It’s common knowledge that eating fatty food can put you at higher risk of having a heart attack. Right? Well, it turns out there may be more to this story than we think.
The idea that eating fat is bad for you might seem like it has always been around, but it turns out that it only really took hold in the United States after World War II. The so-called “Diet-Heart Hypothesis” was put forward by Ancel Keys in the late 1950s. Keys was a researcher interested in nutrition, who had already developed combat rations for the US military. In 1978, he published his now infamous twenty-year long “Seven Countries Study”, which purported to find a connection between a country’s fat consumption and that country’s rate of heart disease. The study was poorly thought out and performed with very questionable application of statistical principles, and has since been frequently ridiculed as an example of how statistical research can be used to mislead people. And yet, the idea that eating more fat meant increased risk of heart attack took hold.
Today, we see remnants of a hypothesis that was almost universally adopted in the medical system and by dietitians, to the point that low-fat diets are still used in many institutions around the world to supposedly provide “healthier” food. And, of course, you are no doubt aware that there is an abundance of “low-fat is better” messaging throughout our food supply and in our medical system. So let me try to explain why I think this is wrong.
Apparently, after Eisenhower had a heart attack in office, there was a lot of political will to try to figure out how and why the American population was suddenly succumbing to an epidemic of heart disease. Senator George McGovern was tasked with leading a Senate subcommittee to look into what kind of dietary advice could be given to Americans to make a dent in the growth of the heart disease epidemic. He and his subcommittee collected testimony for two years, and they ultimately concluded that something that seemed so commonsensical, that eating fat and cholesterol would clog your arteries in a way that would increase your risk of having a heart attack, might not be true.
I think it’s helpful to first understand that heart disease itself has not been with humans for that long. The earliest descriptions of angina, which usually refers to chest pain but sometimes shortness of breath and specifically takes place with exertion, actually trace back to England in the early years of industrialization. So, really only in the last few hundred years has angina started to be described, and it was described by more affluent Englishmen: a subset of society that had access to some new foods that humans had never had access to anywhere before, namely pulverized grains and refined sugar.
Despite what Ancel Keys tried to argue, the reality is that what people had been eating around the world for thousands of years, long before the appearance of heart disease, was actually a high fat diet. From the preponderance of butter and lard used in northern and Eastern European cooking, to the appreciation of fatty fish eaten as sushi and sashimi in Japan, humans the world over have prized the fattiest animal products over all others for their benefits to health and wellness. As an extreme example, the Masai warriors that hail from Kenya have a traditional diet 90% of which is derived from cow’s milk and cow’s blood, both of which are almost entirely made up of saturated fat—and yet, heart attacks were unheard of in this population until they started eating modern foods.
Human beings had definitely already been eating bread and other products made from whole grains for over 10,000 years, but the advent of industrialization allowed for grains to be milled so fine that you can imagine what tasty treats must have now been available: think of cake, pastry, and light fluffy bread. Not to mention, that with England’s colonial conquests in the new world, there was now an abundance of sugar available which could also be refined, thanks to industrial processes, into products like candy and various other sweetened products like baked goods.
So, it is actually modern foods and not traditional high-fat foods that seem to be connected with heart disease. And while I mentioned pulverized grains and refined sugars, I cannot finish this conversation without mentioning the advent and rise of vegetable oil, first by way of vegetable shortening, courtesy of Crisco around 1900. It seems impossible to ignore the fact that the increase in heart attacks throughout the twentieth century has coincided with one group of fats easily becoming the most highly-consumed fats of all: poly-unsaturated fatty acids found only in vegetable oils that require industrial oil refineries. Think of how dependent so many people have become in their kitchens on abundant and cheap vegetable oils like canola, sunflower, safflower, corn, and grapeseed. These are new to our society in the last 125 years, and it is not a stretch to suggest that these oils may be a major culprit in the heart disease epidemics seen around the world. I would suspect it’s a major contributor to India now having one of the highest burdens of coronary artery disease in the world, even though it’s a much more popular medical opinion these days to blame Indian people’s high risk of heart attack on their genetics.
In fact, I was exposed to the reality of this risk quite early in life, when my father was found to have severe coronary artery disease in his late 50s, and another relative in my family had a heart attack at the age of 28. It’s been over 20 years now that I have been on a mission to figure out what diet would be best to reduce my risk, and that of my children. The evidence I have described to you around heart disease levels worsening in the last 125 years, and most importantly the absence of significant heart disease in human societies eating high-fat foods, has led my family and I to try to adopt an ancestral diet instead of a modern one. It’s been very helpful for us to look at our food choices as a choice between eating safe foods that we know human beings have been eating for thousands of years, instead of modern foods that now seem experimental, given that human beings have only been eating some of them for less than a couple of hundred years. Foods that contain vegetable oil, drinks that contain refined sugar, even bread made with instant yeast: all of this is new and potentially harmful.
And it is important to understand the limits of science here, as you may wonder: if what I am saying is true, why is there no proof available?
It turns out that it is expensive and difficult to “prove” whether a food is helpful or harmful. Our scientific highest standard, when it comes to figuring out if some intervention is saving lives or not, generally requires randomized controlled trials, and these are almost impossible to conduct, over any decent time period, when it comes to food. The controversy and disagreement over Keys’ findings is a very good example of this.
If science is not going to help clarify this question, we need to turn to the abundance of human history to tell us how human beings used to eat, before widespread heart disease took hold.
So, if you are looking for a high heat oil, appropriate for frying foods, think of duck fat, or beef tallow, or even coconut oil. Where I live, our local grocery stores carry duck fat reliably, and while you may perceive a slight odor to the fat, as soon as it melts in a frying pan the odor disappears and it has a remarkably clean taste. When you are choosing dairy and meat products, choose the higher fat options the way our ancestors would have, eat the drumsticks and thighs of the chicken instead of the breast, keep the skin on, and choose the fattiest cuts of meat instead of the low-fat cuts.
To take this further, our ancestors would have eaten meat from chickens that were actually running around and eating bugs and grubs, rather than factory raised chickens eating corn and soybean byproducts, and they would have drunk milk and eaten meat from cows that were actually out to pasture eating grass. I have no doubt that the fats and proteins that we would get from these free-range animals may very well be entirely different from those produced by the industrial-farm complex.
So, if you think you know that eating fatty foods increases your risk of heart disease, please do think again. And for the picky eaters out there, remember that there are lots of ancestral diets to choose from, and, thankfully, there is more and more interest out there in eating the way human beings used to. Think of the popularity of making sourdough bread at home, without instant yeast, during the pandemic, and imagine enjoying that bread with butter from a grass-fed cow!
Bon appetit!
