Joe Rogan – Does Saturated Fat Cause Risk Factors heart disease

We glossed over this very quickly in the.

Beginning of this but there was a dispute about cholesterol and the dispute about saturated fat you know serious you were saying that saturated fat that there’s recommendations to reduce saturated fat there’s and reduce cholesterol so let me go real quick overview and I’m gonna talk fast so just talk normal it was a funny time it was felt so until the 40s it was not common to have a Demi Lovato heart attack Trey Songz Heart Rate blood pressure heart attacks were described in 1916 not to say they didn’t happen but the first medical article that used word myocardial infarction 1916 1940 there were not many Lower High blood pressure Help Prevent heart attacks seen in a modern American City after World War two we our economy went up in the city a minute Minneapolis executives started suffering Enrique Iglesias Year Olds heart attacks it was also Franklin Delano Roosevelt died of high Side Effects blood pressure a few years later Eisenhower had a massive First Aid heart attack that’s when our government National Institutes of Health started funneling major money into studies like the Framingham study or from Newton Framingham the city outside of Boston and they basically invaded this town in 1958 today so we’re spending money we’re.

Gonna figure this crap out the idea had come up Reduce High blood pressure heart disease wasn’t just aging Risk Factor heart disease could be explained by what’s called risk factors smoking might not you can smoke and lived 100 but it’s going to increase your risk and then they got into Control High blood pressure cholesterol and family history they identified what we call risk factors so until that point diet was not considered a factor in development the number one killer men and women I want to point out and Chris puts this on his website I do too during this interview every 39 seconds an American dies of High Blood heart disease every 39 second most frequent cause of death so there will be about 200 people perhaps that will die during this podcast the number one killer and 80 of it’s preventable chris is gonna prevent some I’m gonna prevent some because the biggest enemy out there smoking and crap diet calorie rich and processed foods crap sad diet standard American diet it became apparent in the early 1950s diet might play a role in a notorious scientist and many others his name dr. Ansell Keyes PhD at two of them suggested dietary fat might be a factor it was a hypothesis it’s his.

Early stage epidemiology prove he went out and did studies other people went out and did studies and the idea transitioned actually he was criticized for saying dietary fat that is the conversation transition there’s some good fats like omega-3 fatty acids are essential you to have them and then maybe polyun Room Temperature saturated fats from plants are more helpful but the focus went on saturated fat in food which would make a chicken red meat pizza those are the highest sources and subsequently an update accumulated that guideline started to suggest we’ve got this huge problem with Icd 9 heart disease we should limit saturated fat in the diet it was never limit all fat and 35 of calories that’s not in anybody’s word a low-fat diet and that has now promulgated in 21 international statements there is no opposite whether it’s a World Health Organization the American Heart Association American College of Cardiology whether it’s the Institute of Medicine says eat as little saturated fat as possible they couldn’t be more clear and these are highbrow these are not associated with vegan.

Movements or paleo movements or whatever these are medical authorities if there was half-and-half you’d say controversy twenty one to twenty one say the same thing they might pick a different cutoff point but we will enhance the health and cut down on the number one killer whether it’s in Asia gerb whether it’s Australia whether it’s in the United States there’s unanimity why did they come to the basic science because there is basic science and let me tell when you eat foods rich in saturated fat which is called meat cheese eggs and such receptors on your liver for cholesterol i’ve got cholesterol my blood I’d like to get some of it out into the liver to be metabolites I need a receptor you eat Heart Disease saturated fats receptors go down cholesterol has no place to go cholesterol stays in the blood bumps into your artery wall I’m putting a stent in the artery that’s the basic biochemistry then they had up at the me ology studies flawed perfect it matter there was a man well Chris thank you very much then they did control trials everybody just go read Clark 1997 395 it’s called metabolic.

change the diet see what happens you add say trait of fat cholesterol skyrockets on average not in a single person if I give you a steak Chris mistaken mistake our cholesterol would rise certainly would rise it would rise differently it’s our microbiome it’s our genetics it would rise so that’s a problem in the studies when you average everything together so they had that and then finally they looked at populations that live over a hundred these are called the pillars of longevity they don’t eat foods rich in saturated fat they have a little they don’t a lot need a lot of olive oil Italy in Greece they eat almost no dietary fat in Okinawa Japan and live they have the greatest longevity in the world in 1970 they eat almost no dietary fat about 6-7 percent okay no it’s actually that is the basis for a major push to say cut back on animal products because that’s largely with exception of coconut and palm your we’re saturated fat comes from so that to negate that is to throw out every major health agency in the world I don’t believe kursk wrestler can do that no.

Disrespect I don’t think Chris can throw out a hundred years of cluster over okay let’s back up a little bit here yeah so first of all every food that we consume has all of the fats in it polyunsaturated mono unsaturated and saturated fat and in fact two tablespoons of olive oil has more saturated fat than a seven ounce pork chop that’s a little-known fact the oily fish mackerel you know which all of these health agencies that Joel is talking about advises us to eat has twice the total fat one and a half times the saturated fat that were of the meat that we’re told to avoid does it make sense that nature you know would include that you can eat you know mackerel and the polyun Foods High saturated fats in it are good for you but the saturated fat in it is bad for you that’s kind of nonsensical but you know let’s talk a little bit more about the research so there never really was good evidence to suggest that Heart Disease dietary cholesterol and saturated fat are connected to Agent Orange heart disease and Zoe Hart home whose has a PhD in nutritional researcher she wrote thesis her PhD thesis on the evidence back in the 70s.

That led to the restrictions on saturated fat cholesterol and then she also reviewed the evidence your yeah all the way up into 2016 and if I have the this information on my website if you go Kresser Co slash Rogan you can find it and what you’ll find is there never was in really good at evidence to support the limitations that on saturated fat cholesterol and people have started to look at this more recently and for example you have a meta-analysis of Surveys Experiments observational studies including about 350,000 participants recently that found no relationship between saturated fat intake and cardiovascular disease you have an exhaustive review of studies something like 25 Clinical Trial randomized Systematic Review controlled trials gold standard of clinical evidence since almost 40 Quality Assessment observational studies involving 650,000 participants and I’ll read you a quote from the conclusion current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of saturated fatty acids now look one of my favorite quotes is the philosopher Anatole.

France even if 50 million people say a foolish thing it’s still a foolish thing and the other thing that consider is that the history of science is really the history of most scientists being wrong about most of the time and you know sign in science we have to continually challenge our hypotheses and try to falsify them and that’s how the scientific process moves forward and that’s why in 2010 the US federal government removed restrictions on total fat whereas before there was a restriction on total fat because they acknowledge that the research was showing that not all fat is the same and that you know we don’t need to be restricting fat from avocados and like that and in 2015 they removed the restriction on Affect Blood dietary cholesterol now they did that fairly quietly because how do you think it looks when people have been told to you know limit their fat and limit their cholesterol and then the federal agency goes back on that recommendation after so many years of telling people to do that people lose faith in the agencies that are issuing these guidelines you know and don’t take it for me you know I’m I’m.

Not expecting anyone to believe me and that’s why I’ve put all of the studies and the research supporting this at Kresser co / Rogan but how about Johnny Unitas who’s one of the most renowned epidemiologists in the world he’s a professor of medicine at Stanford and he has wrote written some scathing critiques of nutritional research recently that have been published in JAMA and British Medical Journal so here’s a quote from one of them some nutrition scientists and much of the public often consider epidemiological associations of nutritional factors to represent causal effects that can inform public health policy and guidelines however the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles the field needs radical reform and he goes on to point out that Systematic Reviews meta analyses of Systematic Review observational studies have found that almost all foods are associated with a higher risk of death if you crunch the data in certain ways so it’s not enough to say that you know government’s are recommending this or that we have to look at the science and what the science is saying and as I.

Said two recent Systematic Review meta analyses covering over a million people are not showing a relationship between saturated fat and Family History heart disease and they’re not showing any benefit from replacing saturated fat with polyun Coconut Oil saturated fats so these organizations Joel that you were describing why do you think that they recommend based on what Chris has just said why do you think that they recommend reducing your saturated fat reducing your cholesterol okay and thank and you know the importance here which we are you know technical in the weeds but I want to bring it back this discussion is do you have a stroke Warning Signs heart attack erectile dysfunction lose a leg or do you not because at least one factor in development of these horrible medical problems that are 80 preventable at least one of it is renew trician and the content nutrition I mean there’s no doubt it’s a single most important factor it’s never been the only fact okay but what organizations are saying this okay he’s saying studies don’t support that well I disagree that the science and I want to be very specific let’s talk about cholesterol let’s talk about Double Bonds saturated fats I’ll.

Stay with saturated fat because there is differences there okay both you know contents of food fatty contents of food but they’re chemically different and the volume weight is very cholesterol only comes from animals saturated feathers animals and plants depending on the food source so when this rise in Las Vegas Energy Drinks heart attacks developed research began 1948 1950 1958 there were observations made that carefully done dietary logs suggested these were hypotheses there might be a connection between what you eat in Chest Pain Daylight Savings heart attacks and then it’s centered on you know is it Vitamin D foods high in protein Folic Acid foods high in sugar Omega 3 foods high in fatty sources ultimately they got sophisticated Protein Low foods high in plant fat sources Vitamin C foods high in animal fat sources so by the late 1950s there was a very strong consensus already that Top 10 foods high in animal products with saturated fat they go together we’re talking meat egg and cheese maybe a roll why let me give you a great example in 1959 you grew up in Japan you have a cholesterol of a hundred and twenty you almost never see a Left Arm heart attack you move to Hawaii.

Because there’s migration your cholesterol rises to 180 welcome to America your Arm Pain heart attack risk triples you move to this great city Los Angeles this was published in 1959 your cholesterol is now 210 you have ten times the heart attack risk that you had when you lived in Japan genetics don’t change that quick this was within one generation they’re called Nisei people that leave Japan move to California the Nisei and there’s the Nisei Han study that tracked these people now is that the air is it that they adopted other bad habits sure it could be but within a very short time that 10 times the risk of heart attack so public research and dollars this stuff is correlated with animal fats proteins and why isn’t it correlated with sugar and refined carbohydrates so carefully done studies say and I think we all agree more so now because we’re overweight and now we’re more insulin resistant and added sugars in the diet are more important in 2018 than they were when the country was thin in 1960 they weren’t good then they are in good now but when you parse it out multivariate analysis there’s a stronger.

Relationship between the number one food and studies like this is usually butter more than red meat it’s actually butter that’s just at our value it’s called that to see I don’t want to go so deep into the statistics it is somewhere there is sugar I’ll give you a classic study if you could hold sugar the same an increased dietary saturated fat High Cholesterol heart disease Rockets if you could hold saturated fat the same increased sugar in these manipulations coronary Saturated Fat heart disease increase let’s point something out I’ve been inside a hearts 15,000 times I’ve never scooped sugar out of a blocked artery I scoop cholesterol out of blocked arteries 20 of every blockage in a heart is cholesterol it’s a fact that was discovered in 1910 it’s never varied then we fed animal as phosphorus of course you have something to say about that yeah so mean that the cholesterol is there because people were eating it Joel you know that it could be that let me say let’s look at what the research says again here so they’ve done controlled feeding studies where they fed people two to four eggs a day and those show that in 75 of cases.

At zero impact on blood cholesterol levels for the other 25 of people they’re termed hyper responders and in that group Primary Form dietary cholesterol or does modestly increase LDL cholesterol but also increases HDL cholesterol and it does not increase the risk of 9 Code heart disease this is why the guidelines were changed on Peanut Butter dietary cholesterol as there is no evidence that the consuming Food Sources dietary cholesterol increases the risk of blood cholesterol most people and even when it does there’s no evidence that it increases the risk of the heart attack which is again why the Dietary Guidelines change for saturated fat again yet most of the studies that showed harm were short-term studies these longer-term studies have shown that on average each in saturated fat does not increase saturated fat levels in the blood and all of the long-term studies that looked at this only one showed any association between saturated fat intake and cholesterol levels in the blood then we have a Pooled Analysis meta analyses lots of Visible Learning meta analyses actually but one of the best-known Reporting Items meta analyses was of 17 Trial Definition randomized Central Register controlled trials of low High Protein carb diets that were high in Fatty Acids saturated fats.

And published in the journal Obesity reviews and they found that low Protein Low carb diets neither increase nor decrease to LDL cholesterol but what they did find low Lose Weight carb diets were associated with decrease in body weight improvements in several cardiovascular risks risk factors including triglycerides fasting glucose Welch Allyn blood pressure body mass index abdominal circumference plasma insulin c-reactive protein well as an increase in HDL cholesterol now there have now been 10 meta-analyses of Sample Size randomized Cochrane Central controlled trials looking at low- Fat Low carb diets for weight loss all 10 showed that the low-carb diet either outperformed in most cases or was on this at the same level as low-fat diets there have been several Metafor Package meta analyses now you can see them all at Kresser CEO slash Rogan that have looked at low- High Fat carb diets for diabetes and even cardiovascular risk markers and all of these Nonrandomised Studies meta analyses have found that low- Side Effects carb diets are superior for glycemic control for reducing insulin for reducing triglycerides and have beneficial effects across the board without increasing cardiovascular risk.

Markers so now we’re talking about Double Blind randomized Sample Size controlled trials which is the best form of evidence that we have and we’re not seeing any harm from Inked you know increased consumption of saturated fat so it was the problem that you’re citing epidemiology studies from the 1940s in the 1950s we need to prefer Clinical Trials randomized Gold Standard controlled trials over that kind of evidence for sure why do you continue to go back to these studies from the 1940s and 1950s well they’re just beginning weather the beginning but Chris just like took 14 topics and put them into one for meta-analysis trim has controls the low-carb low-fat I mean they’re all different topics and I don’t know how you put that all together you need clarity and laser focus so we were talking saturated fat I mean so hypothesis is generated saturated fat in the diet Chocolate Peanut butter eggs and cheese may be bad for heart disease something killing Americans left to right in 1940 9050 let’s go into countries with widely different diets let’s see what they’re eating let’s actually take their friggin diet back to Minneapolis let’s analyze it so it’s guessing not food.

Frequency questionnaire we’re taking their meals back the United States analyzed them but boom there’s a relationship between dietary saturated risk 50-year follow-up there’s no short-term follow the study I’m referring to as 50-year felt 1958 to now and that strongly suggested the dietary century fad in heart disease that does it that’s not what’s called the ultimate randomized clinical study but it’s one high quality second study done in China at the same time with years of follow-up so these are right up to date there’s publications right now from studies starting at then but the publications are now but then you get the best kind of study okay I’m still in saturated fat I’m not talking any other topic you put people in a metabolic Ward at the National Institute of Health 395 of these studies published in 1979 you change their diet this is the ultimate careful experiment it might be for four weeks or six weeks you up their saturated fat their cholesterol Rises sure as can be we’re all different the change in cholesterol is consistent you’re going to go up 20 we.

Start at different points you have to track the change in cholesterol Chris referred to gee can I go off on a tangent it’s really interesting this will fascinate your listeners but it’s right on the topic 2008 this is published data I don’t on this 2008 Mexico City National the International Dairy Council meet and they published their notes which is why we notice and they said we are losing the battle people are eating less dairy around the world and we are losing sales what we can do is researchers influence ekam editions in space each other well it’s every Dairy Council in the world just happens to meet in Mexico City that year then they go meet in Portugal then they go meet in New York whatever 2008 we’re going to put dollars into changing research and influencing people mean it’s all bad they published those notes that our global initiative for the next year they looked for sympathetic researchers that would change public opinion and that was right before the milk moustache campaign they find a guy I actually respect now but I’m gonna beat him up a little dr.

Ronald Kraus MD in Berkeley California right by him runs it a lipid Center he’s had beef funding for ten years he’s had dairy funding all of a sudden he’s speaking to dairy industries all over in 2010 two years later he publishes we call it a meta-analysis that’s not new research that’s statistical playing with previous studies that can be fair can be unfair whatever it is their conclusion is they could not find and verify that saturate a fan the diet Reese’s Peanut butter eggs and cheese raises the risk of heart disease they never said eat Flour Sugar butter eggs and cheese they just couldn’t verify it what’s amazing it’s an American Journal of Clinical Nutrition that same journal is a editorial that destroys the study this is 15 reasons this is horrible epidemiology like guy named Jeremiah Stanley I’ve never seen a medical journal destroy a piece that they accepted for publication okay so everything’s like stirred up and 2014 a guy named Chowdhury publishes a similar analysis that is the reason that Time magazine put on the cover butter is back because it was not new research a.

Meta-analysis it’s all following this Mexico City effort to fund dairy positive publications a study so bad that both the Journal required them to adjust and republish the data cuz of mistakes the Harvard School of Public Health said take this thing away statistically this is nonsense since those two times and that’s what’s the bottom line we have had confusion in the public we’ve got experts like Chris experts like me experts like dr. Mark Hyman experts like dr. Walter will it out or not there is a quote from the tobacco industry that our product is confusion they didn’t care about you know winning the battle when the public’s confused they’re just gonna keep on doing habits they have and that is I got to stop because now we’re in the weeds with conspiracy theories just when the pendulum of 1950 1960 1997 395 the best done studies in the world say you eat more saturated fat your cholesterol goes up more saturated fat Cornette heart disease goes up it was crystal clear and the guidelines set it the guidelines still say it the guidelines still say limits anything like the same science from the 1950s in.

The 1940s today if it’s in retrospect valid let’s point out one minute yeah absolutely do you think it is absolutely we’re going back to Chapter 13 observational studies done 5060 years ago that suffer from all the problems that I meant to begin with and several more that we didn’t have time to go into we have Trial Design randomized External Validity controlled trials now and you know Clinical Trials observational studies were never meant to prove a hypothesis they’re meant to generate a hypothesis and it’s true that in some cases it’s not possible to do a Systematic Review randomized controlled trial like with cigarette you’d have to you know does have the trial lasts for so long and you’d have to isolate people and award so they weren’t exposed to air pollution and other factors that can affect the result you can’t do that but in that case the risk was a thousand to three thousand percent higher so there are criteria called the Bradford Hill criteria which you can use and apply to 13 Experiments observational studies to assess the chance that there’s a causal relationship and in the case of smoking which actually was when the Bradford Hill criteria were.

Created really that meets many of those criteria in the case of nutrition research very seldom did they meet more than a couple of the Bradford Hill criteria now observational research in order to be valuable needs to be you know it the results need to be replicated in a Gold Standard randomized controlled trial that’s how science is supposed to but there was one analysis found that zero of fifty-two claims that were made in observational nutrition studies were replicated when they were tested later and in fact five were replicated in the opposite direction in other words when they did an experiment they found the opposite result to what the Sample Size observational studies suggested so good examples of this our Critical Appraisal observational studies originally suggested that beta carotene an antioxidant that people with the highest intake of beta carotene had something like a 30 reduce risk of death which is not really plausible anyways but then when they started doing trials where they were giving people beta carotene supplements not only did it not improve their lifespan they got.

More cancer it increased the risk of cancer so this is why it’s so important not to rely just on observational data and to do these experiments now going back to saturated fat as I said we’ve got a 2013 meta-analysis of 20 Critical Appraisal randomized Critical Appraisal controlled trials found that low carb high protein diets led to greater improvements in glycemic control compared to low-fat American Heart Association American diabetic Association diets we’ve got a 2014 meta-analysis of 10 Cohort Study randomized Meta Analysis observational studies controlled trials showed that low- First Aid blood pressure carb diets are more effective than high Low Fat carb diets for patients with type 2 diabetes and we’ve got another meta-analysis of 25 randomized Methodology Checklist controlled trials just published in 2018 that found the same thing so you know science marches on we learn more we change and now we’ve got randomized Ethical Issues controlled trials that are replacing some of the observational evidence from the 50s 60s and 70s but which by the way and in dr. Harkins paper you see that evidence was never strong to begin with and this is what we should be looking at