In the debate over food and health, it is too soon to absolve fat and demonise sugar. Some nutritional clarity is urgently needed
ACCORDING to the Oxford English Dictionary, the expression "heart attack on a plate" was first recorded in 1984 in a newspaper interview with actor Michael Caine. He was living in health-conscious Los Angeles at the time and missing his full English breakfast. That rings true, as it was around then that the US public was being urged to reduce its intake of saturated fat to cut the risk of cardiovascular disease.
Thirty years on, the idea that pigging out on bacon, egg and sausages can lead to a heart attack is second nature to most of us; it is probably the single most influential piece of nutritional advice ever dished out.
But in recent weeks and months a steady drumbeat of media coverage has suggested that saturated fat has been unfairly maligned. "Eat Butter", declared the cover of Time magazine. "Everything we thought we knew about dietary fat is wrong," said the blurb on The Big Fat Surprise: Why butter, meat and cheese belong in a healthy diet, an influential book by investigative journalist Nina Teicholz.
Really? Everything? As usual, the truth is less earth-shattering. Yes, two large reviews of the evidence have cast doubt on the supposedly rock-solid link between saturated fat and cardiovascular disease. Scientific understanding of how the human body handles fat has indeed moved on. And the original research that proved the link has been questioned (see "Heart attack on a plate? The truth about saturated fat"). But it is too soon to declare saturated fat innocent of all charges. Much more research is needed before the nutrition rule book can be rewritten. In any case, meat, butter and cheese already belong in a healthy diet, as long as you don't eat too much of them.
If there is an immediate take-away message, it is that singling out one nutrient at the expense of the wider dietary context is a mistake. In our rush to cut down on saturated fat, we may have inadvertently upped our intake of other unhealthy nutrients, especially sugar. In fact, one of the interesting by-products of the saturated fat debate is that it is helping to reinforce the emerging idea that refined sugar is the real demon in our diets.
The case against sugar is getting stronger, as our story earlier this year spelled out (New Scientist, 1 February, p 34). But it would be a mistake to fixate on sugar at the expense of everything else.
As Susan Jebb, professor of diet and population health at the University of Oxford, told New Scientist: "If we have learned anything from the low-fat era, it is surely that it is not as simple as one single nutrient. Are we not in real danger of making the same mistake again by saying it's all about sugar, and if we cut the sugar it will be fine?"
Those charged with making and disseminating public health advice should take that message very seriously. Part of the reason for the gleeful, almost celebratory, response to the saturated fat rethink is that people do not like being lectured to by the health police, and enjoy gloating when they appear to have got it wrong.
We need public health authorities, of course, but we also need them to get their messages right. With the confusion surrounding fat and sugar, it is surely time for the appropriate bodies – including the UK's Scientific Advisory Committee on Nutrition, which last reviewed the evidence on fat in 1991 – to step up to the plate and provide some clear, honest and evidence-based advice on what now constitutes a healthy diet.
This article appeared in print under the headline "The low-down on fat"
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