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.