Why demonising fat is daft…

by Zoë Harcombe

Last week the British Medical Journal carried a stinging indictment of decades of dietary advice. ‘Scientific evidence shows that advice to reduce saturated fat intake’ wrote cardiologist Dr Aseem Malhotra, (Saturated fat is not the major issue) ‘has paradoxically increased our cardiovascular risks.’ The article was picked up by UK newspapers and others around the world even though he wasn’t saying anything new.

But for me and other real food and real fat campaigners like American Dr Michael Eades and Jo Blythman over here, who have known this and used it to help people for years, it was like winning the lottery. We all metaphorically laughed and clapped our hands, delighted. Why?

Because it had been published in the British Medical Journal. Because it had been written by a cardiologist – an NHS employee challenging the discredited standard model, which all medics are expected to sign up to. Because it’s just so flipping wonderful to see such common sense about real food when in the real world it is anything but common.

Questioning fat’s bad rap in obesity

Dr Malhotra went further than defending saturated fat and questioned the bad rap that fat gets in obesity because it contains twice as many calories as carbohydrates. He highlighted the link between demonising fat and the idea that the way to stave off heart attacks was by lowering cholesterol with life-long prescriptions of statin drugs and their associated side effects.

But then, normal business was resumed just three days later when Public Health England made this announcement: “Thousands of tonnes of saturated fat to be taken out of the nation’s diet.” Public Health Minister, Jane Ellison, launched the “Responsibility Deal Saturated Fat Reduction Pledge.”

For those of you not familiar with the “Responsibility Deal”, this is the genius government plan to place the food industry in pole position in the attempt to solve the obesity epidemic. The primary cause of the obesity epidemic is modern processed food, so let’s get the makers of this modern processed food at the heart of our obesity strategy.

Get rid of fake foods

Yes – it is just like putting the cigarette manufacturers in charge of smoking cessation policy. Food giants exist to make profit for shareholders. It is not their job to set public health policy. It is the job of government to know this and to set public health policy itself. There should be a serious tension between the Department for Employment and the Department for Health – one trying to protect food industry jobs and the other recognising that the health of the nation would be best served by fake food ceasing to exist.

But with a headline grabbing analogy, the latest public health minister (they change with the seasons), Jane Ellison, announced that “more than one and a half Olympic size swimming pools of saturated fat will be removed from the nation’s diet over the next year…”

This is so ignorant, it’s difficult to know where to start:

Five things that Public Health England should know about saturated fat

1) There are three dietary fats: saturated; monounsaturated and polyunsaturated. All fats are made up of chains of carbon atoms (chemical symbol C) with hydrogen atoms attached (chemical symbol H). They have a COOH group at one end (carbon, oxygen, oxygen and hydrogen). It is differences in the way these atoms are arranged that gives each fat its different qualities. The more hydrogen they have the more stable they are.

  • Saturated fats have all available carbon bonds filled with (i.e. saturated with) hydrogen. Saturated fats are solid at room temperature.
  • Unsaturated fats have pairs of hydrogen atoms missing. Monounsaturated fats have one double bond in the form of two carbon atoms ‘double-bonded’ to each other and, therefore, lack two hydrogen atoms. Monounsaturated fats are liquid at room temperature.
  • Polyunsaturated fats have two or more double bonds and therefore lack four or more hydrogen atoms. Polyunsaturated fats are liquid at fridge temperature.

Saturated fats are therefore the most stable fats and the safest ones to cook with (this is a factual statement about chemical structure). This is because at high temperatures they are less likely to change structure, creating unwanted effects, unlike unsaturated fats.

2) All foods that contain fats contain all three fats – there are no exceptions. Fat is found in most real food (that should tell us something for starters!) All meat, fish, eggs, dairy products, nuts, seeds, avocados and olives contain fat, as do some other foods – even grains. Every single food that contains fat contains saturated, monounsaturated and polyunsaturated fat. Only the proportions vary. (Food for Thought: Have We Been Giving the Wrong Dietary Advice?)

3) The NHS list of saturated fat is primarily a list of processed carbohydrates. Cakes, biscuits, pastries, pies, ice cream, confectionery, savoury snacks etc are extremely likely to be bad for us, but not because of any natural saturated fat they contain but rather because of the sugar, flour, vegetable oils and myriad of ingredients that you won’t be able to pronounce, let alone recognise. Demonise these fake foods by all means, but stop ignorantly calling them saturated fat.

4) There is only one food group on the planet with more saturated than unsaturated fat – dairy products. Meat, fish, eggs, nuts, seeds, avocados, olives – even lard! – all have more unsaturated than saturated fat. Which is not to say that one real fat is better or worse than any other but just to set the record straight.

So if you are going to warn people away from saturated fat you are warning them away from  dairy products, which are vital for optimal health. This quickly leads to contradictory statements. At the same time the Public Health Minister was promising to banish swimming pools of fat,  England’s Chief Medical Officer was promising action on the re-emergence of rickets in children (Prevention pays our children deserve better). And what might protect against children’s bone problems? The saturated fats in dairy products that contain such priceless bone nutrients as calcium, phosphorus and vitamin D.

5) We don’t even know HOW saturated fat could raise cholesterol, let alone that it does.

Chair of the Responsibility Deal Food Network, Professor Susan Jebb said: “…too much saturated fat can increase cholesterol levels and cause heart disease and premature deaths.” (Jonathan Edwards would be proud of that triple jump!)

But how can saturated fat (actual saturated fat – not cakes, biscuits, pastries i.e. processed junk, which is predominantly carbohydrate) raise cholesterol? Indeed, how can any real dietary fat (saturated, monounsaturated or polyunsaturated) raise cholesterol? I’ve totally failed to find a biochemist who can explain this. In fact studies have found that countries that eat more saturated fat have lower rates of heart disease.

It may surprise you to know that the correlation between cholesterol levels and rates of heart disease is also inverse – the higher the population cholesterol levels, the lower the deaths from heart disease and the lower deaths from any cause for both men and women. Here’s the data from the World Health Organisation for 192 countries . (Cholesterol & heart disease – there is a relationship, but it’s not what you think)

We’d love Professor Jebb to explain to HealthInsightUK readers how saturated fat causes heart disease.

Zoë Harcombe

Zoë Harcombe

Zoë Harcombe is a qualified nutritionist, with a degree in mathematics and economics, who is dedicated to solving the obesity crisis. The plan was set out in one of her books The obesity epidemic: What caused it? How can we stop it? She blogs about it at theharcombediet.com and zoeharcombe.com
Zoë Harcombe

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  • Zoe,Influential National Health Directors in UK and Ireland just don’t get it. They are blind and deaf to the widely distributed factual and healthful information before their eyes !

    My offered “A REVIEW OF THE OBESITY CRISIS”several years ago was completely ignored, while they continued to promote their unhelpful health directives and misguided food policy in the name of health ! Dr Neville Wilson-Ireland.

  • Is Zoe Harcombe saying dairy products are vital for adult’s as well as children’s optimal health?

  • Hi Dr Wilson – I’ve recently come across your great work via Twitter. It’s so fab to have someone thinking and writing the way you do in Ireland. May they listen to you or suffer the consequences!
    Very best wishes – Zoe

  • Zoe,

    This is a good summary of the case against the anti-fat campaign. I would however appreciate some justification of the statement that “dairy products…are vital for optimal health.”

    I have three problems with this assertion: (1) Conceptual (Why should the milk of one species be vital for the health of adults of another?) (2) Empirical (There are many examples of societies with dairy-free diets enjoying excellent health – e.g. the Okinawans.) (3) Practical (I’m lactose intolerant, avoid dairy, and enjoy excellent health.)

    Many thanks.

  • Zoe, excellent article as always. Doctor Malhotra is to be highly praised for his standpoint on fat; alas I’m sure the powers that be will have other plans for him.
    Here is an extract from CNN money from Oct 2012:
    {As the price of corn has climbed, farmers either sold off their pigs and cattle, or they found alternative feeds,” said Mike Yoder, a dairy farmer in Middlebury, Ind. He feeds his 400 cows bits of candy, hot chocolate mix, crumbled cookies, breakfast cereal, trail mix, dried cranberries, orange peelings and ice cream sprinkles, which are blended into more traditional forms of feed, like hay. The farmer said that he goes over the feed menu every couple of weeks with a livestock nutritionist who advised him to cap the candy at 3% of a cow’s diet. He said that the sugar in ice cream sprinkles seems to increase milk production by three pounds per cow per day. Sugar also helps to fatten up beef cattle, according to livestock nutritionist Chuck Hurst, owner of Nutritech, Inc., in Carmen, Idaho},
    It is also interesting that the appoximate animal feed macronutrint composition for cattle fattening is extremly close to the reccomended diet for humans to stay slim.

  • Hi Eric
    It’s vital that we get the nutrients that dairy products provide. If people avoid dairy for various reasons, then it is vital that the dairy nutrients are obtained elsewhere. Hopefully the word vital will provoke people into realising that nutrients are not optional.

    The most important of your three points, in my view, is the lactose intolerance and I write extensively about this. It’s strongly related to ethnic origin, so true lactose intolerance in white Europeans is relatively rare – much more common in Asians. As you avoid dairy products, hopefully you consume approximately 200-250g of sardines (bones and skin) daily to get the calcium, vitamin D and phosphorus you need for bone health.

    On point (2) there are communities that consume relatively little in the way of dairy but any populations that remain entirely dairy free are almost certainly non-modernised generally and therefore the main health benefit will be the absence of modern processed food. The Okinawans have pork and goat as key dietary components. Goats milk and cheese comes free with goats – they even enjoy goat’s ice cream! Okinawans also benefit from the absence of junk and probably smoking and stress and sugar and all sorts of things that we have in the ‘developed’ world. It is not possible or reasonable to attribute any excellent health enjoyed by Okinawans to being dairy-free – not least because they aren’t.

    Point (1) is a standard vegan argument, which I’ve never understood. It matters not to me where milk comes from. It matters that it contains the majority of the 13 vitamins and c. 16 minerals that humans need for health. Why would it contain what humans need if we weren’t meant to consume it?

    This wasn’t what the article was about anyway – it was about saturated fat and the fact that our governments don’t know saturated fats from processed carbs.
    Best wishes – Zoe

    • Zoe

      Thanks for your detailed response.

      Point conceded on the Okinawans.

      On point (2), there are good reasons (Lindberg, Cordain, et. al.) based on biochemistry to be skeptical on the health benefits of milk. (I’m not vegan.)

      I do agree with the assertion in your reply that “It’s vital that we get the nutrients that dairy products provide.” However, in your original post what you said was that it is the dairy itself that is “vital”. On that point I don’t agree.

      But as you say, this was not the point of the article, which I enjoyed reading and plan to forward on to friends.

      Kind regards,


      • Great article Zoe and fair play to Dr Malhotra!
        I would also question the emphasis from certain quarters on the need for so much dairy in our diets. At the risk of being implicated in a conspiracy theory, there is a huge industry benefiting from their sales. Getting back to basics – mother nature intended milk to be ingested primarily by calves, so I tend to advise my patients not to avoid dairy products, but consider reducing them, especially if they have issues with excess catarrh (I also tell them to observe the effects of refined sugar and flour, as these can also increase catarrh production). I also recommend that patients (especially Osteoporotic) go easy on cheese, as paradoxically it has been suggested that it’s effect on internal pH can deplete the skeleton of Calcium.(Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc. 1995 Jul;95(7):791-7). You correctly point to the importance of vitamin D in our diet and that diary is a good source. Our deficiency of this essential vitamin, however, has been significantly increased by our fear of the sun and our overuse of sunscreens (from which another large industry profits).
        Keep up the good work & invaluable debate!

  • Off topics indeed but just a curious side note about lactose intolerance. I am asian and my wife is French. As a child and adolescent, I never had any other dairy product than powder or sugared & concentrated milk. When married, I begin drinking milk and eating cheese for about 10 years without any intolerance. Then comes the intolerance (systematic diahree) with liquid milk but not with powder milk or cheese (any cheese is ok). So for about 8 years, I avoided milk, assuming that with age comes a mild intolerance. But about 3 years ago, I seperenditously discovered that I not intolerant to liquid milk anymore so I can enjoy the same breakfast like my wife again. Go figure for lactose intolerance !
    Which leads me to conclude the obvious to probably most readers of your blog : we know so few about nutrition!

  • It was a delight to read Dr. Malhotra’s report but so short lived after the Public Health announcement – the public are now utterly confused. So what will the food industry be adding to processed food now? In attempting to eliminate hydrogenated fats they used palm oil, a saturated fat, but interesting that after years of demonising saturated fats this happened without much comment.

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