What Really Causes Heart Disease?

We live in a world that is fat-phobic.

Everywhere we turn we’re told to limit our fat intake, that fat is fattening, that saturated fat clogs the arteries like it clogs our kitchen sinks. The words match up, and they sound like they make sense when we hear them on a TV commercial or read them in a newspaper headline.

When you’ve grown up with something being told to you again and again, it’s very difficult to hear something else and consider it seriously.

If we look more closely, however, we can start to see the holes in the story we’ve been fed.

How We Stayed Free from Heart Disease

Saturated fat has been a huge part of our diet for millennia.

When we look at the traditional diets of cultures that was free from heart disease, we repeatedly see an abundance of healthy, natural fat, be it from coconuts (54% of the Tokelau diet), or from animals (65% of the Masai diet).

Large-scale reviews of the scientific studies looking at correlation between fat intake and heart disease have been conducted in recent years.

One such review, conducted from Canada’s McMaster University in Hamilton, Ontario, and another from Oakland Research Institute in California, both concluded that epidemiological evidence doesn’t support the link between saturated fat and heart disease.

Another review, this time including intervention trials (providing stronger evidence than epidemiological studies ever could), conducted jointly by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO), again found no association between saturated fat and heart disease. Instead they found links between heart disease and polyunsaturated fats (think vegetable oil) and trans-fats (think margarine).

So what gives?

If the evidence says saturated fat does us no harm, why are we told the opposite with such stubborn conviction?

It wasn’t always this way. Our grandparents wouldn’t have thought twice about slathering roast vegetables in butter to make them yummy. When did it seem like a good idea to extract oil from seeds and hydrogenate  them into solid margarine without knowing the potential dangers?

Something happened since World War Two that changed the way people think about the fat on their plates.

What was it?

It started with one observational study, and ended with one clinical drug trial.

We’ve Been Lied To

Conviction is a powerful motivator, and the late nutritional scientist Ancel Keys, was nothing if not convicted.

He was convinced that dietary fat contributed to heart disease.

He presented an observational analysis to the World Health Organization in 1955. It was a precursor to his more famous Seven Countries Study, but at the time he was harshly criticized for his presentation. There was good reason for the ridicule, as Denise Minger will tell you in this wonderfully thorough piece on the Ancel story.

The takeaway is that his study only suggested a correlation, and not even a strong one, as you can see from the graph. It didn’t say anything about what caused what.

The American Heart Association (AHA) agreed with the WHO. They needed to see direct, causal evidence. They wrote a report outlining that Ancel had jumped to his conclusions.

Three years later, with no change in the scientific evidence, the AHA flipped like a pancake.

They started recommending that people cut down on their saturated fat intake (unprocessed animal products), and to replace it with polyunsaturated fats (processed vegetable oil).

Why did they make such a dramatic shift in policy? What had changed in that time, if not the science?

Their committee was the only thing that changed.

In 1960, two of their six committee members were none other than Ancel Keys and a supporter of Ancel’s, Jeremiah Stamler.

Twenty-four years later, at the publishing of the 1984 Coronary Primary Prevention Trial, the mainstream media finally adopted Ancel’s view, and refused to budge for thirty years.

Here’s What The Science Is Really Saying

Evidence continues to debunk the claim that saturated fat is bad for us. A meta-analysis published just three years ago in 2011 pooled together the results of 48 studies, and found that interventions that reduced saturated fat intake did nothing to reduce the risk the death in general, and they didn’t even reduce the incidence of “cardiovascular events” (such as heart disease or stroke).

Are you seeing a pattern?

The evidence that supports the idea that saturated fat is unhealthy is riddled with observational studies (which cannot show causation), and false assumptions (like cholesterol’s effect on health).

The correlation we’ve seen between cholesterol in the blood and heart disease is not causative. You’ve heard of HDL and LDL cholesterol, and perhaps you’ve heard that HDL is “good”, and LDL is “bad”.

Let’s Clarify:

HDL and LDL are proteins – little biological machines that move the cholesterol around.

Cholesterol is crucial for many bodily processes, from holding together our cells to forming new memories by myelinating our neurons.

Our bodies typically make around 70% of the cholesterol we need, and the other 25% comes from our diet. If we eat more cholesterol, the body will make less. If we cut back and eat less, the body picks up the slack and fills the gap.

Pretty clever, eh?

Most cholesterol is made in your liver. LDL takes cholesterol from the liver to wherever it’s needed in the body. HDL brings it back.

Artery-clogging doesn’t happen by an over-load of free-floating blobs of cholesterol. It happens when this neat little system gets damaged.

What Really Causes Heart Disease

Blame inflammation.

A punch in the face creates a very acute form of inflammation.

Imagine instead that damage of that punch was somehow spread out over a week, and across the whole body. You might not even notice it. When we give our bodies mild toxins through our food, we don’t feel it right away. After enough time, however, the damage starts to accumulate.

One form of that damage is blood vessels that swell up and become numb to LDL. With nowhere to go, LDLs gather in the blood. The longer they stay in the bloodstream, the more likely some will get damaged (oxidized). A damaged LDL is a dangerous thing, so the walls of the blood vessels grab a hold of them to protect themselves and the rest of the body, and keeps them trapped in a clump on the wall of the vessel.

That’s plaque.

It’s not an overload of fat that causes these problems. It’s a damaged bodily system.

You now understand more than 99% of people about heart disease and how it relates to fat.

When LDLs are locked out of damaged cells, and they’re building up in the blood, being clumped together in plaque and eventually blocking arteries, it’s clear to see why some people suspected cholesterol as being the cause, but it’s innocent. It’s the victim, not the perpetrator.

We didn’t used to know all the pieces of the puzzle. Certainly not in 1960.

Nowadays we can see the whole picture.

The Mistake Most Dieters Make

Saturated fat and cholesterol usually come together in the diet, so in a bid to lower blood cholesterol, we’ve been advised to eat low-fat diets.

Now you know why this is unlikely to work. Your liver will simply make more cholesterol, send it out in LDLs that can’t pass through cell membranes, and the problem continues. An optimally healthy body will never allow excess fat (or excess anything) to accumulate in the blood.

So to protect ourselves from heart disease, we must heal the body.

This means we stop punching ourselves in the stomach, by reducing the inflammatory triggers in our lives.

Most inflammation is caused by refined carbohydrates and processed fat, although there are non-dietary causes, such as smoking, sleep deprivation, and chronic stress (although it’s been found that simply believing stress is a good thing can dramatically reduce its damaging effect).

I think we already agree that a restful life full of fresh air and happiness is a good thing. What we need to keep talking about is the diet side, since it can be difficult to hear.

Fat is a wonderful group of molecules. They’re used to make hormones, to build the immune system, and although they pack more calories per gram than any other macronutrient, they’ll also keep you from feeling hungry if your body is used to relying on them.

However, saying that all fat is good for you is like saying all Californians love surfing. Sure, there are some of us that can’t get enough, but generalisations about groups of people are never totally true, and the same goes for sweeping statements about groups of molecules.

Fat is diverse.

Scroll to the bottom of this article to get a free guide to everything there is to know about fats. For now, just know that if it’s a type that didn’t exist in nature, it’s going to be problem for your body to deal with.

Fats to avoid: hydrogenated, trans-fats, and processed vegetable oil or seed oil (exception: olive oil).

Fats to enjoy: saturated, monounsaturated, and polyunsaturated, in that order and in their natural context (exception: omega-3 oil and other fatty acid supplements which are “unnatural” but often good for the body).

Ethically raised animals produce the highest quality fats on our shelves. From improved omega-3 to 6 ratios, to increased amount of CLA (which has been shown to help with weight management), there is nothing about an animal’s body that doesn’t seem to be improved by a happy life eating a diet that’s natural for them. Go for grass-fed beef, wild-caught fish, and free-range chicken.

The best thing about eating plenty of healthy fats, besides all the fat-soluble vitamins you’re loading up on, is that you’ll be getting most of your calories from the most satiating macronutrient on the table. A problem people often experience with high-carb diets is a cycle of frequent energy dips and powerful hunger. I used to think it was normal to get slightly shaky hands if I skipped lunch, before I tightened up my diet. If you know what I’m talking about, think of it like a heavy smoker who can’t keep his fingers still while he lights up. It’s not normal, and it’s not a problem with you. It’s just a sign that you have a system in need of recovery.

Dieters everywhere are following a low-fat regime and finding themselves forced into the hands of refined carbs and processed oils, which makes calorie management arduous and forms a recipe for artery-clogging inflammation, given enough time.

We know better than to fear a macronutrient that we’ve been heavily relying on for millennia.

Listen to What Your Blood Can Tell You

Ask your doctor for a blood test.

Make sure you’re tested for:

 • HDL

 • LDL

 • Triglycerides

 • CRP (C-Reactive Protein)

 • Calcium

CRP and calcium are markers that sometimes goes overlooked, and heart attack victims with great lipid profiles (low LDL and triglyceride levels) often have high levels of CRP and/or calcium in the blood.

Blood markers are a topic for another post. For now, consider getting your numbers for each of the five molecules listed above. From there, we have something work with.

To push each of your numbers in the right directions, we’ll need to make fat a part of the solution.

Beat Heart Disease with Fat

We can relax.

Don’t fear saturated fat. As contentious as it sounds to our indoctrinated ears, fat does not make us fat (refined carbs do), and it doesn’t try to kill us, either.

Use the right fats:

Curb the inflammatory, hydrogenated margarine and enjoy your grass-fed butter. Use it for cooking in place of vegetable oils, which will oxidize when heated (triggering inflammation).

Consider omega-3 supplementation, possibly the easiest change to make that has a significant effect on blood lipid profiles.

Enjoy red meat from ethical sources such as grass-fed cows and sheep. Wild-caught fish, venison, free-range eggs; these all represent some of the richest sources of nutrition available to us, they’re delicious, and they’ll keep you satiated for far longer than a bagel and salad (after you get over carb withdrawal, that is).

As more and more evidence comes out to support the views of our great-grandparents, this crazy fad that has gripped the Western World over the last half-century is gradually coming to a close.

It’s not dying a graceful death. Grown-ups are walking around who are younger than this fad, so it’s going to take some time.

In the meantime, enjoy as much saturated fat as you need. Your body deserves it.

To discover everything you need to know about fats, and for complete breakdowns of the very best and worst sources of fat, enter your email below and receive a free copy of the Ultimate Guide to Fat.