July 21, 2014

Ask the Doctors

I am confused at the moment. In your health columns over the years, and in much of the health literature, it’s been emphasized that saturated fats are unhealthy. We’re now seeing reports that state this isn’t the case. Could you please shed some light on the debate?

This is indeed an important topic. There has even been a recent cover article in Time magazine encouraging people to “eat butter”!* The debate regarding fats and cardiovascular disease, especially coronary artery disease, has raged for many decades, with protagonists on either side of the argument vehemently promoting their ideas. We remember these arguments from medical school—and that’s a few decades ago.

Recent studies have questioned whether too much emphasis has been placed on the role of saturated and especially animal fats in the causation of diseases of the heart and blood vessels.

Drawbacks and flaws, however, can be found in the analyses surrounding these health-related studies. They range from the sources of the various fats consumed to the general diet that individuals follow, even if they cut down on fats. For example, if individuals reduce their saturated fat intake but don’t pay attention to the kind of carbohydrates they eat, the health benefit of cutting down on fats may be neutralized by the harm caused by the consumption of refined carbo-hydrates.

When we speak about the dangerous fats or saturated fats, we mean those fats that are solid at room temperature and particularly those that are of animal origin.

Apart from the nuances of interpreting studies, it’s always helpful to revert to basic physiology when we wish to understand how the body works and how disease processes take place.

There’s an unfortunate hereditary disease that’s known as familial hypercholesterolemia. This is where individuals are born without the ability to process cholesterol appropriately in the body. This results from a basic abnormality in the liver cells that does not allow cholesterol to enter the liver and be metabolized. In this condition one sees premature and significant disease of the arteries occurring at early ages.

In our practices we have seen teenagers with advanced coronary artery disease to the extent that they required coronary artery bypass surgery before reaching adulthood! All these individuals have extremely high cholesterol levels in the blood.

Many treatments have been tried in the attempt to reduce this problem, but the most definitive and successful treatment known to date is liver transplantation. Familial hypercholesterolemia shows the indisputable relationship between elevated cholesterol levels in the blood and associated disease of the blood vessels, especially of the heart, brain, and legs (the latter often called peripheral vascular disease). So despite the many arguments that will no doubt continue to rage, the association between high cholesterol and vascular disease seems to be well established.

Interestingly, scientific literature is also debating whether it’s possible to be overweight and healthy. These thoughts have stemmed from certain studies that show that some individuals, although overweight, tend to do reasonably well following heart attacks.

It needs to be stressed again, however, that obesity is not only unhealthy but also has a strong correlation with vascular disease and type 2 diabetes. It seems as though we grab at straws to support the argument that suits our favorite position or our body habits!

Our answer to your question is basically a simple one: stick with a plant-based diet and avoid saturated fats. Avoid flesh food and use dairy products sparingly.

A huge amount of evidence proves that not only from the point of view of cardiovascular disease but also the prevention of type 2 diabetes and cancer, the avoidance of saturated fats and the wise use of a balanced plant-based diet are without doubt the very best plan.

This instruction was given to the fledgling Adventist Church in the mid-nineteenth century, and this position has been strongly upheld and reinforced by the extensive and well-performed Adventist health studies.

We also encourage you to bear in mind the counsel of God’s Word: “Have faith in the Lord your God and you will be upheld; have faith in his prophets and you will be successful” (2 Chron. 20:20).

Make healthful choices!

Coconut oil is in the news a lot, being touted as a “wonder oil.” I’m wondering whether it would be better than olive oil, and a suitable replacement for butter. I’ve also heard it helps one lose weight. What do you think of it?

You’re correct in that it is getting a lot of publicity. We recently found a Web site that listed 101 uses for coconut oil. That in itself would not be a problem, except many of the uses are medically oriented and, for the most part, either unsupported by any evidence or in some ways contrary to known physiological principles. Where touted for “hemorrhoids” or as a “skin moisturizer” little harm can ensue; although, again, the evidence for positive results is lacking. The products are promoted strictly on the basis of testimonials.

We see many products touted and promoted without any evidence to substantiate the claims. Our insistence upon “evidence” irritates some, but charlatans have hijacked so many people—including Adventists—that our stance is vindicated.

In the case of coconut oil, nine of the first 10 results of our Google search were selling either oil, books, or diets. Benefits, like so many of these panaceas, are imagined, or at the best not very specific to the coconut oil. Claims that it helps with weight loss seem certain to prove incorrect, as fats of all digestible varieties give some nine calories per gram. Claims for increased “mental alertness” would again rely upon subjective feelings and be difficult to prove. It’s also important to keep in mind the strong power of suggestion, proved by numerous scientific studies.

There is no credible evidence supporting coconut oil for weight loss, and because it is 90 percent saturated fat and raises cholesterol levels, it actually could be an unhealthful product. Superiority over butter has also not been demonstrated.

Coconut is an important cash crop in India, the Philippines, and Indonesia, and while we would not wish to hurt their economics, we cannot promote it as a health food or panacea.

When a person’s diet is at or below subsistence level, it is quite possible that the harmful effects of any oil are minimized. In societies consuming an excess of calories, the types of fat do assume greater importance because they contribute to fat storage in the body, some of which may be in our blood vessels. Saturated fats in general increase the LDL (low-density-lipoprotein cholesterol), which is associated with atheromatous change. (Atherosclerosis is the buildup of a waxy plaque on the inside of blood vessels.) Reduction of saturated fats to less than 7 percent of the daily caloric intake has been shown to reduce blood cholesterol levels by 5 to 10 percent.

We’re aware of the debate about cholesterol levels and heart disease and that some people doubt the traditional wisdom that high cholesterol levels are the cause of arteriosclerosis. In the same way that we ask for evidence for all these counterclaims, we look askance at unfounded claims for substances such as coconut oil. While we might believe that olive, sunflower, and canola oils have good properties, we would be skeptical about exuberant claims of benefit for any of them as well.

Balance, moderation, healthy skepticism, and caution serve us well in the minefields of sensational promotions.

Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected], While this column is provided as a service to our readers, Drs. la
ndless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.

*  http://time.com/2863227/ending-the-war-on-fat/