Dr. Jim Painter PhD, RD

The Fat Theory of Heart Disease Etiology Total fat isn’t the issue Saturated fat doesn’t seem to always be harmful

1. Replacing saturated with linoleic acid may not work 2. Replacing saturated fat with omega-3 may provide the benefit

Saturated at within the whole food complex may be neutral Coconut oil Dairy fat within dairy foods

2015 Dietary Guidelines

The Seven Countries Study is the cornerstone of current cholesterol and fat recommendations and official government policies

Keys had data available from 22 countries----- only used data from 7 countries that supported his hypothesis

Bowden, J., & Sinatra, S. (2012). The Great Cholesterol Myth. Beverly, MA: Fair Winds Press.

British physician Malcolm Kendrick used same data available to Keys and discovered that by choosing different countries you can prove an inverse relationship

Fat and cholesterol intake

Risk of Heart Disease

Bowden, J., & Sinatra, S. (2012). The Great Cholesterol Myth. Beverly, MA: Fair Winds Press.

The Snackwell Phenomenon Food companies rushed to create low-fat versions of all foods and market it as “heart healthy” Butter was replaced with margarine which is high in trans fat! Vegetable oils were aggressively promoted as a healthy alternative to saturated fat most vegetable oils are highly processed, pro-inflammatory, and easily damaged when reheated repeatedly

Bowden, J., & Sinatra, S. (2012). The Great Cholesterol Myth. Beverly, MA: Fair Winds Press.

The US Federal Guidelines recommend for heart health: • Following a Mediterranean style diet • Limiting total fat to 20-35% of total calories

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MeDiet + EVOO MedDiet + Nuts Control Diet

Intake of Energy

Baseline End of Trial

Primary End Point (Acute Myocardial Infarction, Stroke, or Death from Cardiovascular Causes

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Consumers(n=39)

Students (n=40) Faculty (n=17)

Dietary Fat as a Major Contributor of Heart Disease

Dietary Fat as a MajorContributor of HeartDisease

2015 Heart Disease Risk Factors Perceptions- Total Dietary Fat

Are they really the villains everyone says?

Nurses Health Study

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Intake (lowest to highest)

TransSatsMonoPoly

2003

Saturated fat improves good cholesterol more than other fatty aids, suggesting it may reduce risk of heart disease.

Change in: Bad Cholesterol: LDL Good Cholesterol: HDL

Total HDL Cholesterol Change

2010

Changes in Total Cholesterol: HDL-C Ratio for Consumption of SFA, MUFA, PUFA, and TFA

2016

Linoleic Acid and Saturated Fat Composition of MCE Control and Intervention Group Diets

Baseline Intervention Control

Changes in Serum Cholesterol in Intervention and Control Groups

Meta-analysis for mortality from coronary heart disease in trials testing replacement of saturated fat with vegetable oils

rich in linoleic acid

I. Balance Omega-3 and Omega-6 Fatty Acids

Effects: Reduction of high blood pressure Prevents vascular clotting Lowers triglyceride levels Reduction of atherosclerosis Anti-inflammatory effects

PresenterPresentation NotesConsumption of omega-3 fatty acids may reduce the risk of coronary heart disease.

Why do they help? It may be directly related to antiatherogenic functions of the fatty acids platelet aggregation and adhesiveness.Or helps indirectly through their modification of risk factors associated with CVD.

Omega-6 Omega-3 Arachidonic Acid EPA/DHA Cyclooxygenase pathway PGE2 PGE3 Pro-inflammatory anti-inflammatory

Process of Inflammation

Omega-3 Intervention Studies

Gissi et al. 1999

11,324 0.850-0.882 g/d of EPA + DHA for 3.5 years

Decreased CVD death and non-fatal MI

Von Schacky et al. 1999

223 6 g/d fish oil; 3 months 3g/d fish oil; 21 months

Decreased CVD death, fatal and non-fatal MI

Singh et al. 1997

360 1.8 g/d EPA + DHA for 1 year

Decreased cardiac deaths and non-fatal MI

Burr et al. 1994

227 3 g/d fish oil for 2 years

Decreased CHD deaths

Study N Treatment Results

Gissi et al.

1999

11,324

0.850-0.882 g/d of EPA + DHA for 3.5 years

Decreased CVD death

and non-fatal MI

Von Schacky et al.

1999

223

6 g/d fish oil; 3 months

3g/d fish oil; 21 months

Decreased CVD death, fatal and non-fatal MI

Singh et al.

1997

360

1.8 g/d EPA + DHA for 1 year

Decreased cardiac deaths and non-fatal MI

Burr et al.

1994

227

3 g/d fish oil for 2 years

Decreased CHD deaths

Sources: Omega-3 Fatty Acids Common sources:

Fatty fish and fish oil Marine plants Canola oil Flaxseed Soybeans Many nuts and seeds

Sources: Fish and Seafood

Sardines (in oil, cooked) 3.3g Mackerel, Atlantic 2.5g Trout, lake 1.6g Salmon, pink 1.0g Oysters, Pacific 0.6g Tuna 0.5g Shrimp 0.3g Lobster 0.2g

Omega-3’s in 3.5oz, raw

Coconut oil 92% saturated fat 50% form MCT Most past studies used hydrogenated coconut, which contains trans fats Helps increase absorption of calcium and magnesium Also contains short chain fatty acids

Impact of Coconut Milk and Soy Milk on Lipid Profile....

HDL LDL

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Dairy Fat

Dairy Foods and Milk Fat on Heart Disease

Dairy Foods and Milk Fat on Heart Disease

2009

Dairy Fat and Heart Disease

Dairy Fat and Heart Disease

Conclusions: …there is no clear evidence that diary food consumption is consistently associated with a higher risk of CVD. Thus, recommendations to reduce diary food consumption irrespective of the nature of the dairy product should be made with caution.

German, et al. 2009

PresenterPresentation NotesIntro – animate/pop out conclusion

2010

Conclusions: Milk fat biomarkers were associated with a lower risk of

developing a first MI, especially in women.

2011

Conclusion: This ..meta-analysis of prospective studies indicates that milk

intake is not associated with total mortality but may be inversely

associated with overall CVD risk...

PresenterPresentation NotesSeparate papers, one per slide

Symposia of: Eurofed Lipids Congress (2014) –France) Dairy Nutrition Annual Symposium (2014-

Canada) American Society for Nutrition (2015 –USA) Experimental Biology (2015 –USA) Federation of European Nutrition Societies

(2015 –Germany)

“The emerging scientific evidence indicates that the consumption of regular fat dairy foods is not associated with an increased risk of cardiovascular disease”

October 28, 2015

Conclusions: Total and especially full-fat dairy food intakes are inversely and independently associated with metabolic syndrome in middle-aged and older adults, associations that seem to be mediated by dairy saturated fatty acids. Dietary recommendations to avoid full-fat dairy intake are not supported by our findings.

PresenterPresentation NotesAnimate, find the real one who’s being quoted.FIND ARTICLE!!! Total and full-fat, but not low-fat, dairy product intakes are inversely associated with metabolic syndrome in adults

2015

Dairy’s Role in Cardiovascular and Metabolic Health Recognized by DGA’s Advisory Committees 2010 and 2015

“Moderate evidence also indicates that intake of milk and milk products is associated with a reduced risk of cardiovascular disease and type 2 diabetes and with lower blood pressure in adults.”

“Consumption of dairy foods provides numerous health benefits, including lower risk of diabetes, metabolic syndrome, cardiovascular disease and obesity.”

-2015 Dietary Guidelines Advisory Committee Report

-2010 Dietary Guidelines Advisory Committee Report

Here is the answer When someone asks if _________ is good for me to

eat. Compared to what?

Conclusion saturated fat! Saturated fat may not be the main cause of CVD Replacing sat fat with linoleic acid isn’t effective Omega-3s may be the effective substitute for saturated fat Coconut oil may be neutral or beneficial Full fat milk is back

No more ice milk. Eat Haagen-Dazs! Remember the power of cheese!!

Thank You!

Thank you!

jimpainterphd@gmail.com

mailto:jimpainterphd@gmail.com

Saturated and Unsaturated FatsThe Fat Theory of Heart Disease EtiologyI.) Total Fat Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Primary End Point (Acute Myocardial Infarction, Stroke, or Death from Cardiovascular CausesSlide Number 13II.) Saturated Fat: Coconut oil & ButterSlide Number 15Nurses Health StudySlide Number 17Slide Number 18Slide Number 19Slide Number 20Slide Number 21Slide Number 22Slide Number 23Slide Number 24Linoleic Acid and Saturated Fat Composition of MCE Control and Intervention Group Diets Changes in Serum Cholesterol in Intervention and Control Groups Slide Number 27Meta-analysis for mortality from coronary heart disease in trials testing replacement of saturated fat with vegetable oils rich in linoleic acid I. Balance Omega-3 and Omega-6 Fatty AcidsSlide Number 30Omega-3 Intervention StudiesSources: Omega-3 Fatty AcidsSources: Fish and SeafoodCoconut oilSlide Number 35Slide Number 36Slide Number 37Impact of Coconut Milk and Soy Milk on Lipid Profile....Slide Number 39Slide Number 40Slide Number 41Slide Number 42Slide Number 43Dairy Foods and Milk Fat on Heart Disease�Dairy Fat and Heart Disease�Slide Number 46Slide Number 47Slide Number 48Symposia of: Dairy Fat Inversely Associated with Metabolic Syndrome�Slide Number 51Dairy’s Role in Cardiovascular and Metabolic Health Recognized by DGA’s Advisory Committees 2010 and 2015Here is the answerConclusion saturated fat!Thank You!Questions?