It's the ultimate betrayal, akin to the flat earth theory that inexplicably gained traction in the 21st century despite clear and indisputable proof of the opposite. See how the American Heart Association is using selective interpretation of the evidence to pull the wool over your eyes.
AHA Renders Itself Obsolete With Long-Refuted Dietary Advice
According to the American Heart Association (AHA), saturated fats such as butter and coconut oil should be avoided to cut your risk of heart disease
Replacing saturated fats with polyunsaturated fats such as margarine and vegetable oil might cut heart disease risk by as much as 30%, about the same as statins, the AHA claims
The AHA bases its outmoded conclusions on four studies dating back to the 1960s — studies shown to have problematic performance biases
This article was previously published July 5, 2017, and has been updated with new information.
For well over half-century, a majority of health care officials and media have warned that saturated fats are bad for your health and lead to obesity, high cholesterol and heart disease. The American Heart Association (AHA) began encouraging Americans to limit dietary fat in general and saturated fats in particular as far back as 1961.
Like its previously revised version, the current version of the U.S. Department of Agriculture's food pyramid, called "MyPlate,"1 more or less eliminates fats altogether, with the exception of a small amount of low-fat or no-fat dairy. According to MyPlate, the food groups are fruits, vegetables, grains, protein and dairy — not the three biological building blocks known as carbohydrates (fruits, vegetables, grains), protein and fats.
All the while, studies have repeatedly refuted the wisdom of these low- to no-fat recommendations. Even so, the AHA has spent the past decade issuing warnings reminiscent of the 1960s all over again.
If you've followed the news, you’ve seen bold headlines declaring coconut oil dangerous, and that you should switch from butter to margarine to protect your heart health! How is this even possible? It's akin to the flat Earth theory that inexplicably gained traction despite clear and indisputable proof that we indeed live on a planetary sphere.
Many have expressed confusion and bewilderment in response to the AHA's margarine push, and no wonder. Let's not forget that creating doubt is a core strategy used by industry to delay change. This margarine-promotion also happens to conveniently sync up with news about a vaccine to lower cholesterol2,3 — a strategy that would be unnecessary if people were to just eat healthy saturated fats like coconut oil and butter, and eliminate processed foods and sugar.
The vaccine first made news in 2015,4 but nearly seven years later, in October 2021, researchers were lamenting that the vaccine was still in trials, and that although significant reductions in LDL were observed in mouse studies, there were still concerns about the cost, limitations of shelf-life and safety that were holding it back.5
AHA Sends Out Warning to Cardiologists Around the World
According to the AHA,6 saturated fats such as butter and coconut oil should be avoided to cut your risk of heart disease. Replacing these fats with polyunsaturated fats such as margarine and vegetable oil might cut heart disease risk by as much as 30%, about the same as statins, the AHA claims.
This “Presidential Advisory” was sent out to cardiologists around the world, not just to those in the U.S. Overall, the AHA recommends limiting your daily saturated fat intake to 5 to 6% of daily calories or less.7 According to The Daily Mail:8
"The scientists analyzed all available evidence on the subject and found saturated fat — such as that found in butter, whole milk, cream, palm oil, coconut oil, beef and pork — was linked to an increased risk of heart disease.
Replacing this with polyunsaturated fat — found in spreads and vegetable oils — or monounsaturated oils found in olive oil, avocados and nuts — cuts the risk of heart problems. The study … bolsters NHS advice that saturated fat should be lowered in the diet.
Lead author professor Frank Sacks, of Harvard School of Public Health, said: 'We want to set the record straight on why well-conducted scientific research overwhelmingly supports limiting saturated fat in the diet to prevent diseases of the heart and blood vessels. Saturated fat increases LDL — bad cholesterol — which is a major cause of artery-clogging plaque and cardiovascular disease' …
The authors, however, warned that not all margarines and spreads are healthy. They found that some forms of margarine which use 'trans fats' — a type of fat which improves shelf life — actually raise the risk of heart disease."
Victoria Taylor, senior dietitian at the British Heart Foundation, also made sure to note that "lifestyle change should go hand in hand with taking any medication prescribed by your doctor; it shouldn't be seen as one or the other." In other words, don't think you can avoid statins simply by eating right.
Then, referencing coconut oil specifically, the AHA added: "Because coconut oil increases LDL cholesterol, a cause of CVD [cardiovascular disease], and has no known offsetting favorable effects, we advise against the use of coconut oil."9 USA Today announced that advisory with a June 16, 2017, nonsensical headline, "Coconut Oil Is About as Healthy as Beef Fat or Butter."10
Why, yes, it is! But what they were trying to claim was that all of these are unhealthy, which is altogether backward and upside-down. It didn’t take long for USA Today to realize its faus pax, though, so it changed the headline June 21, 2017, to “Coconut Oil Isn’t Healthy. It’s Never Been Healthy.”11
While the newspaper noted the “correction” on its webpage, all references to the original headline have been scrubbed from the internet archive, Wayback.12 So much for transparency in newspaper reporting.
On What Evidence Does AHA Base Their Recommendation?
How did the AHA come to the conclusion that they were right about saturated fat 60 years ago and have been right all along? In short, by cherry-picking the data that supported their outdated view. As noted by American science writer Gary Taubes in his extensive rebuttal to the AHA's advisory:13
"The history of science is littered with failed hypotheses based on selective interpretation of the evidence … Today's Presidential Advisory … may be the most egregious example of Bing Crosby epidemiology ['accentuate the positive and eliminate the negative'] that I've ever seen … [T]hey methodically eliminate the negative and accentuate the positive until they can make the case that they are surely, clearly and unequivocally right …
[T] he AHA concludes that only four clinical trials have ever been done with sufficiently reliable methodology to allow them to assess the value of replacing SFAs with PUFAs (in practice replacing animal fats [with] vegetable oils) and concludes that this replacement will reduce heart attacks by 30 percent …
These four trials are the ones that are left after the AHA experts have systematically picked through the others and found reasons to reject all that didn't find such a large positive effect, including a significant number that happened to suggest the opposite …
They do this for every trial but the four, including among the rejections the largest trials ever done: the Minnesota Coronary Survey, the Sydney Heart Study and, most notably, the Women's Health Initiative, which was the single largest and most expensive clinical trial ever done. All of these resulted in evidence that refuted the hypothesis. All are rejected from the analysis."
Taubes, an investigative science and health journalist who has written several books on obesity and diet, points out that this advisory document actually reveals the AHA's longstanding prejudice and the method by which it reaches its conclusions.
In 2013, the AHA released a report14 claiming "the strongest possible evidence" supported the recommendation to replace saturated fat with polyunsaturated fats (PUFAs). This, despite the fact that several meta-analyses, produced by independent researchers, concluded the evidence for restricting saturated fats was weak or lacking.
The advisory document reveals how the AHA could conclude they had the "strongest possible evidence." Then, as now, they methodically came up with justifications to simply exclude the contrary evidence. All that was left — then and now — were a small number of studies that support their preconceived view of what they think the truth should be.
AHA's Referenced Studies Are Based on Outdated Science
Would it surprise you to find out that the four studies that made the cut all date from the 1960s and early 1970s? It makes sense, doesn't it, since those are the eras when the low-fat myth was born and grew to take hold. The problem is nutritional science has made significant strides since then.
As noted by Taubes, one of the studies included was the Oslo Diet-Heart Study,15 published in 1970, in which 412 patients who'd had a heart attack or were at high risk of heart disease were randomized into two groups: One group got a low-saturated fat, high-PUFA diet along with ongoing, long-term "instruction and supervision" while the other group ate whatever they wanted and received no nutritional counseling whatsoever.
"This is technically called performance bias and it's the equivalent of doing an unblinded drug trial without a placebo. It is literally an uncontrolled trial, despite the randomization. (… [A]ll the physicians involved also knew whether their patients were assigned to the intervention group or the control, which makes investigator bias all that much more likely.)
We would never accept such a trial as a valid test of a drug. Why do it for diet? Well, maybe because it can be used to support our preconceptions," Taubes writes.
Taubes goes on to state that he was so curious about this Oslo study he bought a monograph published by the original author. In it, the author describes in more detail how he went about conducting his trial. Interestingly, this monograph reveals that the sugar consumption in the treatment group was only about 50 grams a day — an amount Taubes estimates may be about half the per capita consumption in Norway at that time, based on extrapolated data.16
"In this trial, the variable that's supposed to be different is the [saturated fat]/PUFA ratio, but the performance bias introduces another one. One group gets continuous counseling to eat healthy, one group doesn't. Now how can that continuous counseling influence health status?
One way is that apparently, the group that got it decided to eat a hell of lot less sugar. This unintended consequence now gives another possible explanation for why these folks had so many fewer heart attacks. I don't know if this is true. The point is neither did Leren.
And neither do our AHA authorities," Taubes writes. "All of the four studies used to support the 30 percent number had significant flaws, often this very same performance bias. Reason to reject them."
Dr. Cate Shanahan,17 a family physician and author of "Deep Nutrition: Why Your Genes Need Traditional Food," emailed me an even stronger rebuttal, saying, "This message from the AHA is not only false, it is dangerous," noting that the AHA is actually making false claims since none of the four studies they included in their analysis involved coconut oil.
As an explanatory side note, most of the early studies on coconut oil that found less than favorable results used partially hydrogenated coconut oil, not unrefined virgin coconut oil.18 As always, the devil's in the details, and hydrogenated oil is not the same as unrefined oil, even when you're talking about something as healthy as coconut. This little detail is what led to the undeserved vilification of coconut oil in the first place. That said, let's look at what else Shanahan has to say on the matter:
"Most doctors don't notice that the medical leadership is making unfounded claims, and the reason they don't notice is because … articles asserting the existence of human clinical trial evidence against coconut as well as all other foods high in saturated fat, conflate the sources of saturated fat with the saturated fat itself.
Saturated fat does not actually exist in the food chain; what they're talking about are saturated fatty acids, the components of triglyceride fat, the substance chefs call simply 'fat.' We often say things like 'coconut oil is a saturated fat' and 'butter is a saturated fat.' But it would be more correct to say 'coconut oil is high in saturated fatty acids.'
Coconut oil, butter, lard, tallow and every other animal fat also contain monounsaturated and even some polyunsaturated fatty acids in addition to saturated fatty acids … The idea is foods contain blends of fatty acids in varying proportion."
Put another way, most foods contain a blend of fatty acids, not just one. Margarine and shortening also contain saturated fatty acids, yet the AHA makes no mention of this. The harder the margarine, the more saturated fat it tends to contain, in some cases more than butter or lard.
"So, when people eat margarine and shortening, in addition to toxic trans fatty acids they're also eating saturated fatty acids. And that means that when a study says it's swapping out saturated fat for vegetable oils, that does not equate to swapping out butter and lard. It could very well be the case that margarine and shortenings were among the foods that got eliminated," Shanahan says.
"And because most doctors don't realize that margarine and shortenings contain saturated fatty acids, they also don't consider it particularly important to wonder whether or not studies like the four core citations mentioned in the Advisory are actually confounded by the fact that the baseline, high-saturated fat diet included a significant amount of margarines and shortenings that contain toxic trans fat.
Because if they did, then that means whatever health benefits were observed in the studies may have nothing to do with the reductions in saturated fat. It's cutting back on trans fat that makes the difference to health."
Non-Saturated Fat Recommendations Have Been Followed With Disastrous Results
Since the 1950s, when vegetable oils began being promoted over saturated fats like butter, Americans have dutifully followed this advice, dramatically increasing consumption of vegetable oil. Soy oil, for example, rose by 600% (10,000% from 1900) while butter, tallow and lard consumption halved.
We've also dramatically increased sugar consumption, with more than half of Americans consuming over 17 teaspoons a sugar a day in 2021.19 That’s down from the 25 teaspoons a day they were consuming in 2014,20 but it’s still more than the maximum 12 teaspoons recommended by the CDC.
Alas, rather than becoming healthier than ever, Americans have only gotten fatter and sicker. Heart disease rates have not improved even though people have been eating what the AHA suggests is a heart-healthy diet. Common sense tells us if the AHA's advice hasn't worked in the last 65 years, it's not likely to start working now.
As noted by Shanahan, technology that allows us to study molecular reactions is relatively recent, and certainly was not available back in the ‘60s and ‘70s. Modern research is just now starting to reveal what actually happens at the molecular level when you consume vegetable oil and margarine, and it's not good.
For example, Dr. Sanjoy Ghosh,21 a biologist at the University of British Columbia, has shown your mitochondria cannot easily use polyunsaturated fats for fuel due to the fats' unique molecular structure.
Other researchers have shown the PUFA linoleic acid can cause cell death in addition to hindering mitochondrial function.22 PUFAs are also not readily stored in subcutaneous fat. Instead, these tend to get deposited in your liver, where they contribute to fatty liver disease, and in your arteries, where they contribute to atherosclerosis.
According to Frances Sladek,23 Ph.D., a toxicologist and professor of cell biology at UC Riverside, PUFAs behave like a toxin that builds up in tissues because your body cannot easily rid itself of it. When vegetable oils like sunflower oil and corn oil are heated, cancer-causing chemicals like aldehydes are also produced.24
Source: The Telegraph November 7, 2015