Research Review: Should you balance your fats for better health?

By Helen Kollias 

For fifty years, scientists told us that too much saturated fat was bad for our hearts, and advised us to switch to polyunsaturated fats instead. Oops.

It turns out that polyunsaturated fats are not all equal, and some of them actually increase the odds of cardiovascular disease and death.

In this week’s Research Review, we’ll explore why mistaken conclusions in science can sometimes become accepted wisdom – and which fats you really should eat for better health.

Introduction

Ever notice how a particular food can become all the rage – only to drop out of fashion a few years later?

And how the food or nutrient that our doctors told us to get more of in 1990 can morph into the one they are warning us against in 2013?

It’s enough to harden a person’s arteries.

With so much conflicting information out there, it can be tough to figure out what to believe.

But as you’ll learn in this article, health is about balance. Too much or too little of any nutrient can lead to trouble.

Keep that in mind as we explore the complicated world of fats and their role in heart health.

What fats should I eat?

In the last half of the 20th century, doctors and nutrition professionals agreed: too much saturated fat was bad for the heart.

The recommendations were clear: If you want to avoid heart disease and keep your arteries free of build-up, you should increase polyunsaturated fats and decrease saturated fats in the diet.

That’s what they told us – and most of us listened.

But lately, there’s been a shift in scientific understanding.

• Saturated fats don’t seem to be as bad for us as doctors used to think.
• Polyunsaturated fats are not equal in their effects.
• And the type of polyunsaturated fat you eat may be just as important as how much of it you eat.

Keep fats real

Here’s one simplified way to understand the relationship between some different fat types.

Notice that generally, fat type alone doesn’t determine the healthiness – rather, healthy fats are found in whole, unprocessed foods, while unhealthy fats are found in processed foods.

For example, you’ll notice that naturally occurring saturated fats (such as coconut) are important in a healthy diet. On the other hand, artificially created saturated fats (fats that start out unsaturated and are then chemically processed  – for instance, through hydrogenation — to become saturated, such as margarine) are not as healthy a choice.

Our bodies know what to do with real food. They don’t know what to do with the other stuff.

Keep fats in balance

Here at PN, Dr. John Berardi has long recommended getting:

• 1/3 of your fatty acids from saturated fats;
• 1/3 from monounsaturated fat; and
• 1/3 from polyunsaturated fat (with a good amount of omega-3 fatty acids)

Of course, these should mostly come from whole, unprocessed foods. (We’ll give you some ideas below.)

Want to know why omega-3 fatty acids are special, check the Research Review: How do omega-3 fatty acids work?

Are polyunsaturated fats bad for your heart?

Every once and awhile a food or nutrient gets vilified. (By food I mean anything that has been around for at least 100 years. Low fat, low cal, low-sugar cookies — not food.)

But the truth is, there’s really no such thing as a “good” food or a “bad” food. And almost anything we swallow can be good or bad for us, depending on whether we have a deficiency or a massive overabundance.

Don’t believe me?

Let’s take a look at water. Pure, innocent, cornerstone-of-life water.

You’re mostly water – about 70%. You need water daily to live. So water is good, right?

But even water can kill you. If you over-hydrate yourself you can get water intoxication. Too much water causes a decrease in key electrolytes that are really important for important things like your heart pumping.

And of course, your lungs like to be moist but not full of water.

Again, it’s all about balance. The right amount in the right place at the right time.

Finding fatty acids in the grocery store

Now you know which fats you should eat in what proportions. But there’s no “fat” aisle at the grocery store, and most nutrition labels don’t classify fats beyond telling you whether they’re saturated or unsaturated.

Here’s how to recognize what kind of fats you’re buying and eating.

• Saturated fats come mostly from animal fats (e.g. butter, meat fats) and tropical oils (e.g. coconut oil). They’re usually solid at room temperature.
• Monounsaturated fats come mostly from avocados, nuts, and olive oil.
• Most other oils are polyunsaturates.

Start with whole foods

If you’re looking to add good fats to your diet, start with whole food-based fats in their natural, least-processed state. This includes things like:

• fatty fish and seafood; sea vegetables
• raw nuts and seeds
• avocados
• fresh olives
• fresh coconut; raw cacao
• pastured butter and full-fat dairy
• fatty meats if pastured / grass-fed

Choose cooking oils wisely

Unless you’re grinding and pressing your own olives or seeds, remember that all oils have undergone at least some processing.

Look for “cold-pressed” or “extra-virgin” varieties of oil where possible.

The table below (source) breaks down the fatty acid composition of different types of oils that can be used for cooking – along with butter, for comparison. Highlighted oils are lower in omega-6 fatty acids.

Cooking Oil	Sat/Mono/Poly Fatty Acids (%)	Omega-6 (%)	Omega-3 (%)	Omega-9 (%)	Smoke point
Almond oil	8.2/69.9/17.4	17.4	0	69.4	420 F (216 C)
Avocado oil	11.6/70.6/13.5	12.5	1.0	67.9	400 F (204 C)
Butter	63.3/25.9/3.8	3.4	0.4	24.6	300 F (149 C)
Butter oil	62.3/28.9/3.7	2.3	1.5	25.2	485 F (252 C)
Canola oil	7.4/63.3/28.1	19.0	9.1	61.7	400 F (204 C)
Coconut oil	86.5/5.8/1.8	1.8	0	5.8	350 F (177 C)
Corn oil	13.0/27.6/54.7	53.5	1.16	27.3	450 F (232 C)
Cottonseed oil	25.9/17.8/51.9	51.5	0.02	17.0	420 F (216 C)
Flaxseed oil	9.4/20.2/66.0	12.7	53.3	20.3	225 F (107 C)
Grapeseed oil	9.6/16.1/69.9	69.6	0.1	15.8	420 F (216 C)
Hazelnut oil	7.4/78.0/10.2	10.1	0	77.8	430 F (221 C)
Macadamia oil	12.5/83.5/4.0	2.0	2.0	83.0	413 F (210 C)
Mustard oil	11.6/59.2/21.1	15.3	5.9	11.6	489 F (254 C)
Olive oil	13.8/73.0/10.5	9.8	0.8	71.3	375 F (191 C)
Palm oil	49.3/37.0/9.3	9.1	0.2	36.6	455 F (235 C)
Peanut oil	16.9/46.2/32.0	32.0	0	44.8	450 F (232 C)
Safflower oil	7.5/75.2/12.8	12.7	0.1	74.8	510 F (266 C)
Sesame oil	14.2/39.7/41.7	41.3	0.3	39.3	510 F (266 C)
Soybean oil (refined)	15.3/22.7/57.3	50.3	7.0	22.6	460 F (238 C)
Sunflower oil	13.0/46.2/36.4	35.3	0.9	46.0	440 F (227 C)
Walnut oil	9.1/22.8/63.3	52.9	10.4	22.2	400 F (204 C)

Notice the smoke point of the various oils. That’s the temperature at which they begin to burn.

When you’re cooking, you want to prevent oil from burning because overheating causes chemical deterioration and produces toxic compounds that circulate in your body and lead to inflammation. Not good.

Cooking with oils high in omega-3 fatty acids is a bad idea because these oils are especially sensitive to heat, and break down easily into trans fats.

Research question

To recap: For many years, conventional wisdom held that polyunsaturated fats were good for the heart.

Recall, also, that omega-6 fat (linoleic acid) is a type of polyunsaturated fat.

So what happens when people with coronary heart disease increase omega-6 fatty acids (linoleic acid) in their diets? Today’s research review seeks to answer that question. And the answers may surprise you.

Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, Ringel A, Davis JM, Hibbeln JR.  Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. BMJ. 2013 Feb 4; 346:e8707

Methods

First surprise: This study is more than 50 years old! True, it was published just this year, but the raw data was collected between 1966-1973.

Typically in science we tend to put the highest value on the most recent discoveries. Yet here, a collection of old data has given us new insights. And in some ways, the age of this study may even be an advantage. Hindsight allows us to put its findings in context.

That’s precisely what the researchers here attempted to do. They took raw data from the Sydney Diet Heart Study and re-evaluated it in light of recent mortality data for coronary heart disease and cardiovascular disease, hoping to learn what kind of fats are really good for the heart.

Subjects

The original Sydney Diet Heart Study involved a total of 458 men between the ages of 30-59, each of whom had suffered a recent “coronary event.” Coronary events included acute myocardial infarction (86%) and acute coronary insufficiency or angina (14%).

• The average age was 49, and the average BMI was 25, which is borderline overweight.
• Their total blood cholesterol levels were high (281 mg/dL on average), but there’s no data on the subtypes of cholesterol (LDL vs. HDL).
• Their blood triglycerides were considered borderline (at 187.5 mg/dL on average).
• Blood pressure was at the high end of normal (at 136/89 on average).
• Most of the subjects smoked (about 70% admitted to this) and fewer than 7% had diabetes.

Dietary changes

About half the men (237) were assigned to a control group. Researchers didn’t ask them to change their diets in any way, although some voluntarily stopped using butter in favor of the (supposedly) healthier margarine.

Meanwhile, the rest of the participants (221) were asked to make two changes.

1. First, they ate more polyunsaturated fatty acids (PUFA), aiming to get about 15% of their daily calories from these fats.
2. Meanwhile, they reduced their saturated fatty acids to less than 10% of their daily calories and tried to keep dietary cholesterol to less than 300 mg per day.

Even today, many doctors would give you similar advice.

Subjects continued with this regime for up to seven years. The median length of participation in the study was three years.

To get their PUFA intake up, researchers gave the men safflower oil and margarine (aka solid safflower oil) for their cooking needs.

Both groups got advice to stop smoking and to lose weight.

This might be the first instance of dramatic irony I’ve seen in a recent research study.

Two things we know today, that nobody knew or cared about 50 years ago:

• Margarine contains trans fats.
• Trans fats are bad for you.

It wasn’t until the 1990s that eating margarine containing trans fats was linked to heart disease (2). Whoops.

Results

The authors of the original study (3) hypothesized that eating more polyunsaturated fat would contribute to lower levels of saturated fat in the diet. Lower levels of saturated fat would, in turn, decrease cardiovascular risk factors such as total cholesterol and total triglycerides.

Ultimately, they believed that this would reduce the incidence of cardiovascular and coronary disease and lead to lower death rates.

True to their expectations, 12 months after the study’s start, the intervention group showed more significant changes than the control group in the following dietary and blood measures:

• polyunsaturated fat intake (↑)
• saturated fat intake (↓)
• total cholesterol intake (↓)
• total blood cholesterol levels (↓)
• total blood triglycerides levels (↓)

In other words, one year into the Sydney Diet Heart Study, all findings supported the original hypothesis.

Four years later, it was a different story.

By then, it had become clear that the intervention group was experiencing higher death rates, higher rates of cardiovascular disease and higher rates of coronary disease!

In the original study – published in 1978 – researchers did report these findings. But they didn’t try to explain what had caused the increased death rates (4).

Why? We don’t know for sure. But it’s possible that these findings confused them, because they went against accepted wisdom.

How could a clear decrease in cholesterol be linked to higher rates of cardiovascular and coronary disease? It didn’t make sense, given the state of knowledge at the time.

Looking back at other studies

In the meta-analysis under review, the scientists scrutinized a number of other, similar studies to try to figure out what caused the increased death rates in this particular study.

Their review of eight different papers revealed that the type of polyunsaturated fats used in an intervention seemed to be key.

Increasing omega-6 oils exclusively in an intervention seemed to lead to a higher risk of cardiovascular disease and death. Using mixed omega3/omega-6 polyunsaturated fats actually decreased these risks.

Conclusion

There are two main conclusions we can draw from this study:

1. Eating more polyunsaturated fats in the form of omega-6 fatty acids increases rates of death, cardiovascular disease, and coronary disease.
2. Science is context-dependent.

If you follow PN, the first conclusion – that eating more omega-6 fatty acids could increase the risk of disease – won’t come as a huge surprise. You already know that some omega-6 fats have been linked to inflammation. (See All About Bad Fats.)

But for many people, this is big news. And after years of being told by doctors, nutritionists, and the media to eat vegetable oils high in polyunsaturated fats, they’re understandably confused and exasperated.

Our second conclusion, that science is context dependent, can help us make sense of this.

Most of us tend to imagine that science proceeds in a linear fashion. Start with an idea (hypothesis), gather data, interpret the data, and presto-bingo, you have the answer! Or, even more misleading, you have Truth.

But that’s not really the way that scientific knowledge advances.

In the Sydney Diet Heart Study, researchers hypothesized that more polyunsaturated fats would decrease death due to cardiovascular and coronary disease, and that cholesterol is a good measure of predicting coronary disease.

If you look at the data today, with the benefit of hindsight, it appears that hypothesis was wrong.

But back in 1970, all other available data supported a diet low in saturated fat, high in unsaturated fat, and low in cholesterol. And researchers agreed that this was the type of diet that was best for heart health.

It’s almost impossible to publish data that refutes the accepted wisdom in a given period – especially if you have no plausible explanation for your anomalous results. And the results of the original study were, quite simply, impossible to interpret, given what the scientific community knew and accepted in 1970.

Fast forward to 2013.

With the advantage of 50 years further study and experimentation, we know that not all polyunsaturated fats are equal.

Omega-6 polyunsaturated fats, in particular, can increase the risk of death from coronary disease – probably because they increase inflammation.

But in 1970, scientists didn’t distinguish between the sub-types of polyunsaturated fat, and didn’t recognize that cholesterol is not a good measure for predicting coronary disease.

That’s why, in the end, it’s important to understand that science is a process. Knowledge builds over time.

This is why we shouldn’t jump on every nutritional bandwagon; sometimes we need context to make sense of recent discoveries. Common sense and patience are key.

Bottom line

There are no “good foods” or “bad foods” and no good or bad nutrients, either. Eating whole foods is always the safest (and healthiest) bet.

So whenever you hear somebody speak in absolutes about a particular nutrient (e.g. “Carbs are bad for you”, or “No one should ever eat saturated fat”) it is best to take this suggestion with a (healthy) serving of salt.

The Sydney Diet Heart study revealed the uncomfortable truth that diets high in one type of fat (omega-6 fatty acids, particularly from processed sources like cooking oils) contribute to higher rates of death from heart disease.

But the solution is not to base your diet on another type of fat.

The healthiest diets include a balance of different fatty acids, ideally from a diverse diet of whole, unprocessed foods.

Keep it simple. Keep it real. Keep it in balance.

Putting it into practice

Today, look at your fat intake. What could you get more of? What could you get less of?

Make small changes to keep it simple, real, and in balance.

Choose whole foods.

Decrease your intake of processed fats.

Get more omega-3 fatty acids, ideally from fish or other marine sources.

 

 

 

Detoxing the Mind

By Shannon Lough of Myyogaonline
Ever wonder why we spend so much time worrying about spring cleaning, purging our overabundance of things, reorganizing our homes, and trying out new body detoxes to clean out those winter cobwebs and reemerge fresh and new for the season. We spend so much of our time rearranging the space around us, and the physical space within us through diet and exercise, but so little time on our minds.

It wasn’t until I heard a lecture given by Tenzin Palmo, a Tibetan Buddhist nun, who said that "the mind is the true home, but we don’t clean it, get rid of the junk, exercise it, or air it out." It was at a retreat in Dharamshala, northern India, where I began to discover techniques to rewiring the mind to free it from all the clutter.

The mind is our true home. This is where the conscious lies. Instead of focusing on detoxing and cleaning our outer and physical space, why not try to exercise that mental space? We spent an hour at the gym, or 90 minutes at the yoga studio, giving our bodies that extra attention it needs to tone and redefine how it articulates in our daily lives. We eat clean and natural foods, free of GMOs, preservatives, and trans fats. But if the mind, (the chitta) the full consciousness that allows for a clear perspective on life and happiness, is unclean, unstable, then the rest doesn’t matter.

We’re not machines, but we often get caught up in what Jon Kabit-Zinn calls the “time urgency”. Where we are run by our thoughts that convince us that we have to do this and that to function and be happy. We spend all our time going through a checklist of things we need to do: pick up groceries, make dinner, do laundry, do this at work, call that person, write that email, do at least 45min of exercise, sleep at least seven hours. We create our own stipulations for how our lives must be or else we won’t be content. Often, healthy people are the worst at creating time urgency. They deliver standards for themselves to follow in order to be a good healthy person. They stress over if they’ve followed their guidelines, if they’ve gotten enough exercise, eaten well, or presented themselves to others in a holistic way to others.

We become convinced by our own ego-self (the ahamkara), our own sense of identity, that we need to be a certain way. We become attached to activities and rituals that we think we need to be the type of person we think we are, but it’s unnecessary. Peace begins from the mind.

Have you ever crossed paths with a Tibetan monk? Or looked at the Dalai Lama when he speaks? There’s a particular lightness in their presence. They look irrevocably happy, and content. The Tibetans may be refugees, and uprooted from their homeland, but I’ve crossed many a Tibetan monk’s path, and the glint in their eye brings peace to my soul. It’s not in the maroon robes, or shaved heads, or their diet, but in their minds that brings them that air of contentment.

The Tibetan Buddhists exercise their mind daily through meditations. They work towards quelling the fluctuations that make the majority of us seem scattered and strung out. The second aphorism in Patanjali’s yoga sutras: yoga citta vrtti nirodhah (yoga is the restriction of the fluctuations of consciousness). The fluctuations are constant. They are the alerts on your smart phone when you get a text, they’re the traffic jam, the line up for a coffee, the to-do list, the friends you have to see, the way you have to look. It’s everything that fluctuates, that doesn’t have permanence in this life.

When you’re laying in savasana, or even in bed at night, and your mind wanders into the fluctuations it prevents you from finding peace with the present moment. The tools are there to find peace, and it begins with meditation, whatever that means for you. It could be becoming mindful in daily chores, like doing the dishes, or it could be going for a long run to empty your mind. For some it’s sitting, practicing non-doing, for a length of time. Focusing on the breath, and tracking the thoughts as they pass by, but letting them go and not clinging to them. They’re just thoughts that we create, and we can let them go. Another opportunity to clear, or detox the mind, is to participate in a retreat. Like a vipassana or meditation retreat, where you refrain from speech and stray from your comforts, to dwell only on settling the consciousness. Many people think that not being able to speak for a week is impossible but consider it like a vacation from your self. You don’t have to think and conjure what to say to others. You simply live in peace with yourself, and spend quality time rediscovering the breath, and rewiring the mind. Think of it like defragging a computer. Every once and a while I used to defrag my old laptop, to put things back in order, delete old files, and clear space so that my electronic mind flowed smoothly again. Why don’t we do that with our own minds?

There are techniques that can be practiced daily, and discovered through retreats, yoga, mindfulness guru’s like Jon Kabat-Zin or Thich Nhat Hanh, that once you imbibe their qualities it’s like learning to ride a bike, you’ll never forget. There will be moments that you’re tested, but once you gain new perspective, and a method to still your mind, you realize that your thoughts are just thoughts and not really who you are. Try exercising your mind this spring, and find your method to be free and enjoy each moment as it is, as you are.

This Mineral Could Save Your Life

By Lisa Collier Cool
Up to 80 percent of Americans are jeopardizing their health by failing to get the recommended daily allowance (RDA) of a mineral that protects against heart disease, diabetes, osteoporosis, stroke, and other dangerous disorders. In fact, this essential nutrient—required by every cell in your body—is so often overlooked that it’s been dubbed “the forgotten mineral.”
Skimping on this crucial mineral—magnesium—could actually be fatal, a new study suggests. The researchers checked the magnesium levels of 7,664 initially healthy people (using urine tests), then tracked the participants for an average of 10.5 years. Those with the lowest urinary levels of magnesium were 70 percent more likely to die from heart disease, compared to people with higher levels, even after other cardiovascular threats were taken into consideration.
The researchers report that low magnesium levels are an independent risk factor for heart disease, while a diet that’s rich in this vital mineral may be protective.
Yet most of us eat a dangerously unbalanced diet that’s too high in calcium and too low in magnesium, a combination that may actually boost risk for heart attacks and strokes, according to another new paper.

Low Magnesium & Heart Disease Risk

The paper, which analyzes decades of peer-reviewed science, reports that low magnesium levels—not cholesterol or saturated fat—is the leading predictor of heart disease. The paper argues that medical research took “an early wrong turn” by ignoring studies dating back to 1957 showing that lack of this essential mineral may actually cause plaque buildup in arteries.
“This means we have been chasing our tails all of these years going after cholesterol and the high saturated-fat diet, when the true culprit was and still is low magnesium,” study author Andrea Rosanoff, Ph.D., Director of Research & Science Information Outreach Center for Magnesium Education & Research, in Pahoa, Hawaii, contends in a statement.
“It should be obvious that cholesterol isn’t the cause, since heart disease remains the leading killer of Americans, despite two decades of statin use,” adds Carolyn Dean, MD, ND, author of The Magnesium Miracle (Ballantine Books). Indeed, a 2009 study of more than 136,000 people hospitalized for heart attacks found that nearly 75 percent of had LDL (bad) cholesterol levels considered normal under national guidelines, and close to half had“optimal” levels.
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“Magnesium deficiency is the missing puzzle piece that explains why people with normal or optimal cholesterol—as well as those being treated with drugs to lower cholesterol—suffer heart attacks and strokes,” reports Dr. Dean.
“Not only is there very solid scientific evidence that magnesium helps prevent heart attacks, but there is also research showing that if one occurs, immediate treatment with magnesium can actually stop cell death and save lives,” Dr. Dean adds.
In a randomized study of 194 heart-attack patients, those treated with IV magnesium had one-fourth the in-hospital death rate compared to those who received a placebo, and also had lower rates of irregular heartbeats and congestive heart failure. A follow-up study by the same researchers also found that five years later, nearly twice as many in the placebo group had died from heart disease or other causes and those who survive had higher rates of impaired heart function.

Magnesium Helps Protect Against Chronic Disease

Magnesium plays a key role in more than 300 biological functions of the human body. It helps maintain healthy muscle and nerve function, supports the immune system, keeps bones strong, and aids regulation of blood sugar levels and blood pressure, reports the NIH’s Office of Dietary Supplements (ODS).
Potential health benefits of magnesium include:

• Reduced risk for type 2 diabetes, according to data from very large studies. That’s because magnesium plays a key role in carbohydrate metabolism and may influence the release and activity of insulin, according to ODS. Low levels of magnesium are common in diabetes and may also contribute to insulin resistance. Insulin resistance is the root cause of type 2 diabetes and implicated in 70 percent of heart attacks.
• Protection against osteoporosis, the brittle bone disease that leads to fractures, deformity and disability in older people, particularly women. Several studies suggest that taking magnesium supplements may boost bone density.
• Maintaining healthy blood pressure levels. A diet that’s high in fruits and vegetables, both of which are good sources of magnesium, has consistently been linked to lower blood pressure in large studies, including the well-known DASH (Dietary Approaches to Stop Hypertension) study.
• Reduced risk for coronary artery disease (CAD). Several studies have tied higher levels of magnesium to lower risk for CAD—clogged arteries that can lead to a heart attack. There is also evidence that getting enough magnesium may help prevent stroke and heart arrhythmias.

How much magnesium do you need?

The RDA is 400 to 420 mg. daily for men, and 310 to 320 mg. daily for women. For pregnant women, the RDA rises to 350 to 400 mg. daily, according to MedlinePlus. In the UK, the RDA is 700 mg. daily, the amount that Dr. Dean recommends to her patients.
Foods that are rich in magnesium include leafy green vegetables like spinach and beans, fruits like bananas and apricots, peas, nuts, seeds, whole grains, soy products, and some types of mineral water.
It is extremely common for Americans to have low levels of magnesium because most don’t eat the recommended amount of fruits and vegetables. These foods are also lower in the mineral than was the typical in the past, since today’s produce is often grown in magnesium-depleted soil.
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What are the warning signs of deficiency?

Symptoms of magnesium deficiency include chronic fatigue, weakness, insomnia, poor memory, mental fog, nausea, muscle cramps, tingling, and numbness. In more severe cases, people can experience seizures, abnormal heartbeats, and heart spasms.
Because these symptoms can overlap with those of other conditions, if you think you might be deficient, consult a healthcare provider, who can order tests to check your levels. Also talk to your provider before taking magnesium supplements, which can interact with certain medications.
If a supplement is advised, one type Dr. Dean recommends is magnesium citrate powder, such as Natural Calm (sold at most health food stores). However, the powder can have a laxative effect if you take too much at once, so she advises spreading the dosage through the day. If you prefer to take a pill, magnesium dimalate is available as a sustained release pill.