Just Read: Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions

This peer-reviewed editorial, with what some would call a controversial title, was published in April, 2017 and has been widely reported on already. As I like to say, I’m not that smart and my ideas are not that unique :).

The piece is written by Dr. Aseem Malhotra (@DrAseemMalhotra), London-based cardiologist and a leading physician voice in challenging the paradigm of low-fat diets.

The piece is short enough that I don’t need to summarize it here. I have reviewed several of the papers cited, and Aseem relays his point of view and responses to critics in the attached podcast, which you can listen to here.

In a nutshell:

Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.Malhotra A, Redberg RF, Meier P Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions Br J Sports Med 2017;51:1111-1112.

The idea to be put aside/exploded is the one that eating saturated fat coats arteries until they clog. Instead, inflammation creates plaques that rupture and cause blockages. Two very different processes.

Read carefully

  • The piece is not advocating for a high saturated fat diet
  • The piece is not advocating the abandonment of everything we’ve told has been healthy, it is adding evidence on what to focus on
    • Brisk walking is called out (even though exercise has not been shown to reduce weight, it has a zillion other advantages)
    • Impact of stress, and stress during childhood. This has also been well studied, and from what I can tell, underemphasized as an important cause of poor health, still.
  • All foods with fat including ones with healthy fats have saturated fat
  • The Standard American Diet (SAD) has most of its saturated fat coming from processed foods. This is bad.
  • As has been pointed out many times, the evidence for eating a low-fat diet isn’t really there

As I looked around for opposing views, I found a well written piece that challenged the assumptions presented here, citing the same studies. Then as I got to the bottom of the piece I saw significant conflicts of interest. I’ll leave it at that.

Heart Healthiness

As I have walked the aisles of my grocery store, I can see that our society has not caught up to the science. The piece and the studies it cites are worth a read.

2016.10.29 Heart Health and Diet 3311
2016 leftover from a bygone era, when high carbohydrate diets were king – 2016.10.29 Heart Health and Diet 3311 (View on Flickr.com)
2016.10.29 Heart Health and Diet 3312
What do you notice about the shape of the cereal bowl and does the evidence support it… 2016.10.29 Heart Health and Diet 3312 (View on Flickr.com)


In the meantime, I plan to also keep walking 🙂

#activetransportation ❤️ DC 🚶#instaDC #DCAlleyMuseum #Shaw
#activetransportation ❤️ DC 🚶#instaDC #DCAlleyMuseum #Shaw (View on Flickr.com)
Ted Eytan, MD