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The problem with healthy fats

Roxanne B. Sukol, MD
Conditions
November 14, 2011
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Frankly, it rankles me when people use the term “healthy fats.”  We don’t make a distinction like that when we’re talking about carbohydrates, although there are certainly carbs that are nutritious and carbs that are not.

Consider the Atkins diet.  I like to believe that Dr. Atkins was on the right track, but that he had some of the details wrong.  Clearly, he realized that there was something about carbohydrate in the American diet that was causing a problem.  But he did not understand that there is a big difference between muffins and mangoes, white flour and lentils, table sugar and peaches.  So people who tried the Atkins diet lost lots of weight when they removed virtually ALL the carb from their diets, even green beans, and then regained it when they got tired of the restriction and began to eat breakfast cereal again.  Along with doughnuts, pasta, bread, cookies, cake, and potato chips.

Dr. Atkins also did not understand that there is a big difference between a slice of salmon and a scoop of Crisco.  To him, all fats were the same and they all were good.  We know now that that is not true.

We are still sorting out the differences among the three main families of fats: saturated, monounsaturated, and polyunsaturated.  We know for sure that omega-3 polyunsaturated fatty acids are very good for us, and that the standard American diet is extremely deficient in them.  We know that we can increase our consumption of omega-3s by eating more fish, walnuts, flax seed, and green, leafy vegetables.

We have seen the benefits of the Mediterranean diet, in which olive oil (a monounsaturated fat) is the main fat used for cooking, and from this we understand that olive oil, too, is good for us.  Conversely, we know that trans fats (partially hydrogenated polyunsaturated fats) damage blood vessels, causing heart attacks and strokes.  We know they also increase the risk of diabetes, high blood pressure, and high cholesterol.  So trans fats are definitely NOT good.

But there is still a great deal to figure out.  We know, for example, that cocoa butter is one of the most highly saturated fats on the planet.  But….isn’t dark chocolate supposed to be good?  And aren’t saturated fats supposed to be bad?  So what does this tell me?  That we still have a lot to learn.

Want another curious example?  Most animal fats are actually a mixture of a variety of monounsaturated, polyunsaturated and saturated fats.  Which animal fat contains the most monounsaturated fat, similar to olive oil?  Lard.  Yes, believe it or not, that is true.  So what is most clear to me at this point is that we still, indeed, have a lot to learn.

At the same time, there are some things that I do understand.  The fact is that there are good examples of nutritious foods from each of the three main nutrient groups (fats, carbohydrates, and protein).  If I’m going to make a recommendation that you try one, or if I use one in a recipe or an explanation, I don’t think I need to qualify it with the word “healthy.”   Fat IS healthy.  Protein IS healthy.  Carbohydrates are healthy, too, as long as you get most of them the way our ancestors did, from the garden, with the fiber still intact.  Think fruits, vegetables, legumes, whole grains. These are carbohydrates, through and through.  When I include one in a recipe, I don’t need to say “healthy” apples.  You can assume that I am referring to apples without worms or pesticides.

When I talk about fats and oils, you can assume the same.

Roxanne Sukol is an internal medicine physician who blogs at Your Health is on Your Plate.

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