More ‘healthy’ eating advice from the UK Government that is unlikely to do any good at all

Share This Post

Here in the UK we look to the Government’s Food Standards Agency (FSA) to guide us regarding what we should be eating, and we also trust them when it comes to ensuring the food industry doesn’t offer us too much shite to eat. Or that’s the theory, anyway. In reality, I reckon the FSA does a pretty poor job on both these counts.
Just look here and here and here for examples.

Anyway, this week I learn that the FSA’s latest thrust to is to persuade us (again) of the perils of saturated fat. You can see what the FSA statement on this here.

Apparently, the FSA is aiming to ensure that saturated fat does not contribute more than 11 per cent of the calories we consume. This, we are told could prevent up to 3,500 deaths a year.

According to Rosemary Hignett, Head of Nutrition at the FSA: ‘Reducing our intakes of saturated fat is a major challenge but would have clear important health benefits.’ But is this really true? Does the science support saturated fat’s killer image, and does eating less of it really save lives?

Probably the most oft-quoted ‘fact’ about saturated fat is that it increases our risk of heart disease. This nutritional nugget is based on two main lines of ‘evidence’:

1. higher saturated fat intakes are associated with an increased risk of heart disease

2. eating saturated fat raised blood levels of cholesterol (and this, we are told, enhances or risk of heart disease)

Let’s examine these in turn.

Over the last 50-odd years, there have been more than two-dozen studies that have analysed the relationship between saturated fat and risk of heart disease [1-26]. All but four of these studies [9,11,19,25] found no association between saturated fat intake and heart disease. And in one study, higher intakes of saturated fat in the diet were found to be associated with reduced narrowing of the arteries supplying blood to the head (the carotid arteries) over time [27].

The largest analysis to date of the relationship between lifestyle factors and risk of heart attack was published in the Lancet medical journal in 2004 [28]. This study analysed a range of risk factors and heart attack risk in some 12,000 heart attack victims and 14,000 healthy individuals from 52 countries around the World. The researchers involved in this study identified several factors, including smoking, high blood pressure, diabetes, a low intake of fruits and vegetables, and low levels of physical activity that appeared to account for 90 and 94 per cent of heart attacks in men and women respectively. Curiously, this review makes no mention of animal fat, or even dietary fat in general, as being an important risk factor for heart attack.

Taken as a whole, the scientific evidence simply does not support the notion that saturated fat is bad for the heart.

From a scientific standpoint, these studies ” referred to as epidemiological studies ” can only at best find associations between things. A better way to test the concept that eating saturated fat causes heart disease is to get people to eat less saturated fat to see if this reduces their heart disease risk over time.

Ideally, studies of this nature should be double-blind, which means that neither the individuals in the study nor the researchers will know whether they are receiving the true intervention or not. These sorts of studies, known as ‘double-blind’ studies, are generally regarded as the gold standard of intervention studies. To date, only two such studies have been performed with regard to heart disease risk or death [37, 44], and neither showed any benefit.

There are some 20 other studies [29-36,38-43,45-50], of which just six [40,42,50,52,58,60] found benefit. So, of a total of 22 studies, 16 found no benefit from cutting back on saturated fat with heart disease risk.

This doesn’t seem like particularly convincing evidence of the supposed benefits of eating less saturated fat. And the evidence looks even less convincing when you consider that the studies that did find benefit are often what is known a ‘multiple intervention’ studies ” which in this case means that in addition to reducing saturated fat, the participants in these studies were subjected to at least one other modification. For example, in one study [29] individuals were given nutritional supplements. In two of the studies [47,49], individuals were asked to emphasise heart-healthy omega-3 fats as well as fruit and vegetables in the diet. The obvious question that multiple intervention studies raise is whether lowered saturated fat in the diet, or the other interventions, or a combination of these things, that proved effective. Because of these limitations, multiple intervention studies cannot be used to judge the effects of reducing saturated fat in the diet.

One way researchers can get a good idea of the overall effect of some treatment or approach is to perform what is known as a ‘meta-analysis’. Here, results from a number of similar studies are grouped together. The largest meta-analysis to examine the effect of modifying fat in the diet was conducted by UK-based researchers and was published in the British Medical Journal [51]. This particular review amassed the data of 27 individual studies. Neither deaths due to cardiovascular disease (such as heart attack and stroke) nor overall risk of death was found to be reduced by makes changes to intake of dietary fat. The results of this review support the notion that eating less saturated fat has little, if any, benefits for our heart and general health.

Never mind this overwhelming lack of evidence for the ‘benefits’ of eating less saturated fat, though, because this won’t stop some doctors and scientists from playing the cholesterol card (see notion 2 above): saturated fat raises cholesterol which we know is bad for the heart. So, eating less saturated fat will reduce cholesterol levels which has to be good for the heart, right?

As with saturated fat, if we really want to make a judgment of the true impact cholesterol has on health, we need intervention studies ” studies in which cholesterol levels are lowered and the effect of this assessed. In 2005 a meta-analysis of 17 studies in which subjects made dietary changes explicitly to reduce blood cholesterol levels was published in the Archives of Internal Medicine [52]. Overall, these studies brought about a 10 per cent lowering of cholesterol levels. Despite this, the amassed results showed no reduced risk of death, neither in healthy individuals, nor even in high-risk individuals who had a history of heart attack or stroke. Basically, taking dietary steps to reduce cholesterol levels (say by reducing saturated fat intake) has not been proven to save lives.

Some, no doubt, will clutch at straws and tell us that eating less saturated fat will reduce risk of other killers conditions such as cancer. Such individuals may be unaware of the results of the Women’s Health Initiative Study, in which outcomes for women put on a ‘healthy’ diet were compared with those on an ‘eat what you like’ diet over 7 ½ years. In this study, the ‘healthy’ eating women consumed 23 per cent less saturated fat than their ‘eat what you like’ counterparts (that’s actually a much bigger reduction in saturated fat intake than the FSA is heading us towards). And at the end of the analyses they found that the ‘healthy’ eating women did not enjoy a reduced risk in any one or more than 20 types of cancer [53-55].

Put this all together and it appears, to me at least, that the idea that cutting back on saturated fat will saves lives is not supported by the science. But then again, it wouldn’t be the first time that we’ve been given official dietary recommendations for which there is no good evidence.


1. Paul 0, et al. A longitudinal study of coronary heart disease. Circulation, Jul 1963; 28:20-31

2. Gordon T. The Framingham Diet Study: diet and the regulation of serum cholesterol. In:The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease, Section 24. U.S. Government Printing Office, Washington, D.C., 1970

3. Medalie JH, et al. Five-year myocardial infarction incidence. II. Association of single variables to age and birthplace. Journal of Chronic Diseases, Jun, 1973; 26 (6): 325-349

4. Morris IN, et al. Diet and heart: a postscript. British Medical Journal, 1977; 2: 1307-1314

5. Yano K, et al. Dietary intake and the risk of coronary heart disease in Japanese men living in Hawaii. American Journal of Clinical Nutrition, Jul, 1978; 31: 1270-1279

6. Garcia-Palmieri MR, et al. Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program. American Journal of Clinical Nutrition, Aug, 1980; 33 (8): 1818-1827

7. Gordon T, et al. Diet and its relation to coronary heart disease in three populations. Circulation, Mar, 1981; 63; 500-515

8 Shekelle RB, et al. Diet, serum cholesterol, and death from coronary heart disease: the Western Electric Study. New England Journal of Medicine, 1981; 304: 65-70

9. McGee DL, et al. Ten-year incidence of coronary heart disease in the Honolulu Heart Program: relationship to nutrient intake. American Journal of Epidemiology, 1984; 119:667-676

10. Kromhout D, et al. Diet, prevalence and 10-year mortality from coronary heart disease in 871 middle-aged men: the Zutphen Study. American Journal of Epidemiology, 1984; 119: 733-741

11. Kushi LH, et al. Diet and 20-year mortality from coronary heart disease: the Ireland-Boston Diet-Heart Study. New England Journal of Medicine, 1985; 312: 811-818

12. Lapidus L, et al. Dietary habits in relation to incidence of cardiovascular disease and death in women: a l2-year follow-up of participants in the population study of women in Gothenburg, Sweden. American Journal of Clinical Nutrition, Oct, 1986; 44(4): 444-448

13. Khaw KT, et al. Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12-year prospective study. American Journal of Epidemiology, Dee, 1987; 126 (6): 1093-1102

14. Farchi G, et al. Diet and 20-y mortality in two rural population groups of middle-aged men in Italy. American Journal of Clinical Nutrition, Nov, 1989; 50 (5): 1095-1103

15. Posner BM, et al. Dietary lipid predictors of coronary heart disease in men: the Framingham Study. Archives of Internal Medicine, 1991; 151: 1181-1187

16. Dolecek TA. Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proceedings of the Socieiy for Experimental Biology and Medicine, Jun, 1992; 200 (2): 177-182

17. Fehily AM, et al. Diet and incident ischaemic heart disease: the Caerphilly Study. British Journal of Nutrition, 1993; 69: 303-314

18. Goldbourt U, et al. Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees: a 23-year mortality follow-up in the Israeli Ischemic Heart Disease Study. Cardiology, 1993; 82: 100-121

19. Esrey KL, et al. Relationship between dietary intake and coronary heart disease mortality: Lipid Research Clinics Prevalence Follow-Up Study. Journal of Clinical Epidemiology, Feb, 1996; 49 (2): 211-216

20. Ascherio A, et al. Dietary fat and risk of coronary heart disease in men: cohort follow-up study in the United States. British Medical Journal, 1996; 313: 84-90

21. Pietinen P, et al. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men: the Aipha-Tocopherol, Beta-Carotene Cancer Prevention Study. American Journal of Epidemiology, 1997; 145: 876-887

22. Hu FB, et al. Dietary fat intake and the risk of coronary heart disease in women. New England Journal of Medicine Nov 20, 1997; 337 (21): 1491-1499

23. Tanasescu M, et al. Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. American Journal of Clinical Nutrition, Jun, 2004; 79: 999-1005

24. Laaksonen DE, et al. Prediction of cardiovascular mortality in middle-aged men by dietary and serum linoleic and polyunsaturated fatty acids. Archives of Internal Medicine, 2005; 165: 193-199

25. Tucker KL, et al. The Combination of High Fruit and Vegetable and Low Saturated Fat Intakes Is More Protective against Mortality in Aging Men than Is Either Alone: The Baltimore Longitudinal Study of Aging. Journal of Nutrition 2005; 135: 556-561

26. Leosdottir M, et al. Dietary fat intake and early mortality patterns–data from The Malmo Diet and Cancer Study. Journal of Internal Medicine, 2005; 258: 153-165

27. Mozaffarian D, et al. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. Am J Clin Nutr 2004;80(5):1175-84

28. Yusuf S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study Lancet. 2004;364(9438):937-52

29. Morrison LM. A nutritional program for prolongation of life in coronary atherosclerosis. Journal of the American Medical Association 1955;159 (15):1425-1428

30. Ball KP, et al. Low-fat diet in myocardial infarction: a controlled trial. Lancet 1965; 2:501-504

31. Hood B, et al. Long-term prognosis in essential hypercholesterolemia: the effect of strict diet. Acta Medica Scandanavica 1965;178 (2):161-173

32. Rose GA, et a!. Corn oil in treatment of ischaemic heart disease. British Medical Journal 1965; 1:1531-1533

33. Christakis G, et al. Effect of the Anti-Coronary Club on coronary heart disease risk factor status. Journal of the American MedicalAssociation 1966;198 (6): 597-604

34. Bierenbaum ML, et al. Modified fat dietary management of the young male with coronary disease. A five year-report. Journal of the American Medical Association 1967;202(13): 1119-1123

35. National Diet Heart Study. Final report. Circulation, 1968;37(3 Suppl):1-428

36. Controlled trial of soya-bean oil in myocardial infarction. Lancet, 1968;297570):693-699

37. Dayton S, et al. A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis. Circulation 1969;40 (Suppl. Il):1-63

38. Leren P. The Oslo Diet-Heart Study: Eleven Year Report. Circulation 1970;42:935-942

39. Miettinen M, et al. Effect of cholesterol-lowering diet on mortality from coronary heart� disease and other causes. A twelve-year clinical trial in men and women. Lancet 1972; 2(7782):835-8

40. Woodhill JM, et al. Low fat, low cholesterol diet in secondary prevention of coronary heart disease. Advances in Experimental Medicine and Biology 1978;109:317-330

41. Turpenien O, et al. Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. Int J Epidemiol 1979:8:9-118

42. Hjermann I, et al. Effect of diet and smoking in the incidence of coronary heart disease. Lancet 1981:ii:1303-10

43. World Health Organization European Collaborative Group, European collaborative trial of multifactorial prevention of coronary heart disease. Lancet 1986:1: 869-72.

44. Frantz Jr ID, et al. Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota coronary survey. Arteriosclerosis 1989;9:129-135

45. Burr ML, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989;2(8666):757-761

46. Strandberg TE, et al. Longterm mortality after 5 year multifactorial primary prevention of cardiovascular diseases in middle-aged men. JAMA 1991: 266: 1229-9.

47. Watts GF, et al. Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas’ atherosclerosis regression study (STARS). Lancet 1992; 339(8793): 563-569

48. Neaton JD, Blackburn H, Jacobs D, et al. Serum cholesterol level and mortality: findings for men screened in the Multiple Risk Factor Intervention Trial. Arch Int Med 1992: 152: 1490-500.

49. De Lorgeril M, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet, 1994; 343(8911):1454-1459

50. Howard BV, et al. Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. Journal of the American Medical Association 2006;295:655-666

51. Hooper L, et al. Dietary intake and prevention of cardiovascular disease: systematic review. BMJ 2001 322(7289):757-630

52. Studer M, et al. Effect of different antilipidemic agents and diets on mortality. Archives of Internal Medicine. 2005;165:725-730

53. Prentice RL, et al. Low-fat dietary pattern and cancer incidence in the Women’s Health Initiative Dietary Modification Randomized Controlled Trial.
J Natl Cancer Inst. 2007;99(20):1534-43 [Epub Oct 9 2007]

54. Beresford SA, et al. Low-fat dietary pattern and risk of colorectal cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial.
JAMA. 2006;295(6):643-54.

55. Prentice RL, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial.
JAMA. 2006;295(6):629-42.

More To Explore

Walking versus running

I recently read an interesting editorial in the Journal of American College of Cardiology about the relative benefits of walking and running [1]. The editorial

We uses cookies to improve your experience.