The Longevity Solution
Page 16
In 2014, Dr. Dariush Mozaffarian, dean of Tufts University’s Friedman School of Nutritional Science and Policy, did a thorough review of all available literature. He found that eating more saturated fats did not increase the risk of heart disease.17 This finding closely echoes the findings from a 2010 analysis done by Dr. Ronald Krauss, director of atherosclerosis research at the Children’s Hospital Oakland Research Institute, and Dr. Frank Hu from Harvard. Their analysis showed that eating more saturated fats was not associated with more heart disease, and paradoxically, it might be preventative for stroke.18
In 2017, Dr. Salim Yusuf performed the most comprehensive nutritional survey yet done: the Prospective Urban Rural Epidemiological (PURE) study. It spans eighteen countries and five continents; it followed more than 135,000 people for an average of 7.4 years. Given the overwhelming importance of diet and heart disease, it was vital to have rigorous evidence upon which to base national guidelines.
The PURE study showed eating more total or saturated fat decreased the risk of heart disease and death (see Figure 11.3).19 Those subjects who ate the most fat had a 23 percent reduction in risk of death compared to those who ate the least fat, with similar results for saturated fat. The risk of heart disease was also 30 percent lower. The saturated fats that we had all feared as the cause of heart attacks were protective. The widely sanctioned and government-approved dietary guidelines to reduce total and saturated fats in our diets were completely divorced from reality. There was, and still is, no reason to avoid natural fats and saturated fats.
Eating a high-carbohydrate diet, as recommended originally in the 1977 Dietary Goals for the United States was also super harmful. In the PURE study, a high-carbohydrate diet was associated with a 28 percent increased risk of death and heart disease. Ironically, the advice for Americans to consume 55 to 60 percent of their calories from carbohydrates was the precise amount from this study that was the most lethal. The original USDA Food Pyramid made no distinction between processed and unprocessed carbohydrates, so the diet of Americans relied heavily upon the highly refined carbohydrates, like white bread and pasta, that were the most problematic.
Fig. 11.3: Decreased mortality with increasing saturated fat intake
Good Fats: Monounsaturated
Replacing saturated with polyunsaturated fats was not good. But what about using monounsaturated fatty acids (MUFAs)? Most studies of MUFAs are problematic because of confounding by the variations in carbohydrate intake.20 The Kanwu study shows that MUFA21 improved insulin sensitivity in those taking a high-carbohydrate diet.
Switching patients from saturated fat (milk, butter, cheese, and fatty meat) to MUFA (olive oil, nuts, and avocados) resulted in slightly more weight loss, increased energy expenditure, and lower blood pressure despite equal caloric intake.22 More importantly, the MUFA-rich diet improved the more dangerous fat around the abdomen—visceral fat. In other studies, the saturated fat palm oil raised insulin and lowered energy expenditure when added to a diet high in sugar.23 The MUFA oleic acid, on the other hand, showed a slight increase in daily energy expenditure.24
Eating more monounsaturated fats might give you more wiggle room to eat more carbohydrates without becoming insulin resistant or gaining weight. Perhaps this is why many people living in the Mediterranean stay slim and healthy while enjoying bread and pasta. First, they enjoy these foods without gorging on them with bottomless bowls and multiple refills. Second, the high-carb foods often are accompanied by a generous drizzle of olive oil. A large analysis of fifty epidemiological and randomized controlled studies encompassing more than 500,000 people found that adherence to a Mediterranean diet can improve waist circumference, HDL, triglycerides, blood pressure, and blood glucose levels.25
Oleic acid (the predominant fat in olive oil) has a greater oxidation rate than stearic acid (a saturated fat found in beef and chocolate).26 The result is that it liberates more energy, which increases satiety and reduces subsequent food intake. It also increases fat burning at the cellular level27 and requires more energy for digestion.28 These things are true even for obese post-menopausal women, a group that has a notoriously difficult time losing weight.29 Switching from cream to olive oil allowed these women to use more fat for cellular energy rather than carbohydrate. If you want to lose body fat, you’ve got to use body fat, not carbohydrate.
Strategic fats for a higher carb diet include more nuts, olive oil, and avocados, and less fatty meat and full-fat dairy (cheese, milk, butter). If you do follow a low-carb diet and the occasional “cheat day” sneaks in, it might be better to try to get fats from monounsaturated sources than from saturated sources. (Skip the meat-lovers pizza and opt for sushi, with lots of avocado along with the rice.)
Natural saturated fats are fine, but for weight loss, consider replacing them with monounsaturated fat, especially if you favor a more moderate carb intake rather than a low-carb diet.
The Benefits of Consuming Less Saturated Fat and More Monounsaturated Fat
The following are some effects of consuming less saturated fat and more monounsaturated fat for those consuming a diet moderate to high in carbohydrates:30
• Greater weight loss and fat loss
• Less loss of muscle and lean tissue
• Reduced blood pressure
• Greater post-meal fat oxidation (burning fat rather than carbohydrate)
• Lower post-meal triglycerides
• Higher post-meal HDL
Medium-Chain Triglycerides and Coconut Oil
Coconut oil is rich in the medium-chain-length saturated fatty acids lauric acid and myristic acid. Most dietary fats are composed of carbon chains that have twelve to twenty-two carbons. Medium-chain triglycerides (MCTs) have only six to twelve carbons, and this shorter length might provide some health benefits. Coconut oil has MCTs; other sources might include palm kernel oil, butter, and whole milk.
The shorter chain length makes it possible for the body to absorb MCTs more rapidly, so they’re quickly converted to ketones and metabolized for fuel. Technically speaking, MCTs are absorbed directly into the portal circulation that goes from the intestines to the liver. The lymphatic system absorbs longer-chain fatty acids into the blood; from there, the fatty acids go to the fat cells for storage, so much of it never makes it to the liver. In the liver, MCTs cross the mitochondrial membrane quickly (mitochondria are the power-producing parts of cells), and carnitine doesn’t need to be present for this to happen. In short, MCTs go directly to the liver, where they are metabolized much more quickly into energy. This accelerated metabolic conversion into fuel means that potentially less is stored as body fat and more is burned for fuel.
Coconut oil does raise total cholesterol, but it preferentially increases HDL, the “good” cholesterol, which explains some of its reported heart benefits.31 And “virgin” coconut oil, which is similar to virgin olive oil, is even healthier because it’s extracted solely through mechanical means without heat or chemicals and retains all of the bioactive polyphenols typically lost in refinement.32 Organic Traditions makes a great organic raw coconut oil.
Human studies using MCTs show some promising results, including greater weight loss compared to olive oil33 and longer-chained saturated fats.34 The greater weight loss may be attributable to appetite suppression or increased energy expenditure. Fast conversion of MCTs to energy activates satiety mechanisms to stop eating, which has huge significance in weight loss efforts. High MCT intake led to significantly lower overall calorie consumption—in one study, an average of 256 fewer calories per day,35 and 41 to 169 calories per day in another study.36
MCT oil might increase energy expenditure when it’s substituted for other oils.37 Dr. Marie-Pierre St-Onge, an associate professor of nutrition at Cornell University Medical School who has been studying MCTs for almost two decades, says, “Coconut oil has a higher proportion of medium-chain triglycerides than most other fats or oils, and my research showed eating medium-chain triglycerides may increase the rate of metabol
ism more than eating long-chain triglycerides.”38 A diet with 30 grams of MCTs increased twenty-four-hour energy expenditure by 114 calories.39 Although these overall effects are relatively small, the combination of increased energy expenditure with decreased appetite over long periods might hold significant benefits.
MCTs lack the polyphenols found in many foods high in MUFA (such as avocados, olives, and nuts). However, coconut oil significantly raises HDL. Traditional populations in the South Pacific that subsisted on large amounts of coconuts, loaded with coconut oil, maintained excellent health for generations. The traditional foods on the islands of Kitava, Trobriand Islands, and Papua New Guinea included roots, fish, and coconut. Studies of this diet found the “apparent absence of stroke and ischaemic heart disease.”40 A high intake of the saturated fats in coconut oil did not “clog” arteries. Instead, there was virtually no heart disease at all.
The Tokelau migrant study demonstrates once again the potential benefits of coconut oil.41 The small South Pacific island of Tokelau lies northeast of New Zealand, and for generations the locals subsisted on fish, breadfruit, and coconut. It was estimated that 70 percent of their calories were derived from coconut, so their diet was extremely high in saturated fat—almost 50 percent. Early descriptions of their health noted low levels of high blood pressure, heart disease, obesity, and diabetes. In 1966, a tropical cyclone forced the evacuation of a significant portion of the population to New Zealand. The emigration forced by the cyclone provided a unique opportunity to study the effects of changing to a typical Western diet, which was higher in sugar and refined carbohydrates and much lower in saturated fat. The news was not good.
In a comparison of the Tokelauan emigrants and those who stayed on the island, the average weight of male emigrants increased by twenty to thirty pounds over the ensuing decade. Diabetes more than doubled in the population. Blood pressure rose by an average of 7.2 mmHg systolic and 8.1 mmHg diastolic, and gout increased. Replacing the traditional diet heavy in coconut and coconut oil with a Western diet was hugely detrimental to the Tokelauans’ health.
Full-Fat Dairy
For years, we’ve been told to eat low-fat dairy or drink skim milk with the assumption that the milk fat, which is highly saturated, was detrimental to our heart health. This assertion is a direct contradiction of the wisdom of the previous millennia during which dairy was prized specifically for its high fat content. In English, there are many phrases like:
• The cream always rises to the top.
• This is the cream of the crop.
• You’re skimming off the top.
All of these sayings have the same connotation: The cream, the fattiest part of the milk, is also the most desirable.
With the heavy emphasis on eating low-fat dairy, you might think that many scientific studies had shown that dairy fat was unhealthy and that reducing milk fat was healthy. You might also be wrong. No evidence exists to prove that eating high-fat dairy causes heart disease.
Modern research exonerates dairy fat, this former villain.42 A meticulous twenty-two-year follow-up of patients that measured blood markers of dairy fat found that eating dairy fat was not related in any way to the risk of heart disease or death. The study built upon a previous 2014 study that concluded there was no increased risk of stroke.43 Lead author Dr. Marcia Otto pointed out that “the results suggest that one fatty acid present in dairy may lower risk of death from cardiovascular disease, particularly from stroke.”44 Yes, eating full-fat dairy was healthy, not harmful. A 2013 analysis suggests that dairy fat also might be protective against the development of type 2 diabetes, which is a growing epidemic worldwide.45
So, there is no longer a reason to be scared of eating full-fat dairy. Indeed, Dr. Arne Astrup, director of the Department of Nutrition at the University of Copenhagen, wrote in 2014 an article titled “A Changing View on Saturated Fatty Acids and Dairy: From Enemy to Friend.”46 This recent evidence shows why Time magazine proclaimed in 2016 that “butter is back.”
Going Nuts
In the late 1990s, experts discouraged us from eating nuts largely because they are generally high in fat. Because all fats were considered bad, high-fat foods like nuts and avocados were also considered very unhealthy. But several large studies gradually pointed out the fact that eating nuts was associated with significant heart protection. This finding has now been replicated many times,47 and the advice to eat more nuts is now widely accepted.
In this context, nuts include true tree nuts (almonds, hazelnuts, walnuts, and so on) and peanuts, which are a form of legume. Nuts contain primarily oleic acid, the same unsaturated fat found in olive oil, but they also contain plenty of fiber, protein, minerals, and polyphenols. Eating more nuts has been linked to a 13 percent reduced risk of type 2 diabetes, a lower risk of high blood pressure, and lower LDL cholesterol. These findings have prompted the AHA to recommend eating more nuts and seeds to reduce the risk of heart disease.48 For each daily serving of nuts, studies estimate a reduction in risk of cardiovascular disease of 28 percent. Eating organic nuts, such as almonds, cashews, and hazelnuts, is an even better option. (Organic Traditions, which you can find at http://organictraditions.com, is a good source for organic nuts.)
Eating nuts was associated
with significant
heart protection.
Extra-Virgin Olive Oil: Going the “Extra” Mile
Extra-virgin olive oil (EVOO) and pure olive oil are both made from olives, but the two manufacturing processes are completely different. EVOO is an unrefined oil that’s not treated with any chemical processes or heat. The oil is made by grinding olives into a paste and then cold-pressing them to extract the oil. EVOO is generally the highest-quality oil you can buy, and it has a price to match. The remaining paste still contains oil, so it can be treated with chemical solvents and heat to extract the remaining oil. This output becomes “pure” olive oil, which is generally cheaper than EVOO but is a refined oil that’s of a lesser quality.
Extra-virgin olive oil is healthier than virgin olive oil because of its higher polyphenol content. A randomized, cross-over, controlled trial found that increasing the polyphenol content linearly increased the HDL and decreased the oxidized-LDL (the “bad” cholesterol). The authors of the study concluded, “Olive oil is more than a monounsaturated fat. Its phenolic content can also provide benefits for plasma lipid levels and oxidative damage.”49 The phenolic compounds in EVOO have been noted to inhibit the oxidation of LDL, the process that makes LDL cholesterol so dangerous for the development of heart disease.50 A study has shown that 50 grams of olive oil (just under 2 ounces) per day for just two weeks reduces LDL oxidation by 73 percent and macrophage uptake of LDL by 61 percent.51 These numbers suggest that olive oil, especially EVOO, might reduce atherosclerosis.
Also, human studies show that EVOO lowers inflammation,52 the “stickiness” of blood,53 DNA damage,54 oxidized LDL, and blood pressure, and it improves endothelial function.55 For this reason, EVOO—especially a raw, ice-pressed organic olive oil such as Organic Traditions olive oil—is worth the extra mile for our health.
The Benefits of Marine Omega-3s
Consuming high amounts of marine omega-3s EPA and DHA has many health benefits, including fewer cardiovascular events and death.56 Taking just 1 gram of EPA/DHA after a heart attack can reduce overall mortality, sudden cardiac death, and death. However, higher doses of EPA and DHA (3 to 4 grams per day) can reduce blood pressure, lower triglycerides, and stabilize atherosclerotic plaques.57 Long-chain omega-3 fats reduce the risk for obesity by increasing basal metabolic rate and muscle protein synthesis while reducing muscle breakdown.58 Fatty fish, such as salmon or sardines, are great sources of marine omega-3 fatty acids. However, there may be an even better source: krill oil.
Recommendations for EPA/DHA Supplementation
For maintenance of health and those with health conditions: We recommend consuming 3 to 4 grams of EPA/DHA per day from quality sourced wild seafood or a high-quali
ty fish oil or algal oil supplement plus 3 to 4 grams of krill oil.
Krill Oil
Krill are tiny crustaceans (similar to shrimp) that live in the Arctic, Antarctic, and Pacific Oceans. Because krill are so small, they experience less heavy metal contamination than fish. The omega-3 fatty acids from krill provide enhanced absorption and penetration into the brain. A 1-gram dose of Neptune Krill Oil provides EPA/DHA (240 milligrams), vitamin A (100 IU), vitamin E (0.5 IU), phospholipids (400 milligrams), astaxanthin (1.5 milligrams), and choline (74 milligrams).59
Krill oil improves arthritis,60 premenstrual syndrome, breast tenderness, and joint pain.61 Krill oil at 1 to 3 grams per day is also more effective for reducing blood glucose, total cholesterol, and triglycerides and increasing HDL compared to fish oil and placebo.62 Think of krill oil as “super omega-3” as it also contains astaxanthin, a highly potent antioxidant. Astaxanthin is unique because it can span across the entire lipid bilayer of the cell membrane and act as both a water- and fat-soluble antioxidant. Thus, astaxanthin prevents oxidative damage on the outside of the cell membrane and from the inside.
Prehistoric humans obtained “marine” omega-3s by consuming the brains of kills on the African Savannah.63 Ounce for ounce, brain tissue is higher in DHA than salmon.64 This source was more easily absorbed65 and provided early humans with a unique “brain-DHA advantage.” Eating brain is no longer routine, so supplementing with krill oil is the next best thing. Astaxanthin may help prevent the highly susceptible DHA in your brain from oxidizing, as it acts like a highly potent water- and lipid-soluble antioxidant.