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Welcome to February, Heart Month!

For years the medical community has told people to decrease their fat intake to prevent heart disease, but there have been three big problems with this approach.

First, it is hard to do. I spent years telling people to lower their fat intake, yet 95% of my own patients couldn’t do it. They weren’t satisfied, they developed cravings, and they couldn’t stick with it.

Second, I believe the benefits from low fat diets (like Pritikin, Esselstyn, and Ornish) has little to do with eating low-fat. Sure, they do get rid of some bad fat, which is good, but the real reason these eating plans are better than the SAD Standard American Diet is when they’re done right, they’re packed with fiber and they’re high in plant-based nutrients.

Third, although the low-fat diets do some things right, like getting rid of bad fats, they also get rid of smart fats – and that is actually pretty dumb. Smart fats have two BIG amazing benefits. They decrease inflammation and they improve hormone levels, in particular blood sugar and insulin. So when we cut out the Smart Fats, we become more inflamed and lose healthy hormone balance, too. And as the leading causes for heart disease are high blood sugar levels and inflammation, cutting out smart fats increases the risk for arterial plaque growth.

This does not mean eating more of any fat is good, (I am not saying that you should eat more ice cream, sausage, and French fries) but only add more fat if it is smart fat. So, what do I mean by smart fat?

What is a Smart Fat?
Smart fats have proven clinical benefits from published studies. For example, studies have shown that consuming more olive oil and nuts decreases the risk for cardiovascular disease. Hundreds of other studies suggest nuts and olive oil are good for your heart and help to slow overall aging. Wild salmon and sources of fish oil have proven heart benefits, plus they decrease inflammation and they are good for our brain. Dark chocolate, another smart fat, has been shown to have many benefits for blood pressure, overall cardiovascular health, and is also good for the brain. Monounsaturated food sources, like avocado, have been shown to improve both our cholesterol profile and help with insulin resistance.

So, nuts and nut oils, olive oil, cold water fish, dark chocolate, and avocado are clearly good for your heart and health, and can easily be called smart fats. Smart nuts with proven benefits include: almonds, pecans, walnuts, pistachios, hazelnuts, and macadamias.

What is a Bad Fat?
There are obvious examples of bad fats, such as partially hydrogenated fats (also called trans fats) that worsen cholesterol profiles, blood sugar control, and increase cancer risk. Hydrogenated fats are used by the food industry to extend the shelf life of food, but they shorten your life if you eat them.

Another example of bad fats are fats loaded with pesticides and hormones. Feed lots too often feed cows, pigs, and poultry pesticide-packed grain whose chemicals accumulate in the fat. When we eat the animal fat, we may get a big load of toxic fat. Feed lots may also load animals with growth hormones, and these hormones likely increase your risk for cancer.

So, to avoid bad fats, become a savvy shopper – read labels, and if you purchase meat and dairy, buy it from pasture raised, hormone-free, and grass-fed animals.

What are neutral fats?
The big surprise is that over the last few years, several large, powerful studies have shown that saturated fats are neutral, as in they have not been shown to increase the risk for heart disease. Examples of neutral fats are fats in organic cream, butter, grass-fed beef, and palm oil. Despite decades of health agencies attacking food sources of saturated fats, the most recent evidence suggests they are neutral to our health, not harmful and not beneficial. We would be much better off focusing on avoiding sugar and flour, which increase blood sugar levels and are strongly associated with heart disease, memory loss, and weight gain, than worrying about neutral food sources of saturated fats.

How is coconut fat different from animal fat?
Coconut oil is a bit different, as it is mostly saturated fat with different forms of saturated fat and some clear health benefits.

Consuming coconut oil:
• Boosts metabolism (calorie burning) in highly active people.
• Provides a terrific fuel source (medium chain triglycerides) for prolonged exercise sessions and for athletes.
• Has anti-microbial properties, helping to fight infections.
• Appears beneficial for cognitive function, and for people with neurological disease, as eating more saturated fat may protect the brain from injury.

Despite these benefits, there is still controversy with coconut oil as eating more coconut products increases cholesterol levels. It raises LDL particle size (considered good) and healthy HDL cholesterol levels (also good). The problem is we do not have any clinical outcome studies that show eating coconut is either neutral or beneficial, and at least once clinical study using coconut products showed that it decreased artery function, so there should be some hesitation in recommending coconut oil to people with established heart disease.

My recommendation is if you are in good health, or if you have neurological issues, then it’s smart to eat more coconut fats. However, if you have established heart disease or you are being treated by your doctor for abnormal cholesterol problems, I’d recommend that you consult with your doctor and avoid coconut fats and enjoy the many other heart-friendly smart fats recommended above.

Bottom Line
There are smart fats that benefit your heart and multiple aspects of your health and the latest scientific evidence shows that you do not need to follow a low-fat diet to protect your heart. Clearly some fats should be avoided, yet you should eat more nuts, nut oils, olive oil, cold water fatty fish, dark chocolate, and avocados. So, Bon Appétit!

I hope this helps you to make the best choices for your health.
Steven Masley, MD, FAHA, FACN, FAAFP, CNS


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