Heart surgeon waging war on saturated fat seems seriously short on science to support his claims

Eagle-eyed readers may have noticed that the commonly-held belief that saturated fat cause heart disease appears to be waning. In the last few weeks alone we have seen the publication of two significant and weighty studies which have found no link between sat fat and heart disease. These come hot on the heels of another review last year that found the same. I covered these studies last Friday here. These recent studies did not get much airtime in conventional media, but they did at least appear to whip up some interest in the blogosphere.

Now, this might be a coincidence, but on Tuesday there was here in the UK a huge media splash instigated by the suggestion from a heart surgeon that we should ‘ban butter’. (See here for an example of this coverage). The surgeon in question, Mr Shyam Kolvekar, urges us all to cut back on saturated fat (sigh) to save our coronary arteries. Now, Mr Kolvekar’s message got widespread exposure (see here for an example), but he was not acting in isolation. He was aided and abetted by Unilever’s PR agency (KTB). Unilever, in case you are not familiar, is a food company that makes, among other things, highly chemicalised, non-food margarines touted as a ‘healthy’ alternative to butter.

There is no good evidence that I can find that supports the supposed ink between saturated fat and heart disease. So I emailed Mr Kolvekar asking for evidence that supports his assertions. I also asked him to clarify whether or not he had received payment for Unliever for this or any other work.

To his credit, Mr Kolvekar responded. He declared no commercial gain from any work with Unlever (I believe him). However, on the evidence, he was not so forthcoming. He referred me to the FSA (Food Standards Agency) and Department of Health websites. He stated, that what I read in the news was his own personal opinion.

I emailed him back, pressing him for actual studies. I wrote: Can I ask you to specifically cite the evidence (preferably human intervention studies, but epidemiological evidence too if you have it) that supports the assertions you have made regarding saturated fat and butter. Please do not refer me to websites, consensus statements or the like. It is actual studies I am interested in.

I did get a reply, which I suppose I should be thankful for. But it was not particularly fulsome. It actually contained just one citation, with no supporting text. Not even a ‘Dear John’.

I responded to Mr Kolvekar with the following email.

Dear Shyam

In response to my request for you to supply evidence that supports your assertions regarding saturated fat you provided a single reference [1]. This reference concerns what is commonly referred to as the North Karelia Project. As you may know, this project was an attempt to reduce the risk of heart disease in individuals living in the province of North Karelia in Finland. The project started in 1972. Outcomes were initially compared to a control group which was not subjected to any intervention. The intervention was deemed a success, and was subsequently adopted on a country-wide basis. The reference you offer refers to that country-wide intervention.

The first thing to note about the North Karelia Project is that is was multiple intervention in nature. In addition to attempts to have people eat less saturated fat, it also aimed to reduce smoking and blood pressure. It employed a number of strategies including health education, screening and intensification of treatment in those already being treated for cardiovascular disease. Because of the multiple intervention nature of the project, it is simply impossible to gauge which element(s) of it might have been responsible for any benefits seen from the interventions.

A closer look at the project itself reveals other issues, which have been highlighted before [2]. Shah Ebrahim and George Davey Smith point out that while the results of the North Karelia project have been held up as a ‘success’, the reality is that it’s results were quite unimpressive. Let me quote from this letter: CHD mortality trends over the period 1969 to 1995 show a greater decline in North Karelia than the rest of the country, but the 95% confidence intervals for the slopes overlap. An intriguing pattern of decline is hidden in the overall trend. First, North Karelia experienced an almost immediate and rapid decline, a rise and a fall in CHD mortality (1971″1975). Second, rates of decline were significantly greater in the country as a whole than in North Karelia (1976″1985). Finally, death rates tended to approximate to each other (1986″1995). Such trends do not provide unambiguous support for the hypothesis that the intervention was effective.

It is notable that one of the original North Karelia investigators subsequently wrote to the Lancet to express his own doubts regarding the ‘success’ of the project [3]. He expressed the opinion that he did not think it was possible to draw the positive conclusions that had been presented in the original paper.

With the one piece of evidence you have cited to support your assertions regarding saturated fat we have two fundamental problems:

1. It is a multiple intervention in nature, and it’s therefore impossible to draw conclusions about the effects of any specific intervention within it

2. The multiple interventions appeared to have little or no benefit anyway

My belief is that to hold this up as evidence for the benefits of eating a less saturated fat is scientifically untenable.

Against, this, I think it’s appropriate to take a wider view of the saturated fat/heart disease ‘link’. Last year, Mente and colleagues at the Population Health Research Institute in Hamilton, Canada, published a comprehensive review of the link between dietary factors and coronary heart disease [4]. They found that epidemiological evidence did not support a link, and neither were they able to identify appropriate intervention studies that supported any link.

A recent edition of the Annals of Nutrition and Metabolism was dedicated to reporting an expert consultation held jointly by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the US [5]. The consultation undertook a comprehensive review of the relationship between fats and health, and took place in late 2008. The report states with regard to epidemiological evidence that Intake of SFA was not significantly associated with CHD mortality and SFA intake was not significantly associated CHD events. With regard to interventional evidence, it was concluded that fatal CHD was not reduced by low-fat diets.

In addition, earlier this year saw the on-line publication of a meta-analysis of cohort studies assessing the relationship between saturated fat and heart disease [6]. This meta-analysis comprised 21 epidemiological studies (almost 350,000 people followed-up over a period of between 5 and 23 years). This meta-analysis found no significant association between saturated fat and risk of heart disease or stroke.

I do not doubt your motives and think it’s laudable that you would attempt to help inform individuals about healthy eating in an effort to help prevent cardiovascular disease in the public at large. However, it is important I think that such messages should be accurate and evidence-based. Otherwise, we risk doing more harm than good.

I’d be enormously grateful if you would perhaps give me your thoughts regarding the deficiencies of the North Karelia ‘evidence’, as well as the (in my view) compelling evidence which demonstrates that saturated fat does not cause heart disease.

Yours sincerely

John Briffa

References:

1. Puska P. Fat and heart disease: Yes we can make a change ” the case of North Karelia (Finland). Ann Nutr Metab 2009;54(suppl 1):33″38

2. Shah Ebrahim and George Davey Smith Editor’s Response ” exporting failure. International Journal of Epidemiology 2001;30:1496-1497

3. Salonen JT. Did the North Karelia project reduce coronary mortality? Lancet 1987;2:269

4. Mente A, et al. A Systematic Review of the Evidence Supporting a Causal Link Between Dietary Factors and Coronary Heart Disease. Arch Intern Med. 2009;169(7):659-669

5. Fats and Fatty Acids in Human Nutrition. Annals of Nutrition and Metabolism, 2009; 55 (1-3)

6. Siri-Tarino PW, et al. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease Am J Clin Nutr 13 January 2010 [epub ahead of print publication]

48 hours on, I still have not had a response to this email. If I get one, I’ll post it. At this time, however, I think it’s fair to stay that when Mr Kolvekar embarked on his quest to save us from the ravages of heart disease, he was either unfamiliar with the science in this area, or had studiously ignored it. I am genuinely prepared to give him the benefit of the doubt, though, and imagine that Mr Kolvekar’s statements were just misguided and ill-informed. However, if he is unable to produce the evidence that supports his ‘personal opinion’, and now he has in front of him quite a stack of evidence to the contrary, surely the decent thing would be to issue a retraction?

I’m tempted to remind Mr Kolvekar of John Maynard Keyne’s quote I referred to here: When the facts change, I change my mind. What do you do, sir?

49 Responses to Heart surgeon waging war on saturated fat seems seriously short on science to support his claims

  1. Martin Gregory 21 January 2010 at 2:54 pm #

    The quote doesn’t quite work for me. The facts never changed, they were just obscured (for profit?). It would be clearer to say, ‘When the facts were actually revealed to me I could plainly see the truth in them. Now that you’ve seen these same facts, sir, what do you see?’

    I really appreciate your effort on this blog.
    Thanks

  2. Christer Sundqvist 21 January 2010 at 2:58 pm #

    Just a short notice from a biologist living in Finland, the land of saunas, sisu and Puska. I happen to know Dr. Pekka Puska quite well, we have appeared together in the press, we have nice private and public sessions frequently and we have been debating the role of carbs and fat in our food for quite some time. I respect Dr. Puska. He is a nice man. But he is unfortunately a victim of the system of official advice. He is stuck with “his” North-Karelia-project and the guidance he adopted from the project. He is stuck with it for the rest of his life. When the facts change, Puska won’t change his mind. I will be happy to correct you once I hear the happy chimes of repent calling from the ivory towers.

    What we can do, is to put the North-Karelia-project aside as a historical piece of very bad science and let Mr. Puska have his own way of thinking influence us as little as possible. This is the way to survive on an intellectual basis in low-fat Finland.

    Thanks for an excellent blog, Dr. Briffa!

  3. Dr John Briffa 21 January 2010 at 3:02 pm #

    Martin

    ‘When the facts were actually revealed to me I could plainly see the truth in them. Now that you’ve seen these same facts, sir, what do you see?’

    You’re absolutely right, Martin. I stand corrected. And thanks for your kind words.

  4. Chris 21 January 2010 at 3:19 pm #

    John,
    Superb! Simply superb! A comprehensive letter tackling satfat-phobia (SFP) if ever I read one.
    Sadly the SFP meme is deeply rooted. That is why Kolvekar’s comments got picked up so quickly, and why the contrary evidence (particularly Krauss’s meta-study), was simply ignored.
    I think one of the problems is that so much government advice, medical research/reputation and commercial activity (among pharmaceutical, agricultural, advertising and diet/health industries) is geared on the SFP premise that to turn things around would hit a lot of people hard. They have built their case on flawed evidence and it would be financial, commercial and reputational suicide to now follow the evidence.
    Even if Kolvekar retracted his initial statement, then the media would once again thrive on the copy afforded from the seemingly flip-flop nature of dietary/health/fitness advice.
    No one said getting the truth out would be easy. The ‘paleo’ blogosphere is thriving and the message is getting about at the grass roots level. This, in part, is due to the excellent work of doctors like your good self.

    Once again, brilliant work!

    Cheers,

  5. Chris 21 January 2010 at 5:01 pm #

    Is Mr Kolvekars employer, University College London Hospitals, trying to distance itself from this, as a blogger suggests?

  6. Jamie 22 January 2010 at 1:11 am #

    I suspect part of the reason the Krauss papers & others have not been picked up by the main media is that they (the media) often rely on releases from their various foundations. I can’t imagine that these said foundations have got a lot to say at present. If they were to tackle this issue head on, then they run the risk of having their evidence dismantled as in the skillful example Dr Briffa has provided above. Sometimes, when you want information supressed, it is best to say nothing rather than fire up a storm.

    I participate in a professional list of Australian & NZ nutritionists/dieticians. The Krauss papers have & are being rigorously discussed. The general consensus from the mainstream/conventional practitioners is that nothing needs to be changed in terms of conventional wisdom on this & therefore nothing needs to be said. As a nutritionist who often runs health education workshops, rest assured I will be imparting my very paleo take on this topic to those I speak to!

    Jamie

  7. Sue 22 January 2010 at 2:15 am #

    Jamie, what list is this?
    Is it a list for naturopaths too?

  8. Jamie 22 January 2010 at 12:22 pm #

    I don’t see why not Sue. It is based in Australia & is called NUTNET. Reasonably active but very conventional for the most part (though does have a couple of pro-paleo GP’s on there who can be a bit uncoventional at times).

    http://health.groups.yahoo.com/group/Nut-Net/

  9. M. Cawdery 22 January 2010 at 1:39 pm #

    I have read most of your cited papers. I have also read Dr Uffe Ravnskov’s two books, those of Drs Kilmer McCully, Duane Graveline, Dr. Malcom Kendrick, A. Colpo and many abstracts on cholesterol and saturated fats including the massive WHO-EU-Monica survey of most European countries. plus the recent papers you cite. I can as no doubt you can, cite many, many additional papers that challenge both the cholesterol myth and saturated fats claim.

    Max Plank has been quoted on this aspect which can best be summarised as “Science progresses FUNERAL by FUNERAL.

    I find Mr Kolvekar and most KOLs (Key Opinion Leaders) blatantly ignore any research that challenges their beliefs as if those were God given. I call it the “Galileo syndrome” for obvious reasons. Progress will not be obtained until the current KOLs pass on.

  10. Hilda Glickman 22 January 2010 at 6:43 pm #

    I was told by a dietician once (I am a nutritionist) that if I didn’t stop saying that margarine was bad for us, the food industry would sue me!

  11. Chris 22 January 2010 at 8:22 pm #

    oops !
    html tag went wrong.

    Shyam Kolvekars CV

    It was my own mistake and I own up!

  12. bobby dean 22 January 2010 at 9:44 pm #

    Once again Dr B…excellent work.
    We always said in my health field
    ” the art of medicine never catches up to the science of medicine.”
    I appreciate your work and energy and read every newsletter for the past few yrs.

  13. Chris Kresser 22 January 2010 at 9:53 pm #

    Hi John,

    I’ve been following your blog for a few months, and I love the work you’re doing. I write about similar topics over at my blog and it’s always a pleasure to find like-minded people working to expose these persistent myths about nutrition and health.

    I seriously doubt you’ll get a reply from Mr. Kolevkar. Why? It’s the age old saying:

    “You can’t fight faith with facts.”

    Chris
    a.k.a. The Healthy Skeptic

  14. Pete Grist 22 January 2010 at 10:08 pm #

    I’ve always stuck with butter, on the simple basis that it is a simple product consumed for hundreds of years, so it is good to get this information. However, I also happily eat bread on a similar basis, but you do seem to go negative on wheat……

  15. Hilda Glickman 22 January 2010 at 10:12 pm #

    Mary. Your argument does not stand up. In logic it is called an ‘argumentum ad hominem’ , that means judging the worth of an argument by looking at the person who delivers it. Whatever he looks like is irrelevant. Only good research matters.

  16. Mona http://www.planetmona.com 22 January 2010 at 11:24 pm #

    Well done for the post Dr. Briffa. To be honest when I saw the article in the Times of Malta – Malta being one of those countries which is fascinated with margarines and the like – I was quite shocked. I hoped you would write about it.

    As those above have pointed out, it is the presentation of these assertions as ‘facts’, and scaremongering ones at that, that really bore me. Sadly, many others just read and believe.

  17. Mary Lomax 23 January 2010 at 12:47 am #

    I find that, as well as exploring the evidence as it exists, it is a good idea to take a look at anyone offering health advice before deciding whether to listen to them or not. And, judging from the picture used in the press article you linked to, this is not a man who is a paragon of health. If he is practising what he preaches then I will not be taking his advice.
    I hope everyone reading the article made it down to the bottom for the warning against trans fats too. I wonder how Mars are going to ensure they are not producing those in replacing butter with sunflower oil.
    Whilst it may be extreme for some people I very much like Jason Vale’s advice to people who ask him what to look for on a food label.
    ‘The label’
    If it has a label don’t eat it!
    Thanks for the blog – and for calling these ‘experts’ to account!
    Namaste
    Mary

  18. Jackie Bushell 23 January 2010 at 1:20 am #

    Excellent work, as usual, Dr Briffa. Please continue!

  19. Stephen Hoyt 23 January 2010 at 2:08 am #

    I am no scientist sir and not an educated man but I have believed all of my 50 plus years that butter is not bad for my health. I have never liked margarine due to the poor taste, colour, cooking capability and unpronounceable ingredients!

    Your blog is a breath of fresh air! Keep up the good work!

    Stephen Hoyt
    Gatineau, Quebec – Canada

  20. Dr Matti Tolonen 23 January 2010 at 1:16 pm #

    Thank you, Dr Briffa.
    Excellent critics on the North Carelia Project, which is quite familiar to me, too. Dr Puska has in the public (e.g., in the national Finnish TV) implicated that the coronary mortality in North Carelia started to decline AFTER the project began, but it is not true. In fact the decline began a bit earlier in Finland, just like it did elsewhere. Jeremiah Stamler reports from the USA (1985) that the peak of the incidence was just at 1970, and it has declined thereafter, 30% between 1970 and 1981. http://tinyurl.com/yemb2hr

    At the same time, coronary mortality declined in New Zealand. About 40% was attributed to improved care, but 60% was due to unknown factors.
    http://www.bmj.com/cgi/content/abstract/292/6512/33

    Also in Australia, the coronary mortality declined, and it could not be explained by improved care only. http://www.bmj.com/cgi/content/abstract/299/6704/892

    In the famous Minnesota Heart Study the authors state: “From 1987 to 1994, we observed a stable or slightly increasing incidence of hospitalization for myocardial infarction. Nevertheless, there were significant annual decreases in mortality from CHD.” The autors attributed the decline “largely” and “maybe” to improved medical care.
    http://content.nejm.org/cgi/content/abstract/339/13/861?ck=nck

    In the USA the coronary mortality has declined about 62% in men and 45% in women (age group 25 to 84 yrs). In the UK the “Winning the War on Heart Disease” report predicted that coronary mortality would disappear almost completely by 2015.
    http://www.clingov.nscsha.nhs.uk/Default.aspx?aid=2834

    Dr David Grimes calls coronary disease “latitude sickness”, which, he believes, is mainly due to microbe infections and vitamin D-deficiency. He has published an excellent book on this subjects. He, too questions the diet-cholesterol-coronary heart disease theory.

    Dr David Grimes: VITAMIN D And Cholesterol: The Importance Of The Sun. 642 s, Tennison Publishing, £24.95. ISBN 978-0-9562132-0-4 http://www.ypd-books.co.uk/scripts

  21. Vince Edghill 23 January 2010 at 9:40 pm #

    Thanks John, You have quite a fight on your hands trying trying to
    change the religious fervour out there in the media world and you are
    never going to win against the glamour guys that are heart surgeons and
    cardiologists. So you deserve a medal for taking on this surgeon. Those
    of us engaged in the fight against the sat fat will kill you brigade
    are, in my view, slowly beginning to make a bit of headway. I speak as a
    practicing type 2 diabetic doctor and live in country NSW Australia and
    have long given up referring my patients to dietician services where
    they preach the same old mantra that saturated fat is to be avoided and
    butter will kill you and that you need to eat a high carbohydrate
    diet.But that of course is something they learn as students. You almost
    need to become diabetic to really get to grips with the nonsense (
    non-science ) involved in that standard teaching, since you realise the
    folly of it in very short order. That’s actually the easy bit. But then
    comes the problem of prising patients away from their worries about
    saturated fat as they have had that meme embedded. In the same way that
    they worry about their cholesterol. You can put money on it that your
    heart surgeon will have had a very light smattering of teaching in
    nutrition and I speak with authority there, as I too have a post
    graduate British degree and am a member of the UK Royal College of
    Physcians which is of course the medical side of this guy’s surgical
    degree and even at a post- graduate level in Scotland , nutrition simply
    didn’t feature as something we had to take too seriously as we were
    never going to get a question on it in the Membership exam. And when
    presenting for the surgical Fellowship nutrition would have been even a
    bigger joke. And yet the population at large seek advice on nutrition
    advice from us and even from surgeons! Laughable really if it were not
    so important. Poor old John Yudkin would turn. But as Prof. Lustig from
    California told us in his excellent review ( easily Googled ) the
    Americans only export 3 things now. Weapons, Entertainment and Food. So
    we are taking on that multitrilion dollar industry in the same way that
    Yudkin faced the massive Sugar Industry in the 70′s ( and actually beat
    them up a bit ). So the nutritionists and of course diabetic ”
    educators ” ( apologies to the few that may be out there moving away
    from ” the mantra “) are locked into the winning Ancel Keys camp with
    it’s soft science. And look around at the way that has served the world
    and poor old type 2 diabetics like us. We have a nice lady nutritionist
    in Australia who is the media doyenne here and who recently wrote in a
    widely read GP journal here a long ” therapeutic ” article worshipfully espousing
    Ancel Keys and re-iterating the sat fat will kill you mantra… So I
    keep plugging away and you are doing an excellent job and thank you. And
    forget that surgeon. He’s a knife man, don’t forget. Nutrition
    commentator ? What a joke.

  22. Jamie 23 January 2010 at 11:57 pm #

    @ Hilda… I can certainly see your point regarding what a person looks like & I think in this instance it is largely irrelevant as you suggest. However, there are times when I think it is quite valid to look at the appearance of someone dishing out health advice. I work in the fitness industry & obviously within nutrition fields too. All too often I see personal trainers who clearly do not practice what they preach both with regard to exercise & nutrition. I believe that part of the art of health care & working with individuals comes from walking the talk, being passionate about what you do, and having the insight of having had to face your own demons along the journey. I certainly wouldn’t give my money to a doctor/nutritionist/personal trainer etc, who didn’t subscribe to & practice their own advice (e.g. Dr’s who prescribe certain drugs that they would never personally take themselves).

  23. Hilda Glickman 24 January 2010 at 12:06 am #

    Mary. It is NOT a good idea to judge evidence by looking at the person delivering it. This would mean that anything said by a fat, unhealthy looking person is untrue. For example if a very fat person said that vegetables are good for us would that be untrue just because they said it? People look fat or fit for all sorts of reasons and some people can look great while eating lots of junk foods for a while anyway. Science wins out every time and what you say makes no sense.

  24. Hilda Glickman 24 January 2010 at 12:12 am #

    For those who want to read further see ‘The Mararine Hoax’ on the web. It explains why margarine has been promoted so fervently. Vegetable oils are everywhere in foods. Nearly all processed foods have them. However the study used by the heart surgeon is an observational one which can never prove causation. We need to look at cells and see what these fats actually do to the cell membrane which made up of phospholipids.

  25. Jamie 24 January 2010 at 8:10 am #

    @ Vince

    Great comments! Wholeheartedly agree! The doyenne of nutrition commentary that you refer to would be an R.Stanton by any chance would it?

  26. Jamie 24 January 2010 at 8:15 am #

    @ Hilda…

    I don’t think it is about judging the evidence but rather more about judging whether a person applies that evidence to themselves or not. Granted, you can’t always tell this from appearances. But I do stand by partly judging a health professional by whether their appearance represents the message they are ‘selling’.

  27. Jamie 24 January 2010 at 9:08 pm #

    Hilda,

    I really do think you have taken the wrong end of the stick with this. I’m not referring to whether someone is good looking or otherwise. When I look at a person, I look for cues regarding their body structure, how much musculature they carry, how they move, what their posture is like, etc. In the example of supermodels you use, I would pull holes in most of them left right & centre by virtue of me being able identify key markers for muscle mass, postural balance etc, that most of the time (though not always) indicate to me whether someone is engaged in some form of physical activity. Someone might have psoriasis or eczema, but if they are doing all the right things, you will still see a certain quality to their skin & eyes as a result. I am talking about seeing past some of the things that you might be otherwise thinking rather than just judging on a superficial level.

    I’m not suggesting that health professionals have to be body-beautiful, but I will always look for evidence that the person advising me takes their own advice & is attempting to live by the paradigm they are selling to me. E.g. if a trainer is telling me I should integrate 3 sessions per week of lifting weights into my lifestyle, I want to see & know that they do the same – not look at them & note that they rarely if ever do their own strength training & give out lame excuses as to why (I used to manage a team of 30 PT’s & this scenario was incredibly common). If a nutritionist is telling me I need eat a diet rich in wholegrains only to see that they are stick-thin because they eat both low carb & low fat, does that instill me with confidence in their advice?

    If I’m overweight & my overweight Dr is telling me that I need to find time in my already busy lifestyle to exercise, but upon asking my overweight Dr what they do for exercise, I get the answer that they are too busy running the clinic to fit much in, what does this tell me as their patient?

    WRT ‘selling’ – do we not ‘sell’ facts & science? Is that not what Dr Briffa is attempting to do here with this blog? And by ‘selling’ I am obviously referring to one making a sufficiently convincing argument based on facts, science, art, passion, etc, for moving a person away from a view they already hold. If I hold the view that saturated fat is bad for me, but Dr Briffa presents the facts & science in such a way that I take onboard this new paradigm, then has he not done a good job in ‘selling’ this to me?

    So once again, I stand by my original assertion that;
    - Mary’s comment on the appearance of Dr Kolvekar’s was irrelevant in this context,
    - In some context’s it is entirely appropriate to evaluate a health professional’s physical appearance & other attributes against the health message they are trying to ‘sell’ their patient/client.

  28. Jill H 24 January 2010 at 10:18 pm #

    Hilda

    ‘It is not about ‘selling’. It is about facts and science.’

    I understand what you are saying Hilda, and one part of me sort of agrees with you – but I also think I understand what Mary and Jamie are saying.I am afraid this is going to sound very unscientific but I do believe that healthy food can come only from healthy plants and animals and that there is a ‘life force’ in any healthy living creature or plant – an ‘organising principle’. For example you cannot measure it but see it in a healthy, happy animal. Really good food bursts with taste and freshness – you know it when you eat it and feel better for it. Super models may look super thin and are probably airbrushed to look healthy but if they are eating rubbish I am not sure they do look, or more importantly feel great. I totally agree there is no correlation between weight and health and I know many a person who is ‘glowing with health’ and ‘big and beautiful’ because they care about what they eat. I believe that science has proved what our intuition has always told us that our health and our wellbeing are intimately bound up with our diet. Good health is about more than just the absence of disease and actually, I do think you can see it in people that ‘walk their own talk’.

  29. Hilda Glickman 25 January 2010 at 12:58 am #

    It is not about ‘selling’. It is about facts and science. There are super models who enjoy drugs, cigarettes and caffeine, ear a poor diet and look great. A person with psoriuasis for example could still have that no matter what they eat as it is very difficult to treat nutritionally. I suspect as a trainer you are talking about weight in relation to health. There is no strict correlation between weight and health. See Dr Briffa on this. Also what is wrong with the way the heart surgeon looks? Whether someone pratices what they preach is again not relevant. It is quite logically correct to state that cakes are bad for us and still eat lots of cakes!

  30. Sue 25 January 2010 at 5:34 am #

    Vince said:
    “nice lady nutritionist in Australia who is the media doyenne here and who recently wrote in a widely read GP journal here a long ” therapeutic ” article worshipfully espousing Ancel Keys and re-iterating the sat fat will kill you mantra.”

    Jamie, I didn’t think of Rosemary Stanton. I was thinking Janella Purcell who is always on the Today Show, is a nutritionist and naturopath.

  31. simona 25 January 2010 at 5:01 pm #

    Well done, dr. Briffa.

    I wish your answer and analysis had as much coverage as Mr. Kolvekar’s ‘opinion’, at least to show that there is no bias in news reporting.

  32. Chris Highcock 27 January 2010 at 8:36 pm #

    All – please feel free to join the Facebook group – “Do not ban butter – it is a healthy fat!”

    http://www.facebook.com/group.php?gid=258317319731&ref=share

  33. Chris Highcock 27 January 2010 at 8:37 pm #

    Also – Dr John – how about a similar letter to the FSA? Their top scientist is still spouting the same rubbish re sat fat

    http://blogs.food.gov.uk/roller/science/entry/mad_bad_and_dangerous_to

  34. alfredoe 27 January 2010 at 11:17 pm #

    Hi All. The idea that saturated fats harms your health in any way is a myth.

    Saturated fats are actually very healthy fro us, the problem is that the vegetable oil industry and some other food industries with the help of some health associations have demonized it.

    PLease read more at http://www.omega-3-fish-oil-wonders.com/good-fats.html

    Best wishes

  35. Hilda Glickman 28 January 2010 at 12:10 am #

    Jamie, This is silly. There are people who all the right things but do not look as well as others who do not. The bottom line is that logically (and I have a degree in this) there is NO connection between saying that something is good for us abd actually eating it yourself. I know that greens are good but I never eat them as I hate them. That does not mean that if I say they are good that I am saying something that is wrong. If I say that sugar is bad and I eat it it does not mean that I am wrong in this either. Yes, peole do judge each other in the way you suggest but they are wrong and irrational in doing this.

  36. Jamie 28 January 2010 at 2:10 am #

    So Hilda, lets say I know nothing about nutrition & I come to you for advice. You tell me that I should eat greens & not eat sugar & make a very sound case for both of those pieces of advice. I’m reluctant to take on that advice as I don’t really like greens & love sugar. So I ask you what you do, only for you to tell me that you don’t do either as you too don’t like greens & but love sugar. What confidence is that going to instill in me regarding the efficacy of your advice.

    Reading comprehension might have been amiss in your degree. At no time in my comments did I say there was a link between the efficacy of a health statement & a person’s appearance [I too have qualifications in this area if you want to play trumps: PGDipNutMed, PGDipSportExMed, BSc (Nutrition), BPhEd (Sport & Exercise Science)]. In fact my first statement was in agreement with you that Dr Kolvekar’s appearance was irrelevent to his statements he made, regardless of whether his statement was right or wrong. What I did state, and still stand by, is that whether a person walks the talk (and sometimes this is evidenced by their physical attributes) is relevent to their credibility, particularly when they are trying to convey a strong message.

    If we take this blog for example, Dr Briffa is able to give quite a unique perspective on his musings as being both a doctor & a practitioner of many of the things he discusses. How would it look if he were to write a blog on the virtues of a particular quit-smoking strategy only for it to become apparent that he still smokes & has never actually tried that particular strategy. Having been a relatively recent convert from conventional dietary wisdom to Paleo/Primal eating strategies, I have gained the most insight into this paradigm by reading the many blogs written by people who practice what they preach (Dr Briffa included). I was quite shocked (then pleased) to read that a local gastroenterologist who writes books & tours the world preaching the evils of gluten (and has done so for many years) has only just gone gluten free themselves. And as mentioned, I have worked with & managed many personal trainers who charge their clients considerable amounts of money & extol the virtues of particular training regimes that they have never done themselves, have no idea what they feel like, & are pushed by people who don’t look particularly healthy themselves.

    Whether a statement is true, logical, or otherwise might not have anything to do with the appearance of the person conveying the message, but it certainly helps with the salespitch whether you think that is shallow & superficial or not.

  37. Anon. 29 January 2010 at 5:46 pm #

    “The facts never changed, they were just obscured (for profit?). It would be clearer to say;

    ‘When the facts were actually revealed to me I could plainly see the truth in them. Now that you’ve seen these same facts, sir, what do you see?’”

    *

    “Progress will not be obtained until the current Key Opinion Leaders pass on.”

    *

    ” the art of medicine never catches up to the science of medicine.”

    Is it that the evolutionary pace of innovation and change, driven by the quest for profit, delivers consequence faster than the ability of those whose job it is to mitigate against such consequence?
    Mis-information, to which Mr Kolvekar could be unwittingly contributing, seems to outpace any efforts or possibilities of respectable KOLs to arrive at an informed consensus.

    A few days ago I had a discussion with a practicing GP on unrelated club membership matters. The ban butter topic entered the conversation. This ban butter release, media coverage, and furor had completely escaped her radar. I was astounded. Furthermore, she seemed unaware of what the issues, inferences and implications might be. I retained my thoughts, and spared her the explanation.

    I’m sure I saw something on Nature.com that was a call to include more on nutrition in med school, a positive sign perhaps. I’m afraid I can’t turn it up now that I’d like to.
    On the other hand I found this reference to a paper on obesity reduction that uses the term ‘obesogenic environment’.

  38. Chris 13 February 2010 at 3:34 pm #

    The view my untrained eye gleans from this paper is that where fat is concerned it is quality rather than quantity that matters.

    “Dietary Fat Quality and Coronary Heart Disease Prevention: A Unified Theory Based on Evolutionary, Historical, Global, and Modern Perspectives”
    (Link)
    Christopher E Ramsden MD, and others.
    Current Treatment Options in Cardiovascular Medicine 2009, 11:289”301 Current Medicine Group LLC ISSN 1092-8464

    This would appear to add to the body of evidence and/or opinion that over-consumption of the polyunsaturated fatty acid LA is a factor that is promotional of CHD, and likely more ill health besides.
    If this emergent paradigm is valid, and if people (and manufacturers) migrate to increased use and consumption of vegetable oils as a consequence of the dogmatic anti-saturated fat message, then it is nothing short of a colossal disaster and unmitigated scandal.

  39. Jill H 13 February 2010 at 9:33 pm #

    These words jumped out at me. My oldest son is getting married in May and he and his fiancee introduced me to a book ‘Clean’ by Alejandro Junger with the words ‘Mum, this is the way you eat anyway isn’t it?’ Perhaps an ‘ah ha’ moment for them as they both looked wonderful following the recommendations in this book. I bought the book to read for myself and read the following ‘I heard my patient laughing so hard his oxygen mask flew off his face. …………I asked him what was so funny. He said ‘I just changed my favorite phrase from ‘I can’t believe it’s not butter’ to ‘I wish it had been butter’! Finding humor in tragedy sometimes carried me through those long nights on call. It also reminded me how believing in the latest product invented can be dangerous, even if it’s approved by the FDA and endorsed by cardiologists.’ Alejandro Junger, MD would appear to be a cardiologist with a different take on things.

  40. McHarris 1 April 2010 at 8:24 am #

    I have always enjoyed your blog and read it as it arrived. I missed the one about this Heart Surgeon. Caught up with it all now and also linked to your articles with my blog.

    Thanks for all the hard work you do on our behalf.

    http://just-me-in-t-health.blogspot.com/2010/03/is-saturated-fat-clogging-your-arteries.html

  41. anthony Kerstein 23 October 2011 at 3:22 pm #

    The high heart attack rate in North Karelia at that time probably had more to do with the fact that the population there, 20 years before lived in South Karelia, but 500,000 fled in the clothes they stood up in when the Soviet Union reclaimed and occupied that part of Finland. Social disruption and the stress that it causes is the biggest cause of heart attack, not diet.

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