19 January 2010

Ban butter ? No, we should ban processed margarines!

Supports Chapter One: Trick to Treat

The UK media have been full of a story which illustrates well how we are put in fear unnecessarily - and irresponsibly.

Shyam Kolvekar, a consultant heart surgeon at University College London Hospitals has said that butter should be banned to protect the nation's health. Warning of the dangers of other foods high in saturated fat, he advises people to eat less red meat, take low-fat milk and switch to olive and sunflower oil. He went on to warn that:
"Saturated fat is blamed for a third of the 200,000 premature deaths from heart disease a year. . . By banning butter and replacing it with a healthy spread the average daily sat-fat intake would be reduced by eight grams."
BUT: That's not what the evidence shows!

Mr Kolvekar may be a good heart surgeon, but he is obviously not an expert in nutrition and its effects on health. In its report of this story, the BBC shows Mr Kolvekar operating on an Indian Hindu - in the UK. Indians have been using ghee (clarified butter) for centuries - without getting blocked arteries. Mr Kolvekar said when he became a consultant cardiac surgeon eight years ago the bulk of bypass operations he did were on older people. Now he is seeing people in their 40s and 50s needing triple bypasses. So are Indians eating more ghee than they did just eight years ago? Of course not!

In 1967 Dr S. L. Malhotra, reported that in Madras, the population was vegetarian, living mainly on rice.[1] The principal fat in their diet was polyunsaturated peanut oil. Malhotra compared the Madrasis with a population who lived near Udaipur in the north. Their religion allowed them to eat meat and their fat intake was almost entirely from animal sources. They cooked with ghee and had probably the highest butterfat consumption in the world.

Present-day wisdom would predict that the vegetarians would have the lower rate of heart disease, but Malhotra found the opposite: the vegetarian Madrasis had 15 times the death rate from heart attacks compared with the northern Indians even though those in Udaipur ate 9 times as much fat - and that fat was animal fat.

Twenty years later, a paper in the Lancet noted an increase in heart-attack deaths amongst the latter group.[2] By this time their diet had been made 'healthier' by replacing the traditional ghee in their diets with margarine and refined vegetable oils. This was confirmed 10 years later by a third study which found that reducing saturated fat did not reduce heart disease risk.[3]

The truth is that arteries are not blocked by eating ghee, but by adopting our 'healthy' western diet. This is backed up by many studies showing that south Asians in the UK have higher heart disease rates than they do in India.[4-5]

People who have had one heart attack are invariably told by their doctors to cut out butter and use polyunsaturated margarines instead. But there is no evidence that this will prolong their lives. Quite the opposite. As long ago as 1965 survival rates were studied in patients eating different fats and oils.[6]

In this study, patients who had already had one heart attack were assigned to one of three groups, who were given polyunsatu­rated corn oil, mono­unsaturated olive oil or saturated animal fats respectively. Blood cholesterol levels were lowered by an average of 30% in the polyunsaturated group, while there was no change in the other two groups. At first sight, therefore, it seemed that men in the polyunsaturated group had the best chance of survival. However, at the end of the two-year trial only 52% of the polyunsaturated group were still alive and free of a fresh heart attack. Those on the monounsaturated olive oil fared little better: 57% survived and had no further attack. But those eating the saturated animal fats fared the best with 75% surviving and without a further attack.

The hypothesis that saturated fats raise cholesterol and clog arteries was proposed in the 1950s, but has never been verified and confirmed - and it isn't for want of trying. There is not now, and there never has been any evidence that saturated fats are harmful in any way. In fact all the evidence points the other way. If any fats should be banned, it's the processed vegetable margarines and cooking oils.

References
1. Malhotra SL. Serum lipids, dietary factors and ischemic heart disease. Am J Clin Nutr 1967; 20: 462-475.
2. (No authors listed.) Ghee, cholesterol, and heart disease. Lancet 1987; 2: 1144-1145.
3. Singh RB, et al. Low fat intake and coronary artery disease in a population with higher prevalence of coronary artery disease: The Indian paradox. J Am Coll Nutr 1998; 17: 342-350.
4. McKeigne P M, Marmot M G, Adelstein A M, et al. Diet and risk factors for
coronary heart disease in Asians in Northeast London. Lancet 1985; ii: 1086.
5. Raheja BS. Obesity and coronary risk factors among South Asians. Lancet 1991; 337: 971.
6. Rose GA, et al. Corn oil in treatment of ischaemic heart disease. Br Med J 1965; 1: 1531-33.

22 comments:

Dr.A said...

Thanks for this post, Barry. The low-carb blogosphere is up in arms about it - I was slightly less polite than you in my post!
And Clarissa Dickson-Wright has put her boot in in the Daily Mail.

Dr.A said...

Sorry! By 'it' I meant the Kolvekar thing, not your post!

Luddite_Jean said...

Unfortunately, my mother listened to the doctors and would only eat Flora et al and cook using sunflower oil, as well as eating lots of carbohydrates as recommended by the health industry. When she died after 20 years of misery from illness, she had breast cancer, cataracts, macular degeneration (wet and dry), COPD, arthritis, rheumatoid arthritis, dementia, diverticulitis, congestive heart failure, blocked arteries, osteoporosis and asthma.

I've been avoiding margarine and using quality butter for about 10 years now, and have just embarked on reducing carbohydrate in my diet.

Nightingale said...

It's really tragic, especially that doctors can't get their minds around the data.

I've just been diagnosed with a cancerous lesion in my breast, and already I'm hearing about the joys and benefits of going vegan and fat-free. Boy am I going to upset people, because I will not go that route.

Mr. Groves, I have tried in vain to copy and send you latest article to friends and family, but the computer will not allow it to be sent. Is there some sort of hold on your articles?

Keep sounding the alarm.

Barry Groves said...

Hello Nightingale

Thank you for your support. I'm so sorry to hear of your news.

There should be nothing to stop you from copying anything on my websites but, if, for some reason you can't, let me know and I'll email what you want.

Dr A
Some were even less polite than you about our infamous surgeon. I'm happy to say that the Daily Mail published my letter to them in today's edition. It occupied almost a whole column.

Jean
It is because of stories like yours that I knew it was time to write Trick and Treat

Barry

Anonymous said...

Hi Barry

Can't find your letter on the Daily Mail website - can you post it here please?

Why was I not surprised that Kolvekar has links to Unilever!

Tanya

Barry Groves said...

Hi Tanya

My letter to the Daily Mail is what I wrote in my blog, above, below the heading: "BUT: That's not what the evidence shows!"

The Mail published the body text of that minus the references.

In the same edition was a very big article, which was saying exactly the same thing as I did in Trick and Treat about how vets and the pet-food industry are destroying dogs' and cats' health in order to line their pockets. You can read it here

I must write another book. I'll call it Trick and Treat for Pets: How 'healthy' pet foods are making them ill"

Barry

Anonymous said...

do you have a the link to this on www.daily.co.uk ? I do the IN THE NEWS page on the new WAPF website and I need a link to add this there.

Carolyn

Barry Groves said...

Hi Carolyn

the URL of the original article is http://www.dailymail.co.uk/health/article-1244048/Ban-butter-save-thousands-lives-says-heart-surgeon.html. My letter is not published online.

Barry

Dr.A said...

Re the pet food.. I'm always confused why some cat food has rice and vegetables in.. I guess it's just a marketing gimmick for gullible owners!

Robert Su, Pharm.B., M.D. said...

One who blames fats for illness does not know how each of the nutrient, carbohydrate, protein, and fat, works on his health. We have ignored or forgot the ill impacts of carbohydrates, which indeed should be restricted! Visit www.carbohydratescankill.com

Barry Groves said...

Dr A

Rice and vegetables are used for one or more of several reasons:

1. rice and veges are cheaper than meat

2. incorrect diet helps to keep vets in business

3 owners are ignorant and/or gullible: I actually get emails from dog owners telling me that dogs really should eat veges!!

4. pet-food manufacturers are ignorant and/or greedy.

You pick which you like.

When we had cats, they always ate nothing but meat. We would leave food out for them all day; they could eat as much as they wanted, when they wanted; we never had a fat cat.

Except once.

One cat liked the dry cat biscuits, so we let her have just 6 of them a day. Suzie was really slim. On one occasion, when we went on holiday for two weeks, we left the feeding of Suzie to a cat-sitter, with strict instructions about feeding and on the number of cat biscuits she could have. When we returned, Suzie was fat! And the box of biscuits, which should have lasted months, was almost empty. We never employed a cat-sitter again.

Suzie was our last cat. She lived an entirely healthy life to the age of 17 1/2. She was never vaccinated and we had only one vet's bill when she had been attacked by a predatory bird.

Hi Robert Su

I really don't like my blog being used purely for advertising purposes; however, I'll leave your post on as your website has a wealth of useful references.

Barry

Anonymous said...

Barry,

A bit of googling on the name Kolvekar:

http://www.drbriffa.com/blog/2010/01/21/heart-surgeon-waging-war-on-saturated-fat-seems-seriously-short-on-science-to-support-his-claims/

Steve

Nigel Kinbrum BSc(Hons)Eng said...

Hi Barry.

Dr John Briffa's post does an excellent demolition job on the infamous "North Karelia Project".

RE Cat food: I had to laugh at Richard Nikoley's retort to Sylvia Anderson. "Tell you what, genius: go get a cat and feed it lettuce & carrots. Tell me how it works out."

Cheers, Nige.

Barry Groves said...

Hello again Nigel

John Briffa did indeed demolish Kolvekar. It's a great letter. I have also written an email to Mr Kolvekar, along the lines of the subject of this post. As yet I have had no reply.

I am very surprised that Mr Kolvekar used the North Karelia Project as his reference as it is one which certainly does not support any of the interventions. I had found this last century when I wrote "The Cholesterol Myth", which was the first article I published on my website a decade ago. The results of the Karelia Project were clear and unequivocal. There was a decline in CHD mortality throughout Finland during the period of the study; the decline was less in the intervention group (North Karelia).

As I said in that article, it certainly does not provide any support for lowering saturated fat intake, or any of the other interventions. Indeed the interventions in NK appeared to prevent the decline in heart disease.

It is instances like this that remind me of a saying of Morrie Brickman:
I don’t know if the world is full of smart men bluffing or imbeciles who mean it.

I think I know the answer to that dilemma.

Barry

TedHutchinson said...

For those interested in the science underlying the claim, saturated fat does not lead to heart disease, these 2 online full text papers provide a good summary.
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease Patty W Siri-Tarino, Qi Sun, Frank B Hu, and Ronald M Krauss, Jan. 2010
Dietary Fat and Coronary Heart Disease: Summary of Evidence from Prospective Cohort and Randomised Controlled Trial
C. Murray Skeaff Jody Miller
Department of Human Nutrition, University of Otago, Dunedin , New Zealand

Suzie said...

Yes Barry, trick or treat for pets would be a great book, loads of information to uncover out there. Raw feeding is the way forward.

Suzie Uttley

Barry Groves said...

Hello Suzie

Thanks; that's a good idea. But, while I could certainly put something on my website about animal feeding, I doubt I have enough for a book. I#'ll think about it.

Barry

Nightingale said...

Dear Mr Groves,

Just as I suspected the books on breast cancer are advocating a low fat, high complex carbohydrate diet. I tried that 10 years ago and had a bout of raging hypoglycemia.

The breast cancer books also state studies that link a high fat diet to breast cancer. I've also heard people site "studies" that say eating a high fat meal decreases blood flow in coronary arteries.

Can you site any studies that refute these two assertions? I really need this information.

Barry Groves said...

Hi Nightingale

To answer your breast cancer questions, see:
http://www.second-opinions.co.uk/cancer-breast.html and
http://www.second-opinions.co.uk/fats_and_cancer.html

The only study I know of purporting to show that eating a high fat meal decreases blood flow in the coronary arteries, involved just 5 participants eating both high and low fat diets and the confidence intervals crossed the nul point, meaning that some participants benefited from eating high-fat meals! (Ann Intern Med. 2002 Apr 2;136(7):523-8)

I really wouldn't worry about it.

Barry

TedHutchinson said...

Nightingale may also find Cancer as a metabolic disease an interesting read.

But don't forget Omega3 and Vitamin D3 are also an important part of the equation.

Barry Groves said...

Hi Ted

That new paper certainly looks useful. I haven't read it all yet, but I thank you for mentioning it.

I have covered both vitamin D3 and omega-3 fats in the two references I gave. While I am a great believer in the cancer protective benefits of vitamin D3 - it's why I'm in Lanzarote now - I am not convinced that larger intakes of omega-3 fats are helpful. I mentioned this HERE

"In 1990, Martin called Newsholme's Oxford University office but by then Newsholme had retired. Martin spoke to his successor to find that they were still treating autoimmune diseases with PUFs. By then they were using fish oil. The doctor said the reason for the fish oil was that the degree of immunosuppression increased with the degree of unsaturation and fish oil was much more unsaturated than sunflower oil. Martin asked the doctor why they were not talking about PUFs causing cancer. The doctor replied that if he did that he would be run out of Oxford."

Rather than increase omega-3 fatty acids, I think it is safer to reduce omega-6 to achieve a balance.

Barry