In a recent video by Gil Carvalho, he looks at a new review that focuses on the effects of substituting other calorie sources in place of saturated fat. The evidence would seem to weigh against saturated fat.
What is your opinion on this evidence?
He starts off with the assumption that eating more than 10% your calories from SFA increases your risk of CVD, and at some point the ‘risk’ remains the same if eat enough of it.
For epidemiology/observational studies:
He mentions the PURE study which shows no assosciation of all types of fat with cardiovascular events. In contrast, higher carbohydrate intake was associated with CVD events.
He mentions the UK Biobank study, which shows no association of SFA intake with CVD. It does say substituting PUFA’s with SFA increased risk. It also says higher carb consumption from sugar and starch increased CVD risk. It thinks the UK biobank “missed” the data that shows increased intake of SFA was associated with higher instances of death.. but that could be associated with life decisions (people who eat higher SFA might do more risky activities).
Another 2 Dutch studies found no association between SFA and CVD risk.
RCTs:
A PREMED study found that an unrestricted Mediterranean Diet(with a control group of low-fat), decreased risk of CVD compared to that of the Mediterranean low-fat diet.
A study looking at lipid levels found no reason to say we should be decreasing SFA’s.
A study in India found that using coconut oil to cook with for 2 years, which is high in SFA, did not change the occurence of CVD.
Metas/Systematic Reviews:
Meta and SR’s suggest that substituting SFA’s with PUFAs lowered CVD risk, also there were metas that found no change in risk.
(He goes on to say the analysis being done is not being done well enough. He goes on to say ‘high glycemic index carbs can only be ‘low quality carbs’),
He sites 2 observational study analyses with over 1million participants each show increased fat intake (SFA, MUFA, PUFA) correlates to increase all cause mortality.
He goes over the conclusion of the study he’s talking about… He thinks the study misses important studies that do show a risk and thinks the people who did the study really dropped the ball at analazing all available evidence and they didn’t know what they were doing (without justifying it).. He goes on to discredit the author who conducted the study based on the author’s background.
He says there is a high quality review that didn’t go ‘viral’ and didn’t get a lot of attention because it didn’t go against the grain.
Goes on to dispel talking points made by the meat community.
Take home message: focusing on one macronutrient is where the confusion is. Focusing on nutrition as the big picture is the way to go. Have your diet consist of 50% fruits and veggies, 25% whole grains, and 25% with some meat, but mostly nuts and seeds.
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The whole point of this is.. “does SFA increase risk of CVD”.. the studies presented show it doesn’t.. but replacing them might help lower risk. That doesn’t mean having SFA’s increase risk. Also, the 2 studies with over 1 mil participants are observational/epidemiology.. you can’t conclude that eating SFA’s causes an increase to all-cause mortality.. lifestyle bias IS a thing that isn’t accounted for nearly enough in these types of studies. He is a vegan doctor who is against eating meat (which has SFA).. it’s not surpirsing he wouldn’t reccomend eating meat.