Saturated Fat: Not Guilty

What a great weekend I had in Phoenix at Nutrition and Metabolism Society Symposium which was part of the American Society of Bariatric Physicians 2008 Western Regional Obesity Course.

- We heard Gary Taubes, author of the tour-de-force book Good Calories, Bad Calories speak both days. The first day was about obesity - how we've come to believe what we do about the causes of obesity and why they don't hold up to scrutiny. For example, we're told "just to cut calories". And yet, to maintain weight, which in general our bodies do very well unless something goes wrong, requires an accuracy of better than .4 percent, which amounts to about 10-12 calories per day. Our bodies have hormonal and other signaling systems to make sure weight is regulated. The idea that we can consciously intervene in this system for years on end is a fool's errand.

- The next day Taubes did the same thing for low-fat diets in general and saturated fat in particular. As a science write tackling an issue, he likes to go back and ask the question, "How did we come to believe that...". By going back in history to when the issue was controversial, he can trace how the science evolved. In the case of fat, there was a distinct lack of science, and instead lots of opinions getting popular in the right place at the time (or, in this case, "wrong" place and time). The attitude was, "people are dying out there, and we don't have time to wait and prove that this is really true...we'll just recommend it anyway". Over the years, as more science has come in, the original ideas are going down, but the medical establishment moves slowly.

If you haven't read Gary's book yet, it is highly recommended, especially if you like lots of science and history.

- Dr. Richard Feinman had an engaging and fun gimmick for his talk, "Dietary Carbohydrate and Saturated Fat: What we Teach Medical Students". We each got a white wand with buttons (A through E), and he asked us the same multiple-choice questions he asks his medical students for this lecture. We clicked on what we thought were the answers, and then a bar graph of our guesses appeared on the screen at the front of the room. Then he told us the real answer and explained. (Example: The dietary component most likely to raise plasma triglycerides is: carbohydrates, protein, or fat. Correct answer: carbohydrates.) It was interesting to see the answers of this group of doctors.

- Dr. Jeff Volek talked about the interaction of dietary carbohydrate and fat metabolism. It turns out that the context of a low-carb vs high-carb diet may actually make a difference in the effects of saturated fat in the body and how fat in general is metabolized. For example, people on high-carb diets, make a lot more fat, much of it saturated, than people on low-carb diets. So even though people on low-carb diets eat more saturated fat (in general) they end up with less in their bodies. I plan to talk to Dr. Volek more about this and report back to you in the months to come.

- Dr. Bruce German, an expert on fats, asked the provocative question, "Did saturated fat evolve to kill 50-year old men?" He emphasized how much variation there is between individuals to fat (and other dietary components) and feels that this is the future of nutritional research and advice. He is very concerned that agriculture is moving too quickly to eliminate certain fats from our diets. Dr. German is another person that I will talk to more in the future.

- There were many other dynamic and interesting talks, and I hope to bring tell you more about them. But in addition to all the people speaking, we got to see a movie! This is a documentary called "My Big Fat Diet" about research that was conducted in Alert Bay, British Columbia. In that area, there is a big problem with diabetes and obesity among the First People (Native people) there. The idea was to put them back on a diet similar to the ancestral diet of those people - high in fat and very low in carbohydrates. The documentary follows them through a year on the diet and the wonderful results - people stopping medication, losing weight, normalizing blood glucose, and other positive changes. Dr. Wortman, the principle researcher, also spoke, and the filmmaker was on hand as well. More Information About the Documentary

The final verdict on saturated fat? One speaker put it this way: In a court of law, it would be ruled "not guilty beyond a reasonable doubt" - the evidence is mixed but mostly that it is benign, and even the "bad" evidence shows it to be a very minor player in the risk factors for heart disease. This isn't to say that we don't still have a lot of learn about individual responses to saturated fat, how different saturated fats work in our bodies (coconut oil, anyone?), or how carbohydrates can modify the effects. There is still MUCH work to be done in this area!

Other highlights of the weekend for me personally:

- Chatting with Jackie Eberstein, who worked with Robert Atkins for 30 years, and hearing her moving reminiscences of him. We just recently passed the 5-year anniversary of the death of Dr. Atkins.

- Having a low-carb meal with likes of Mary Vernon, Gary Taubes, and Michael and Mary Dan Eades, and meeting so many interesting people -- scientists who are studying and thinking carefully about how our bodies work, physicians who are using carbohydrate restriction in their practices, and people working in many ways to get the word out about the health benefits of low-carb eating.

- Laughing (OK, and a little gossiping) with prolific blogger and podcaster Jimmy Moore and his wife Christine.

I'm already looking forward to next year!