the graphic gil showed has a 1.02 all cause mortality. That means, you have a 2% more chance to die...big deal...its not statistically important. There are far bigger things to concentrate. Smoking, sugar, refined grains, food deficiencies, alcohol, exercise, stress and mental health, sleeping, contamination, etc.
😂
Great episode- I appreciate the open dialogue and the scientific explanations for those of us that don’t read scientific articles on a regular basis. It’s helped me understand were some of the “cholesterol doesn’t matter “ ideas came from. Thank you for the clarity ❤
a deep bow of appreciation to both , I learnt so much and am subscribing now, please keep up the hard work to help us all live healthfull
I really appreciate the access to quality findings you both present. You work well together 👍
Thank you!!
Well done. Thanks!
Great video guys !
What a great episode! And for all I've heard of saturated fat and heart disease in the last year through your channel and others like it I had somehow missed the note about Stearic Acid and it's effect on cholesterol. Good to know now, especially for dark chocolate
saturated fat in red meat is higher in stearic acid than the stearic in dairy fat, more holes in their arguments than swiss cheese
Terrific! All my questions and concerns answered!
That ice example was really good!
I trust Dr. Gil 100%. Very honest and knowledgeable and smart. His only fault is he is too trusting of industry funded research. I wished he would completely disregard biased research.
You are spot on. Only a certain select group of individuals will use industry funded research and only a select group of researchers will use refined coconut oil in all their studies instead of the unrefined ones which by most consumers purchased. Something is very wrong here, hmmm... I wonder what is?
Great Video!!
Both of you are really impressive
Well, for example Dr. Paul Mason PhD is a scientist and has very different opinion. He recommends high saturated fat carnivore diet. One interesting point he makes is that LDL increased by saturated fats is not the real problem we have to focus on, if other markers (trig, HDL, ...) are good. And how is it possible, that saturated fat from coconut oil doesn't increase LDL if saturated fats are supposed to be unhealthy? Actually the correct answer is, that it increases phytosterols instead. I think that the whole issue about saturated fats is not fully understood yet and there are still many contradictions to be resolved. No, science is not settled and consensus of the majority scientists doesn't determine what science is.
Yep, i suggested to Simon in an earlier post that he should invite Paul Mason on.
We need some ideas challenged.
Once again Simon, get these 2 gentlemen on together, and lets discuss these very complex topics with an open mind.
Some commonly held views should be questioned.
A bit more on that coconut oil. That one contains 80% more saturated fat than butter, but doesn't increase LDL according to Dr. Paul Mason at all. Allegedly because it increases phytosterols instead. Olive oil similarly increases phytosterols, but not LDL. But it doesn't mean that phytosterols are better than cholesterol. They are actually worse, because we can not use them for production of hormones and vitamin D3 as we do with cholesterol. We do not fully understand cholesterol and its functions. Most of those tests about cholesterol and risk of cardiovascular diseases were done with people on very mixed diets. They were not done with people on paleo/ketogenic diets let alone on carnivore diet.
@@TheProofWithSimonHill Bring him on your show.
He seems a very affable chap, and knowledgeable.
It would be an interesting discussion.
@@TheProofWithSimonHill I would have to see that literature, he is misinterpreting. I know from my own experience, that on high saturated fat diet I had LDL 6.7 mmol/L and after I switched to coconut and olive oils it dropped to 3.05 mmol/L. And there are many other people on ketogenic diet with similar experiences.
@@TheProofWithSimonHill That study is interesting, but it is a meta-analysis from other studies, which could have had confounding factors like different carbohydrate intakes. I would like to see a study how is it going to behave when there is very low sugar intake or none at all.
@25:55
8% of calories from saturated fat IF someone is eating the correct amount of calories for them at a healthy weight. If someone is 50lbs overweight and eating 3,200 cals per day when if they were their healthy weight and only needing 2,500 calories per day I sure as hell would hope that they aren't eating up to 8% of 3,500 calories per day from saturated fat!
My brain start to think after following Dr.Gil. I was sold to saturated fat and high cholesterol are good for health. Even after I see increased inflammation. I am moving 90% plant base, fish and organ meat once a week. Done with red meat and too much butter and sugar, salt etc and low calorie.
Reduced to nil inflammation for me after switching over to saturated fats. Good saturated fats will be the key to good health. Get on with your research.
Dr. Gil gives too much important to the saturated fat thing. Based on the graphic Dr. Gil Showed, if you overeat saturated fat you have an all cause mortality of 1.02. That means, you have a 2% greater chance to die. Its not statistically important. There are far bigger things to concentrate than saturated fat. Smoking, sugar, alcohol, refined grains, food deficiencies, exercise, stress and mental health, sleeping, contamination, etc. Based on that 1.02 all cause mortality number, we shouldn't even be talking about saturated fats...
@@leonardoyi3183 And he used meta analysis which is garbage in and garbage out yet he hasn't realized. Nobody uses refined saturated fats like what they studies purported or trans fat in substitution, when you switched to unrefined saturated fat you become healthier and this is in tandem to what the American College of Cardiology as well as Cambridge University findings.
These two meeting was an amazing day for this planet
Dr. Gil is BASED!!
BASED?????😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂First, learn how to spell. Second, capitalizing something doesn’t make it true.
“People like to hear good news about their bad habits.” Dr. John McDougall
Nice one Chris! 🤣
based in... science. ha ha ha ha ha
@@markmiiwurdz4016 it shows Based for me, what are you talking about?
Diet is such a highly contentious issue because it's something we're all personally invested in. That would also explain why so many experts in the field struggle to remain objective.
What about all this micro plastics that are being absorbed into the bloodstream and body? Could that have an effect on artery accumulation of plaque and calcium.
great work Simon, both you and GIl are amazing communicators! Quick question: I eat around 4,500kcal a day due to my training... should I still try to keep under 8% of sat fat? because that would mean that I am basically eating the double of someone on a 2000kcal, or should, in my case, try to keep under 4-5% then? tks!
@@TheProofWithSimonHill cool, tks for the advice, will do that!
I lived most of my life in Calgary Alberta. It is nicknamed COWTOWN. I have difficulty believing that any study coming out of Alberta not being biased by one of its major exports, the other being oil and gas.
Superb
I recall during the pandemic and nice article that examined how populations react to "stuff". While I was in shock and disbelief at the stuff that was paraded about, I was comforted (read discomfited) that there is about 30-33% of any population that inclined to be contrarian (read denier of facts). History is always a great teacher, and the amount of goofiness (and the expression of that goofiness) was in line with what we were experiencing in the US for both Covid and the Spanish flu. And to my anecdotal eye, that about appears to be the breakdown of harassing comments in the comments section.
So no matter what area one is looking at, there are going to be about a 1/3 of the people that will fail to acknowledge facts and will seek out and embrace good news about their bad habits. You gotta love human DNA. And it sure helps for any that are trying to be compassion practitioners....lots of opportunities are presented.
Question: When speaking of saturated fat % of daily calories, does this principle apply when you are dieting? ie maintenance calorie intake is 3500 but dieting caloric intake is 2800. Thank you for the amazing int yams content.
Great video! Always good to see Dr. Carvalho and some sensible conversations of you Simon. Cheers from America
"The relationship of nutrient intakes to life expectancies in Japan since the Second World War has demonstrated that sufficient intakes of animal protein and fat are crucial for attaining longevity. In the community dwelling elderly, the higher the serum albumin was, the longer the further life expectancy in the elderly. Serum total cholesterol showed a U-shape relationship to further life expectancies in the elderly. Low serum cholesterol was deleterious for higher levels of functional capacity." 2001 article by Hiroshi Shibata.
I much prefer a format where you have two guests that are both experts and they disagree. That demonstrates how complicated the science is and how two bright experts can draw different conclusions from the same “evidence”. I’m no expert on saturated fat but I believe saturated fat consumption has been going down in the past 40 yrs but CVD has been going up.
Spot on. The science is complicated if you use bad saturated fat, zero science or study good saturated fat by the medical industry, that tells a lot.
Total caloric intake and obesity have also been going up. Refined carb and junk food intake have also been going up because people are wealthier on average and junk food is cheaper than before. Exercise has also gone down given that everyone has access to vehicles. Smoking has gone down. Many things have changed. These are all confounders. Science isnt as easy as you make it out to be.
@@ladagspa2008 I think you are agreeing with me. I said science is complicated.
CVD is going up while smoking has gone down, saturated fat consumption has gone down, red meat consumption has gone down, while carbohydrates, junk food has gone up. As I said it might be better if two experts that disagree debate this science.
@@lanarkwandererOvereating makes a massive difference in the speed of disease progression..
My situation s a little different. I have IBS and for the first time in almost 15 years my stool became normal, thanks to a diet high in saturated fats. Since being given the bum's rush, so to speak by your excellent podcasts, I have teamed with my physician and we are following better informed guidelines. But in the area of IBS, would you have any diet-related recommendations? Thanks much.
@@TheProofWithSimonHill Thanks very much. I should have added that I experimented with the FODMOP approach for a number of years. Not impressed. Sticking with that diet leaved me very little that tasted good and/or fueled my workouts adequately.
.
@@TheProofWithSimonHill Now I get it. I watched the doctor's video with his mother. My problem's exactly like hers. And I will start all over again tomorrow with FODMAP. Thanks again very much.
Nice
Is it not possible that there are other thresholds for SF %E vs CVD outcomes? Perhaps even a point at which it crosses back in the other direction as some adaptive mechanism kicks in. 7-13% is a very narrow range to look at, and that end of the scale implies a high amount of accompanying carbohydrates. Pairing could be relevant
Excellent, can we have something more on mindfulness it sounds interesting
I think one other reason is the relative ease of data measurements. If you look at the 3 types of data often associated with diet, weight and body mass are the easiest to measure, then comes blood glucose then lipid parameters and ApoB.
It's easier to sell a keto diet because people can more easily see the immediate benefits of weight loss and blood glucose reduction, while they cannot see the long term downside of high saturated fat intake.
Interesting and probably fair point, thanks.
A keto diet doesn't have to be high in saturated fats, although they often are. It can be high in unsaturated fats and whole plants.
@@jeffreyjohnson7359 It doesn't have to be high in saturated fat, but keto diet followers I know all ignore. dismiss or downplay the risk of cardiovascular health. It's easier to do that because parameters are more complicated and more difficult to measure (not a home test), And it can take 10-20 years for the effect to show up.
@@woofinu
True, like some vegans play down the risk of unrefined carbs, lack of EPA/DHA or B12.
@@jeffreyjohnson7359 Silly them. If they switched to keto, they wouldn't have those problems!
I'd like to see Nick Hiebert (The Nutrivore) on your show. (Along with yourself and Gil) he's currently one of my favourite content creators for reliable evidence based nutrition information
I second that!
Thanks for recommending a new person to listen to. I might end up going the other direction, but always appreciate new views.
1:01:40 - You discussed the best target for healthy ApoB (depending on risk) - But I'm just wondering what a good target for non HDL-C would be?
For people with low risk of heart problems (no previous attacks, normal BP, etc) aim for non-HDL
Why are you looking at HDL-C instead of HDL-P? Not all LDL is bad. Small particle LDL is the problem
@@WA4OSH I'm not interested in HDL-C, it's Non HDL-C i'm interested in (Total Cholesterol minus HDL). And this is because non HDL-C is the most accurate marker of risk that’s available on a standard lipid panel. Unfortunately it's not easy (or free) to get particle counts in the UK (where I live)
And all LDL particles are atherogenic. Smaller particles are more so but larger particles still contribute to risk
@@ItsJordaninnit Makes sense. ApoB is related to the number of cholesterol particles. Here in the US they look for more than 130 mg/dl
@@WA4OSH yeah, that’s right. I’m not sure how easy it is to get ApoB tested in the US, but here in the UK it isn’t routine and I’d probably have to pay privately to get my ApoB.
What would be a healthy level for non-hdl cholesterol here in Canada 🇨🇦 for those of us who can not access APO B testing?
For people with low risk of heart problems (no previous attacks, normal BP, etc) aim for non-HDL
@@pedro.almeida Thank you for taking the time to reply 🙏
The whole debate, with ‘evidence’ and studies on both sides is so disconcerting. Just goes to show that nutrition ‘science’ is probably at the bottom of the sciences - maybe just above the ‘dismal science’ ie economics.
Would having an elevated LP(a) be an exception to avoiding as much saturated fat as possible?
Is there a similar sigmoid function for poly unsaturated fats? Are seed oils bad for you?
Definitely bad.
Is LDL's purpose is to deliver cholesterol made in liver to other parts of the body? If so, does the LDL normally go through blood vessel wall?
Simon
Would like to see you get Paul Mason on the show.
You're both thoughtful and have attention to detail, even if coming from diff nutrition angles. Also Paul has exposed some data fraud from 1990s research which is interesting
I checked a video of his: m.ruclips.net/video/RJ2rpTzqcpc/видео.html
The first thing I decided to fact check was the study referenced around the 8 minute mark. The study he chose to reference did not correct for smoking incidence.
Then I checked smoking incidence. It is apparently three times more common in South India.
Then I looked at 2 studies that compared heart disease in South and North India that corrected for smoking. His claim falls like a brick of poop.
Then I fact checked every statement up until minute 15 and the man is a charlatan. Either he is dumb enough to believe the things he say, or he is lying through his teeth.
@@LinusBerglund Confirmation bias is always present in everyone. However what is certain is that "nutrition influencers" are the greatest cherry pickers for their own cause, and this channel is no exception
@@timh-c7186 listen, I fact checked a couple of his claims and they are not "it is a matter of interpretation". He cited studies to back up claims that the studies didn't support. Many times. I looked through four other studies comparing CVD in north and south India. They all say the same thing: Corrected for smoking the difference is negligible except in smoker, where the low fat group did a lot better.
Yet he chose the 1944 study that wasn't even a heart study but happened to support what he wanted.
I really did fact check all claims he made in the first 15 minutes. He misrepresented most and completely failed to convey the result of the others.
You can do this as well. Just for fun, do it with Gil and Paul in parallel and see what the result is. I have fact checked Gil a couple of times and it always checks out. If anything he downplays results I would like to be true.
It's interesting that plant chompers 3 video episodes on health influencers, the ones he hand picked that lived the longest, and in the best health with awards and honors in their name ate animal products 3 times per day along with a balanced diet in moderation and kept super fit.
Uh…. I’ve watched those repeatedly. Those advocating plant based lived the longest. He really was just comparing age at death.
@@krishnaveganathar I don't know what plant based actually means? Does that mean it is made in an industrial plant like a factory? All junk food is made from plants, the majority of what people eat is from some type of plant. The 3 plant chompers videos showed the people who ate meat heavy diets lived shorter lives than the ones who ate a balanced diet. And no it was not about just age these were health influencers with Ph.D's or MD's not random people off the street.
@@beepbeepnj2658 the saying goes.... "If it came from a plant, eat it; if it was made in a plant, don't.”
One thing that’s consistent is all the experts in the same field have opposite opinions almost across the board.
A huge problem with the guideline is - food industries fund them and they have a HUGE conflict of interest.
Nobody follows the guidelines
The evil twins of nutrition … “saturated fat is good for you” and “ldlc does not cause atherosclerosis”
Good saturated are the healthiest, are they treating us as fool by telling otherwise?
@@wilsont1010Yes, you are a fool for thinking otherwise. I was fooled as well at one point. Do your research, don't listen to the echo chamber tinfoil hat denialists.
@@mikafoxx2717 Keep this corrupted newspeak to yourself and stop calling others as fool.
@@wilsont1010 Unfortunately we have a lot of data from meta-analyses of cohort studies and RCT's, that showed that Saturated fat isn't good for you. PMID: 32723506, PMID: 32827219, PMID: 20351774.
Would it be possible for you to interview professor Tim Noakes in regard to saturated fats?
No they wont. If someone is telling us that saturated fat is bad and rancid fats are good, they are treating us like fools.
the role of processed carbs, fructose and inflammation in the formation of arterial plaque has to be tackled imo. this is always the low carb argument against the diet heart hypothesis. i'm sure refined carbs do play a role but lets put it in perspective. are they to be avoided/ minimized in the same way saturated fat and cholesterol ideally are. are there any studies on this subject??
@The Proof with Simon Hill ok, not to beat a dead horse, but how can nutrition scientists like Johnson and laymanhave such a strong co victim that carbs are the main driver of heart disease. What's going on there
I find this whole debate to be bizarre. Heart attack/disease were rare before 1910. They become an epidemic in mid 20th century and have decreased since that time to roughly the 1910 level. In that time, saturated fat consumption has decreased or stayed the same. How can anyone argue then that they are connected? It doesn't make ANY sense. Why the hysteria around saturated fat?
@@TheProofWithSimonHill It is a great shame that saturated fat has been so demonised. That means most of the population now feels guilty about eating the most nutrient dense and satiating food available to us. The result of that is constant hunger and overcompensating with trashy carbs which has led directly to the obesity epidemic, diabetes and most heart disease left in society. Demonising sat fat is causing far more illness and death than it would cause by encouraging it, and the health and satiation that would flow from that. My 2Cents.
@@damienroberts934 They have never demonized sat fat. It is refined sat fat that they are demonizing, which is no different from RBD palm oil or seed oils. They simply treat us like fools.
P. S. Brilliant metaphor with the ice cube.
I am just at the 26 minute mark so far and maybe my question is answered later. Is saturated fat an independent risk factor or it is only bad to the extent it increases ApoB?
Most of the talk today is about saturated fats from animal foods and ASCVD. A couple of decades ago the debate was about these foods causing cancer.
It would be informative to have a discussion about the current status of that cancer idea. Was it debunked? No one ever talks about that anymore.
Interested to know what 8% of calories equates to in terms of grams of saturated fat? Thanks
Well, that is an easy calculation: 2.000 cal /day x 8%=160cal. 160cal:9cal= 17g saturated fat.
(1g of fat = 9cal).
For the SFA cut-off graph, It appears the data at the 7 and 8% of energy is meaningless. The CVD event RR ranges from 0.01 to 4.15 for the 95% confidence interval. Am I incorrect Simon?
Those are refined saturated fats.
I find the graph at 35:00 about replacement nutrients interesting. I wonder if MUFA/PUFA really deserve top billing in a heart-healthy diet, or are they just better at mitigating the negative effects of SFA than whole grains? If you cut the SFA altogether would the addition of greater amounts of MUFA and PUFA continue to be beneficial? I guess what I'm trying to get at is are people on low fat diets doing themselves a disservice, and could they be better off, potentially, from a cardiovascular standpoint by upping the unsaturated fats? I used to be a lot more pro-oil, fish, and nuts, but after going low fat for a few months the positive changes in my lipids are undeniable. I'm sure there's a lot of individual nuance, and I don't doubt that replacing butter and fatty meats with veggie oils and leaner meats will be beneficial for most people on standard western diets. I'm just thinking out loud. Love the show!
Good saturated fats are the healthiest why go for the bad ones? MUFA like olive oil goes rancid in the blink if an eye, do you think you would want to put that into your body?
@@wilsont1010 Tell that to octagenarians in Italy and Greece where they drink Olive oil by the gallon!
I would stay away from SFA and seed oils, and instead use a bit of EVOO on occasion. The less fat the better, in my opinion. Just eat foods that are naturally high in good oils like nuts, seeds, and avocados. Even fruit cotains some fat. Even though PUFAs and MUFAs are better for you than SFA, this doesn't meant that they are good for you....just better than saturated fat.
@@tanyasydney2235 Yeah, it's an interesting conundrum though, because my understanding of how fats affect blood lipid levels is that SFAs have the effect of down-regulating LDL receptor activity in the liver, whereas MUFAs and PUFAs have a positive up-regulating effect. Fiber can play a minor role in helping to move biliary cholesterol out of the intestine and preventing it from being absorbed. I've heard that this is at best, even with high fiber intakes, a modest effect. It would seem to follow that having a diet centered largely around these unsaturated fats would be the soundest approach from a cardiovascular standpoint. I've tried keto before and found it difficult to reach satiety without going over my calorie limit. It's food for thought, though. There's some studies on plant-dominant low carb diets, and they usually come out on top in terms of blood marker improvements. Search for "eco-Atkins" if you're interested.
@@tanyasydney2235 The Mediterranean diet is a saturated fat diet in disguise, check out why the Cambridge University study on human subject has revealed that unrefined saturated fat is far healthier than olive oil and butter.
Simon didn’t the AMA OR AHA come out and say that saturated fats don’t raise cholesterol within the past 3 years?
Hi Simon, nice podcast and discussion topic. I really only have one comment which might seem a bit trivial or even weird but the noise of you swallowing from time to time picked up by your mic was a bit disturbing. Not sure if mic too sensitive or if u need to swallow then move head away from mic if you are conscious of you doing it etc?? Anyway like I said the content was good and have subscribed 👍
I wish Dr Gil was on IG..
Simon, please invite Paul Mason MD, a fellow Australian, on your podcast to discuss saturated fat and heart disease.
Lol...just commented same thing
I had never heard of Paul Mason so I picked a video of his at random. I am going to echo my comment that I posted in the comments:
I checked this video of his: m.ruclips.net/video/RJ2rpTzqcpc/видео.html
The first thing I decided to fact check was the study referenced around the 8 minute mark. The study he chose to reference did not correct for smoking incidence.
Then I checked smoking incidence. It is apparently three times more common in South India.
Then I looked at 2 studies that compared heart disease in South and North India that corrected for smoking. His claim falls like a brick of poop.
Then I fact checked every statement up until minute 15 and the man is a charlatan. Either he is dumb enough to believe the things he say, or he is lying through his teeth.
Great suggestion!
Yes, Mason, Eric Westman, and Ben Bikman as well.
No they wont. If someone is telling us that saturated fat is bad and rancid fats are good, they are treating us like fools. They have nothing to debate here.
What about all natural organic peanut butter? Is that bad because it has 2.5 mg of saturated fat?
Can you please elaborate on the relative risk plot? I that the risk jumps from 0.2 to near 1.0 with increased saturated fat intake. However, the scale is important. If the scale represents 2/10000 jumping to 10/10000, that isn’t very significant in the absolute sense. Please elaborate, thanks
Your question is unclear without specifying a timeframe
Timestamp 24:09@@TheProofWithSimonHill
Hello. Can you please provide a source which prevents this data the absolute risk-reduction rather than the relative risk reduction? 2/10000 cardiac events prevented is not much better than 1/10000 , even though its a 100% decrease. Thanks@@TheProofWithSimonHill
Can you please have a look at this: "Effects of Total Red Meat Intake on Glycemic Control and Inflammatory Biomarkers: A Meta-Analysis of Randomized Controlled Trials".
1:25:45 "tried to get that low"
I had a look at my Cronometer data, and in the past week, I had a daily average of 1704 kcal and 5.3 g of saturated fat which is approximately 48 kcal. That means a percentage from saturated fat of 2.8% of calories. Today's numbers are 1284 kcal and 3.7 g of saturated fat or 2.6% of calories. 2.5 g of those came from sardines. So clearly, it is certainly possible to go very low.
Simon 'nuance' Hill
Yes, many great reasons why plant-based advocates should totally stop referencing the blue zones !
I’ve looked at many videos from doctors and even nutritionists. There are even cardiologists on both sides of this issue. You’d think they’d have it sorted out by now. I guess the proof in the pudding will be the health of LONG TERM adherents of the keto and carnivore diets. Plenty of them seem to feel very well and have good indicators in the short term, (except maybe for ldl).
@@TheProofWithSimonHill the same graphic Dr. Gil Carvahlo showed at the 24 minute mark showed everything we need to know. All cause mortality going from 0.9 to aprox 1.02 is basically not statistically important. Based on that graphic if you overeat saturated fat you have a 2% bigger chance to die. Doctors in general should focus on more important things that saturated fats. Sugar, Smoking, alcohol, exercise, refined grains, Sleep, Stress and Mental health, contamination, food deficiencies, etc.
difference between raw and pasteurized milk?
Pasteurized milk is less likely to give you listeriosis, tuberculosis, E. coli, and salmonella
I think most people move to low carb diets out of concern about diabetes, not thinking about heart disease.
I rarely hear the critics of keto address this.
This is my current experience. 2 years on low carb, high saturated fat. Stunning results for 18 months, platueu for last 6 months and sky high LDL. Found Gil and through to this podcast trying to find my way to keep my type 2 diabetes under control and find the truth behind the superficial (misleading) headlines
@@cheekywalkThe saturated fat causing insulin resistance even short term was fascinating to me. Drives both diabetes and heart disease.. the less oil in general, the less insulin needed for the same carbohydrate. Or really more carbohydrates for the same insulin load.
Hypertension, hyperlipidemia and diabetes are the primary contributors to cardiovascular/renal disease (and penile health too). They are a devil's triad in driving healthcare costs and exist as comorbidities.
Gil Carvalho is a B R A I N :)
So… if a person has ultra high lp little a, with your 8-10 percent saturated fat discussion in mind, is there even any point in keeping saturated fat under 10 percent, given that our vessels are being constantly bathed in harmful lipoproteins regardless of what we eat? I’m not trying to poke a hole in your discussion, I’m asking out of concern. Please poke a hole in MY argument.
Doesn't dairy have naturally occurring hormones, which can cause certain health problems, as well as being a source of low-grade constant inflammation - like Michael Greger and other researchers have shown?
Gil's point on using proper comparisons in studies is the key to why many low carb studies are not useful. Changing fat from like 40% of the diet to 30% is not going to be significant. We do have doctors employing low fat plant based diets with great success on a variety of illnesses including heart disease, stroke and diabetes. I've heard of a recent study revealing that folks following low carb diets are twice as likely to get a heart attack as those on a Standard diet. We'll see if further studies confirm this but it seems likely as low fat diets have been able to reverse heart disease.
Serious question: Is the documentation supporting mct oil legit? (which is a saturated fat..could also be coconut oil) .. I guess mct oil or coconut oil, both being a saturated fat would increase cvd..but based on research studies available to date, would someone's memory be improved from consuming saturated fat?
In one podcast with Simon and somebody else (sorry forgot), mct (and coconut oil in general) brain benefit was kind of debunked. Apparently it came from one not reliable study. I'd say risk to benefit is too high. There are safer ways to improve brain "health". Exercise, meditation, screen time limitations, etc.
I am still waiting for the science and proof that meat and dairy is good for human consumption? Where are the grand benefits of animal consumption??
Once you figure out the (All Natural) Whole Food Plant Based life style there is no turning back. The improvement of digestion alone is undeniable.
Even if (theoretically) animal products would be "good" for people (which I doubt, as there is no proof so far) - mass production of it makes them deadly. Hormones, antibiotics, corn fed, constantly stressed animals...