Confession time: I grew up in a household that used margarine. But I have an excuse – butter cost a lot more in Ketchikan, Alaska – so only when we had friends over did we break out the butter. Grandma always cooked with butter.
Margarine, vegetable oil, eating less animal fat – all were the fad in the late 1960’s and early 1970’s – and became government policy in 1976 to recommend that people eat less fat, especially animal fat and move to polyunsaturated fat.
Most of this was championed by Ancel Keys, a physiologist who did a “seven country study” showing that serum cholesterol was related to heart disease. Sadly, Dr. Keys ignored data that did not agree with his – including the “French paradox” where France has the highest per capita consumption of dietary fat and one of the lowest incidences of heart disease. He also based this on the erroneous conclusion that with the increase of dietary fat was correlated to the increase of heart disease in the US. In fact, during what Keys described as an “epidemic” of heart disease vegetable fat consumption in the US doubled per capita from 28 pounds post war to 55 pounds by 1976. Also, during this time animal fat consumption dropped from 84 pounds to 71 pounds.
The Framingham study showed that dietary fat did not correlate with the cholesterol level or heart disease. In every population studied where diet, cholesterol, and heart disease were compared showed the same results—that dietary fat did not correlate with cholesterol level or heart disease.
We now know, from the science of how lipids are made – that diet has minimal influences in the serum levels of cholesterol, and that cholesterol itself is not the evil we once thought it was (in fact low levels of cholesterol are associated with an increased risk of cancer). Too much, or too little, of a good thing isn’t good (high levels of cholesterol >250 are associated with increased mortality, as are low levels of cholesterol <160).
One footnote to the seven-country study – the fat intake in Japan increased post World War from 6 percent of the calories to 22 percent of the calories – and the incidence of strokes decreased with no increase in heart disease.
Keys, however, was not stubborn, and in later years stated, “I’ve come to think that cholesterol is not as important as we used to think it was.” When examining the diets of some in Italy came to the conclusion that it was the types of fat – and became a proponent of the “Mediterranean diet.” The reason for this was that the paradox that Keys noted when in Italy- the high consumption of fat (olive oil) and the low incidence of heart disease.
We now know, that the margarine I grew up on contains a lot of trans-fats that increase the risk of heart disease – by raising the levels of LDL-cholesterol (to get it straight think of LDL as “lousy” and HDL – the good stuff as “Healthy or happy”).
Bottom line- the evidence is pretty clear- you can enjoy the eggs, with yolks- you can enjoy olive oil – and the best thing you can do for your health is not go overboard with simple sugars, flours, and lose weight. I think this means that ice-cream is the perfect food, if only I didn’t have this allergy to it (I develop this hive, on my belly, that gets larger the more ice cream I eat and my pants don’t fit).
Julia Child was right- butter, in moderation – is a good thing. “If you are afraid of butter, use cream.”
Enjoy the skin of the chicken (skinless chicken is just silly), forget about lean beef (it really isn’t all that lean) – and eat in moderate or small portions. When someone tells you to eat less animal fat- ask them to show you the evidence – because when the evidence for that is examined- it is nowhere to be found.
For those of you who would like a great comprehensive review of this data it can be found in the book “Good Calories, Bad Calories” by Gary Taubes. I highly recommend it. Of course, my book will hopefully be out soon – where you can see how this foodie-MD will provide you with great food, and real science.
Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.