60. A Public Health Catastrophe

The UK government is currently gung ho about the “Responsibility Deal” in which various food companies have agreed to reduce saturated fat levels in a range of products in order to comply with the following pledge:

Recognising the role of over-consumption of saturated fat in the risk of

premature avoidable mortality from cardiovascular and coronary heart

disease, and public health recommendations to reduce saturated fat

consumption (to less than 11% of food energy for everyone over 5yrs of age,

compared to current levels of 12.7%)”(1).

According to The Guardian (2) these commitments include initiatives by

  • Tesco to take 32 tonnes of fat out of various products
  • Morrisons to reformulate to reformulate own-label spreads to remove 50 tonnes of saturated fat
  • Nestle to remove 3,800 tonnes of saturated fat from Kit Kats

It is confidently predicted by government ministers that these measures will help to reduce the incidence of heart disease despite the fact that rationale behind it does not stand up to rigorous examination. But of much greater concern, there are compelling reasons for concluding that not only will there be no improvement but that the incidence of many common diseases including heart disease and various cancers will increase.

Those who so confidently advocate this policy to lower saturated fat intake should provide an explanation of how it can be justified in the light of the following:

  • The intake of saturated fat was 56.7 g/day in 1969 but by 2000 it had fallen to 29.2 g/day (3).
  • In 1984 the official Committee on Medical Aspects of Food Policy (COMA) recommended that the saturated fat intake should be reduced from 20% of food energy to 15% as part of a strategy to reduce cardiovascular disease (4). This target was reached by 2000(5).
  • Over this period the incidence of obesity has continued to increase. In men it has doubled since 1993, which is when detailed information was first collected (6). Even more worrying is that since 1994 the incidence of diabetes has more than doubled for both men and women (7). People with diabetes have a much increased risk of developing a range of diseases including heart disease, various cancers and Alzheimer’s Diseases, which is often referred to as diabetes Type 3.

In view of the fact that the considerable success in reducing saturated fat in the past has been accompanied by a deterioration in public health standards, is it really credible to expect a further smaller reduction in the intake of saturated fat to have the opposite effect?

The reality is that the rationale for the recommendation to reduce saturated fat is fundamentally flawed. Essentially the case is that the death rate due to heart disease correlates with the level of cholesterol in the blood. Therefore, it is argued, if the cholesterol is lowered there will be a reduction in the risk of heart disease. This certainly does not follow. It is same as concluding that if there if the number of police in a locality is related to the crime rate that the criminality will be reduced by reducing the police presence. Furthermore the critical information about cholesterol is plain wrong because once a person reaches the age of about 60 which is when the vast majority deaths occur the higher the cholesterol the greater the life expectancy. This may not seem credible but there is plenty of good quality evidence to support this fact (8). The single justification for condemning saturated fat is that it lowers cholesterol and so any benefit is solely dependent on this have a beneficial effect.

Even this is very dubious because what is referred to as “saturated fat” is actually a family consisting of at least 30 different members with the number of Carbon atoms varying from 2 to 32. The effect on the cholesterol level varies from one to another and some do not have any effect whatsoever. What
seems to have been ignored totally by those who advocate a reduction in saturated is that many of the individual saturated fats are actually important nutrients, which play a vital role in the normal functioning of the body and, believe it or not, are present in human milk. Examples include:

  • Cell membranes which require saturated fats to be “waterproof” in order to function properly
  • The heart prefers the long chain fatty acids palmitic acid(16 Carbonss) and stearic acid (18 Carbons) to carbohydrates as a source of energy
  • The short and medium chain length fatty acids, which have up to 12 carbon atoms do not need to be emulsified by bile salts and so are rapidly absorbed into the blood stream from the small intestine. They are especially valuable because they boost the immune system and possess anti-microbial, anti-viral and anti-tumour properties. Lauric acid (12 Carbons) is particularly effective.

Many saturated fats are good sources of the fat soluble vitamins, which include Vitamin A, Vitamin D and Vitamins K1 and K2. The fats present in milk and meat are regarded as high in saturated fat, although this is not necessarily correct. However consumers frequently reduce their consumption of these foods in their attempts to lower the intake of saturated fat with the result that they miss out on a range of key nutrients.

On top of this, there is no doubt that as the amount of fat in the diet has declined there has been a corresponding increase in the carbohydrate intake. It is quite common for manufacturers to replace the fat with an alternative, which is often sugar. Even so the emphasis on fat has meant that there has been little attempt to reduce sugar and other refined carbohydrates. For example the “new” Kit Kat will have 15.9g of saturated fat but 49.5g sugar in a 100g portion.

There is growing evidence that many of our current public health problems are caused by not by fat or saturated fat but by excess sugar in the diet (9).

The case for reducing saturated fat just does not stack up. All the indications are that there are absolutely no convincing reasons that there will be any benefit. By contrast, those who attempt to comply with the recommendation, and many will have no choice because many foods are being re-formulated in response to pressure from the government, may well find that they are doing more harm than good. This may well turn out to be one of the most disastrous strategies in the history of publc health policy.

Finally here is a link to television programme broadcast in Australia on 24th October 2013, which features some of the relevant background and explains some of the reasons why we are all in such a mess.

http://www.abc.net.au/catalyst/heartofthematter/

 

 

REFERENCES

  1. https://responsibilitydeal.dh.gov.uk/wp-content/uploads/2013/07/Meeting-11-Saturated-Fat-Pledge.pdf
  2. http://www.theguardian.com/lifeandstyle/2013/oct/26/saturated-fat-cut-pledge
  3. http://webarchive.nationalarchives.gov.uk/20130103014432/http://www.defra.gov.uk/statistics/files/defra-stats-family-food-nfs-nutshist.xls
  4. Department of Health and Social Security (1984) “Diet and Cardiovascular Disease” London: HMSO
  5. http://webarchive.nationalarchives.gov.uk/20130103014432/http://www.defra.gov.uk/statistics/files/defra-stats-family-food-nfs-nfsexcan.xls
  6. Health Survey of England 2010 Adult Trend Tables.
  7. Health Survey for England 2009
  8. http://vernerwheelock.com/?p=105
  9. http://vernerwheelock.com/?p=234