Dietary Fats and their effects

The type of fats we consume in our diets and their effects on the health of our cardio-vascular system has become a controversial area in the last five years. Previously the issue seemed to be clear, the concepts easily explicable and easily understood: as much as possible it was considered wise to avoid ingesting saturated fats whilst unsaturated fat was considered to be relatively good for you. This generally understood position has come under considerable pressure in recent years from many interested groups. In the dietary world the pressure has originated from those advocating low-carb diets and such things as paleo diets.

Somewhat unfairly, all fats tend to have a bad name. As far as human health is concerned they are necessary and perform many important functions in the body: they help to maintain warmth, they keep hair and skin healthy and they are used by the body to store energy. Therefore, it is sensible to have some amounts of fats (preferably in the unsaturated form – see below) in your diet. Government guidelines in the West often talk in terms of 33% of diet being made up of fats. Doctor Esselstyn feels that this is far too high and prefers levels of under 10% for optimal heart health.

Fats are a complex and controversial issue, so in order to come to a clear understanding of the issues involved let us examine the facts.

Fats and their effects in the diet is a complex matter than one could spend many years studying and still not fully understand all the ramifications. In many ways the jury is still out on several of the main issues. For clarity's sake, and in order to have a clear if somewhat simplified understanding of dietary fats, we shall break them down into three main groups.

The first group are saturated fats. These are mostly obtained from animal 'products' such as meat, butter, milk and eggs. Not only will they tend to supply the body with excess low density lipids they will also lead over time and in most cases to weight gain and all manner of illnesses that are associated in the ingestion of large amounts these products (heart problems, diabetes, arthritis, etc). Consuming saturated fats will tend to increase the levels of low density lipids in your bloodstream. If you remember from the last post, LDLs are the more problematic form of cholesterol. According to Doctor Esselstyn, it would be wise as far as possible to keep the ratios of LDLs to HDLs as low as possible. This is almost impossible to achieve if one's diet consists of large amounts of saturated fats.

Saturated fats are solid at room temperature. They often look like the classical idea of fat when we picture such things – white, greasy and sticky.

The second group are trans fats or trans fatty acids to give them their full title. These are considered by many doctors to be the worst type of fat you can ingest. In the human body they have the effect of not only raising your bad cholesterol (LDLs) but also lowering your good cholesterol (HDLs). Obviously our desired ratio of 3:1 or better (LDLs to HDLs) will be negatively affected by this process.

Commercially, trans fat is created by adding hydrogen to vegetable oils by hydrogenating them. For commercial companies this has the benefit of making the oil less likely to spoil and hence prolonging shelf-life. The science behind the negative effects of these trans fats on the human body is not completely clear as yet but it is believed that adding hydrogen makes the oils more difficult to digest. They are a relatively new type of fat, hence the human body has had no time to ajust to them and seems to have little or no defence to their negative properties.

For commercial interests though the advantages are clear and hence there is a great reluctance on their part to stop using this process. Some governments around the world have actually made it illegal but most, probably because of pressure form self-interested commercial groups, have failed to legislate despite the very clear evidence of the harm that such fats do. To be fair on this issue, there have also been groups within the industry itself who have led the way and called for a ban on the use of hydrogenated fats. Not all commercial interests are irresponsible in this matter but at the time of writing those resisting change still have the ear of government (at least in the UK and the US).

Trans fats are to be found in many commercial baked goods such as crisps (known as chips in the US), crackers, biscuits (cookies), cakes and many fried foods. Shortenings and many margarines are often high in trans fats. Oddly, these very products often advertise themselves as 'healthy' because the actual amounts of fats involved is less than butter but, let the buyer beware, the type of fat they do not contain is anything but healthy!

The final groups of fats that we shall address today is Unsaturated Fats. These are normally sub-divided into polyunsaturated and monounsaturated fats. They are primarily found in fish, plant oils, nuts and seeds. Many believe that these fats lower your blood cholesterol and, by so doing, reduce your risk of cardiovascular disease. Dr Esselstyn tends to be quite conservative on this issue preferring to reduce the levels of even these less harmful types of fats down to a minimum. These fats maybe better for you than either saturated or trans fats but they are still fats! Intake therefore should be restricted if one wishes to maintain optimum health. I think it can be reasonably stated though that if you are to ingest fats these are the least harmful of the three groups but, even so, intake should be kept to a minimum.

Unsaturated fats, both mono and poly, remain in liquid form at room temperature.

Polyunsaturated fats have the additional benefit of containing Omega-3 fatty acids. This is an essential fatty acid. Such things are called essential because your body cannot create them itself and so must obtain them from dietary sources. Having adequate amounts of Omega-3, especially in relation to the amount of Omega-6 the body has, is considered essential for health, particularly heart health.

The main non plant-based sources of unsaturated fats are oily fish such as herrings, sardines, mackerel and salmon. If you are sticking to a plant-based diet then you need to look to sources such as hazelnuts, pumpkin seeds, sesame seeds, almonds and avocados. There are also many plant-based oils that are high in polyunsaturates such as olive oil, canola oil and sunflower oil. Esselstyn warns however against ingestion of such fats generally, even thought polyunsaturates are a lot better than saturated fat, and recommends against the use of any oils.

Sticking to the Esselstyn diet will involve the avoidance of fats generally. Whilst true that you do need some in your diet it is also the case that it is now thought to be far less than originally envisaged. Certainly recommending that a third of your diet should be fat would generally resist in problems for the body, the likelihood of putting on weight and subsequently vulnerability to such things as diabetes and heart disease.

Esselstyn's diet is not a moderate solution but having heart problems is not a moderate situation! Drastic steps are needed to counteract years of abuse that the body has often had to suffer. The good news is though, if you stick to the diet you will almost invariably quickly lose weight, look and feel healthier and, if all goes well, halt the progress of heart disease and, if adhered to strictly enough, you may even reverse it. This profound and fundamental change is what Esselstyn is offering. There are sacrifices but I think the results are well worth the things that one has to give up.