Is Butter Back? with Brenda Davis R.D.

so I want to address this really quickly because a lot of people say but wasn’t saturated fat vindicated did anybody see the headlines that saturated fat has been vindicated butter is back you don’t have to worry about saturated fat at all anymore well there were two studies that suggested we don’t have to worry about saturated fat and one was an analysis by Siri Torino and the other was an analysis by child hurry and I’ve highlighted in yellow here a few names that were involved with these trials Frank who Francesca crow dr. Massa Farion dr. Anjali I think Angela you know or something anyway we’ll see it and bigger and then I’ll be able to say it so I can’t read it so well there but here’s the headlines we saw saturated fat isn’t bad for your heart you know saturated fat may not cause heart disease not so bad after all etc etc etc well the people at Harvard said the media misrepresented and sensationalized these study results contributing to a haze of confusion among consumers and they brought together a group of nutrition experts to do a teach-in and in that were Frank who who was an author of the first study dr. Massa Farion who is an author of the second study Frank Sachs Ellis Lichtenstein who wrote the position paper for the American Heart Association and Walter Willett again and here’s what the panel consensus was cutting back on saturated fat is good for health if the saturated fat is replaced with good fats especially polyunsaturated fats if you replace saturated fats with refined carbohydrates like sugar there will be a detrimental effect food quality matters we’ve got to focus on food sources and dietary patterns rather than nutrients alone and they basically determined that saturated fat increases LDL and HDL but with an overall negative effect on car metabolic risk so they’re saying it’s not good replacing saturated fat with polyunsaturated fat lowers risk trans fat increases risk significantly refined carbs adverse effects monounsaturated fat uncertain effects and unrefined carbohydrates favorable effects and dr. Walter Willett did this little diagram you replace that trait of fat with trans fat the worst possible outcome with refined carbs the next worst with monounsaturated fat not so bad with unrefined carbohydrates much better and with polyunsaturated vegetable fat much better as well here’s what dr. who said and remember he was an author of the first study that vindicated saturated fat dietary recommendations should be food based replacing high saturated fat foods such as red and processed meats with and butter with vegetable oils high in Manos and piu FFA’s or polyunsaturated fats nuts seeds legumes and whole grains there’s a world-renowned expert who was interviewed about this whole saturated fat fiasco and he says the fact that saturated fat raises cholesterol is beyond doubt that has been shown in hundreds of trials that fed people different types of fat the observational studies he’s talking about these two studies sometimes do not show a link for two main reasons reason number one the differences in saturated fat intake within populations are too small to produce an effect so if you compare someone eating 12% of calories from saturated fat with someone eating 14% of calories from saturated fat you won’t see huge differences the dietary data is inaccurate in a lot of these studies you know what they do they often do one 24-hour recall what did you eat yesterday and then follow the people for 10 years and don’t know other Dietary assessments none zero that’s shocking it’s shocking the meta-analysis and again the meta-analysis included in the second trial the shop Chowdhury trial gave people margarine that was high in trans fats when the authors omitted that trial they found that people who replace saturated fat with polyunsaturated fat actually had a 19 percent lower risk of heart disease but the meta-analysis buried that finding in a supplement after they were challenged that didn’t make the headlines 19 out of the 20 studies compared populations with almost no variation in saturated fat intake and this is very interesting the rate of cardiovascular disease in Finland where there’s very high saturated fat intake was four point time four point four times higher than that of Japan which was in this study in the same meta-analysis but they didn’t show that because they only looked at differences within each population so the Japanese people that some of were eating 6% of calories from saturated fat and some ate they didn’t see any difference in Finland 15 vs. 17 they didn’t see any difference if they would have compared between the different populations they would have seen a huge difference okay an epic Oxford was the only study in that trial the only Madonna the only study used in the meta-analysis that included a wide range you know the wide range the non vegetarians vegetarians the vegans etc they found a 2 point 7 7 times greater risk in those with the lowest or the highest saturated fat intake versus the lowest saturated fat intake so that tells you something as well now this is very interesting because I I actually emailed one of the authors of the Chowdhury study and I said what’s with this study there’s it just doesn’t make sense based on what we know she wrote me back and she explained to me that she had been very involved with the study when it was first done and she said they found a big difference in people eating the most saturated fat versus the least saturated fat but when they submitted it to a journal it was not accepted there was nothing new so the lead author took and reworked to the data taking out some of the studies like the one you saw in the last slide resubmitted it with a little different finding and it got accepted and she said when it was sent back to her she said it was within a week of being published and there was nothing she could do and here’s what she said the best available evidence from randomized control trials shows that saturated fat intake affects blood cholesterol levels which is an important risk factor for heart disease therefore current guidelines should still recommend that people minimize their intakes of saturated fat and what do people recommend well the American College of Cardiology and the American Heart Association recommend that people aim for a dietary pattern that achieves 5 to 6 percent of calories from saturated fat you’re basically talking a plant-based diet you cannot get down to 5 to 6 percent of calories from saturated fat if you’re not eating a plant-based diet and their level of evidence was the strongest level of evidence that exists okay and that you know that’s our conservative organizations

so what about heart disease reverse so what we know and I won’t go into detail but you know dr. Caldwell Esselstyn has shown heart disease reversal using a low-fat plant-based diet as has dr. Dean Ornish both of dr. Esselstyn showing 72% of those tested getting reversal and and dr. Ornish finding 82% with reversal and a dr. Esselstyn just put out a study in 2014 that was quite interesting 198 patients with cardiovert are do vascular disease 177 adhered to his program 21 were non-adherent the recurrence rate was 0.6% among the adherent people and it was 62% among the non adherent and you know this study wasn’t a good study it wasn’t it was a self-selected group there was no control it wasn’t randomized all of that stuff but nonetheless it’s very interesting and very powerful findings this cartoon says heads you get a quadruple bypass tails you eat your veggies and I think the point here is you have a choice you know on in your treatment for cardiovascular disease and you have a choice in avoiding cardiovascular disease altogether the take-home message is whole food plant-based diets protect against cardiovascular disease and well-designed plant-based diets can provide more effective treatment than our most powerful medications and surgeries

cancer the World Cancer Research Fund and the American Institute for cancer research probably put out the most comprehensive documents ever written on diet and cancer and in 2007 they put out this food nutrition physical activity in the prevention of cancer a global perspective and it involved over a hundred scientists from 30 different countries around the world and what’s really interesting is they have an independent group of scientists that updates recommendations on an ongoing basis this is called the continuous update project so we’re getting you know they keep looking at the research and updating us on diet and cancer and they have a series of goals and recommendations and they basically say that they believe that populations and people who achieve these recommendations will not only reduce the risk of cancer but reduce the risk of many other diseases as well and there are two recommendations that have anything to do with our plant intake and our animal our intake of animal foods and plant foods and they are under plant foods eat mostly foods of plant origin eat at least five servings or 400 grams of a variety of non starchy vegetables and fruits every day eat relatively unprocessed cereal grains and/or pulses or legumes with every meal and limit refined starchy foods and people who consume starchy roots and tubers like potatoes make sure that they have sufficient non starchy vegetables fruits and pulses or legumes as well the justification for this recommendation most diets that are protective against cancer are made up of foods of plant origin and if you look at this list this is inside the book they list vegetables fruits pulses nuts seeds herbs spices and the risk of cancer you can see the decreases risk column and the increases risk column there is nothing in the increases risk column these foods don’t increase risk based on the studies we have but they seriously reduce risk and there was a one finding that was upgraded foods with fiber reduce risk of colon cancer colorectal cancer went from probable to convincing in 2011 animal foods what do they say limit intake of red meat and avoid avoid processed meat people who eat red meat to consume less than 500 grams a week very little if any to be processed justification red and processed meats are convincing or probable causes of some cancers and here’s meat poultry fish eggs in the risk of cancer you can see in the decreases risk column the only thing there is fish for colorectal cancer you can see in the increases risk convincing evidence for red and processed meat and colorectal cancer and probable or limited or suggestive evidence for several other cancers there have been several about seven meta analyses that have looked at unprocessed red meat and cancer in 2012 to 2014 and you can see basically this is unprocessed red meat increasing risk of a variety of cancers between about 10 and about 20 or thirty percent total red meat increasing risk about forty five percent here’s processed red meat and cancer increasing risk about fifteen to twenty five percent per serving the American Institute of cancer research estimated that about 45 percent of colorectal cases could be prevented if we all ate more fiber rich plant foods and less meat drank less alcohol moved more in stayed lean so what are the rates among veg populations vegetarians and vegans well epic Oxford compared to similar health-conscious non vegetarians cancer rates were 19% lower among vegans twelve percent lower among pesco vegetarians and 11 percent lower among lacto-ovo vegetarians so you can imagine this is compared to health-conscious meat eaters imagine what it would be if it were compared to non health-conscious meteor’s the average Western diet eaters it would probably be fifty or sixty percent lower the Adventist Health Study – again almost 70,000 participants compared to non vegetarians cancer risk was 16% lower among vegans twelve percent lower among pesco vegetarians and eight percent lower among lacto-ovo vegetarians 2012 meta-analysis the sames twelve seven studies that I talked about before the result showed cancer incidence and mortality rates were 18% lower among vegetarians compared with non vegetarians so why the veg advantage well plant-based diets have been shown to inhibit cancer cell growth reduce DNA damage improve DNA repair lower igf-1 levels or insulin-like growth factor-1 levels favorably alter fecal enzymes and gut microflora and reduce levels of of a variety of toxic metabolites so what about soy and we talked a little bit about soy yesterday but I want to talk about the weight of the evidence for soy and cancer the American Institute of cancer research had a press release in 2012 and this is what the press relief said release said for all cancers human studies show soy foods do not increase cancer risk and in some cases may even lower it breast cancer patients and survivors need no longer worry about eating moderate amounts of soy foods so here’s what we know about soy and breast cancer in a 2014 meta-analysis soy consumers in Asia had a 41% risk reduction no association was noted in Western countries in this meta-analysis in 2012 there was a pooled analysis of Chinese and American women those with the highest intakes of isoflavones and that is the phytoestrogen in soy were 17% less likely to die from breast cancer and 25% less likely to have a recurrence of breast cancer I think this study is one of the most interesting this is a study from Korea 2013 people with the highest quartile of soy intake had a 61 percent lower risk if they were Braca one or bracha two carriers the people with the highest quartile of median take had a hundred and ninety-seven percent higher risk regardless of their bracha status whether or not they were Braca positive so very very interesting so soy was very protective and the highest quartile of soy was actually four to five servings a day soy intake in childhood moderate soy consumption in childhood adolescents and throughout puberty actually reduces lifetime breast cancer risk so what about soy and prostate cancer well a 2014 system systematic review and meta-analysis report reported that high soy that high-risk men in high-risk men intake of soy or soy isoflavones reduced risk of prostate cancer by 51% preliminary evidence suggests that soy actually reduces prostate cancer metastasis slows rise in PA reduces side-effects also from radiation therapy the take-home message here is populations eating plant-based diets have lower cancer rates and plant-based diets have several lower or people eating plant-based diets lower several metabolic risk factors for cancer