let’s look at one of the most important and misunderstood elements of not only heart health, but the health of your body as a whole: fat.

Fat. It’s delicious and, so we’ve long been told, dangerous – it’s the ultimate bad boy of food. We want it, we don’t quite understand it, we’ve heard it’s done some bad things, we try to stay away, but we just can’t leave it alone. However, in the case of fat, there’s a biological reason for that desire: it’s essential for life. All living things need fat because all living things are MADE of fat. Every cell in your body is coated in fat. We don’t just crave it because it tastes amazing, it tastes amazing because it’s amazingly important to us.

Without fat:

Your brain can’t function properly.
Your system can’t fight disease as effectively.
Your body cannot manufacture proper energy levels.
Your joints (and the rest of you) become like a motor without oil.
Vision, cosmetic appearance, even temperature regulation, all start to fail.

We’ve all heard about “good” fats and “bad” fats. In most of our lifetimes the definitions of those terms have changed at least once, if not a couple of times. Eggs, butter, margarine, coconut oil, avocados, red meat, cheese – each of these, and many more, have been equally praised and demonized over the last fifty years as our understanding of fats and what they mean for our health has grown and changed.

SO, WHAT IS FAT?

Simply put, fat is an essential nutrient compound, insoluble in water, and solid or liquid depending on temperature. Chemically, fats are triesters of glycerol (that’s what a “triglyceride” is!) combined with any number of fatty acids (which are fuel for both the body and the brain).

Now, the term “fat” is used quite loosely. It’s often used interchangeably to describe oils, fats, and “lipids.” Technically speaking, all fats are actually a subset of lipids (a broad category of molecules used for energy storage, cellular communication, and cellular construction). If that fat is liquid at room temperature we call it an “oil,” if that fat is solid at room temperature we most properly call it a “fat.”

Now, hang on tight, we’re going further down the rabbit hole…

SATURATED, UNSATURATED, and TRANS FATS

SATURATED – This is actually a bit easier to understand than you might think. “Saturated” fats are simply fats that are covered (“saturated”) in hydrogen atoms. These include animal fats such as cream, cheese, butter, and fatty meats; as well as certain vegetable products such as coconut oil, cashews, and chocolate. So, basically, things that taste awesome. (Mmmmmm……hydrogen.)

UNSATURATED – “Unsaturated” fats are, naturally, just the opposite – fats that are NOT coated in hydrogen atoms. Don’t worry, these are still great too! In fact, unsaturated fats are not only delicious, but are the primary fats recommended for cardiovascular health (more on this in a bit). This category includes both:

Monounsaturated Fats (MUFAs) found in high amounts in olives, olive oil, various nuts, ground nut oil and nut butters, and avocados.
Polyunsaturated Fats (PUFAs) found in a variety of both plant and animal sources but, in particular, in oily fish! Hence, FISH OIL supplements for heart health. (Again, more on this in a bit.)

TRANS FATS – Trans fats are “hydrogenated” fat structures which, as you now can probably guess, are fats that hydrogen molecules have been added onto. This means cheap, plant-sourced, unsaturated oils can be altered to act more like rich, solid, creamy fats. This category includes margarine, vegetable shortening, and (as “partially” hydrogenated fats) cheap frying oils. Trans fats don’t usually occur in nature but, as a manufactured fat source, have been available for over a century. (The very first hydrogenated fat product? Crisco! – first sold in 1911.)

Hydrogenated fats were developed in the early 20th century as a way to make a greater amount of solid fats commercially available in place of butter-fat and lard, which were in shorter supply relative to a growing population. At the same time, hydrogenated fats were also cheap, shelf-stable, durable and, due to their altered composition, easy to use even immediately after refrigeration. Low cost and convenience led to an ever increasing popularity and wide use by the food industry at all levels – think chips, candy, baked goods, fried foods, frozen foods, fast food, etc. By the 1960s, processed vegetable fats had overtaken animal fats as the primary form used both in the U.S. and abroad. At one point or another, if it was made with fat, it was probably made with trans fat. Only in recent years has this trend begun to change. Due, in large part, to ever changing notions regarding….

CHOLESTEROL!

Fat is an essential nutrient source, we literally can’t live without it yet, for the the better part of the last fifty years, we’ve increasingly been trying to get as much “fat” out of our diet as we can. Why? Well, by the middle of the twentieth century, the rate of heart disease began to show a significant increase in the U.S. and other parts of the developed world. As physicians studied the issue, they eventually found what appeared to be a direct correlation between high fat diets and overall rates of cardiovascular illness. This led to recommendations to reduce the amount of fatty foods in the diet. At the same time, the rise of hydrogenated fats and fat substitutes gave these same individuals areas to redirect consumption. However, even as more and more “low-fat” and “diet” foods started to become available and popular, rates of heart-disease continued to rise.

Researchers were baffled. Still seeing fat and, particularly, cholesterol as the primary issue, they started to look elsewhere for solutions:

They tried to find specific things to eliminate – “keep the whites, ditch the yolks!”

They studied other cultures unique dietary elements to find their secrets – “a glass of red wine a day and you can eat all the cheese you want!”

And, logically, to pharmaceutical research to find something to simply make the problem go away: “One Lipitor a day, blah, blah, blah…”

Improvements were shown here and there, but the issues still persisted. Heart disease, while down slightly in developed countries over the last several years, is still the leading cause of death WORLDWIDE and has been for forty years, in large part because of skyrocketing rates in developing countries – countries who are finally catching up to our way of living and EATING.

So, what is cholesterol and why are we all so scared of it?

Cholesterol is NOT a fat itself, it is a “sterol” (a modified steroid). It is an essential structural component of animal cells and is therefore…..wait for it…..a LIPID! Yes!

While it is not a fat, cholesterol is a PART of all animal fat structures. It is something that any animal – yourself included (you animal) – synthesizes every single day as a part of general cellular maintenance. An average man of 150lbs synthesizes approximately 1,000mg of cholesterol a day and has about 35g (35,000mg) of it in his system at any given time.

There are two types of cholesterol:

LDL (Low-Density-Lipoprotein) Traditionally thought of as “bad” cholesterol because it is specifically the buildup of these cholesterol particles (along with excess calcium and triglycerides) that leads to the hardening of arteries (atherosclerosis), resulting in higher blood pressure (hypertension) and, potentially, an eventual blockage – that’s heart attack.

HDL (High-Density-Lipoprotein) Generally considered “Good” Cholesterol because HDL particles remove fats and cholesterol from cells and take it back to the liver to either recycle or dispose of. People with higher HDL levels tend to have fewer problems with cardiovascular disease.

So, how did we get to the point of demonizing cholesterol and ditching animal fat entirely?  It is largely thanks to one man – Ancel Keys.

Ancel Keys was an American scientist who, in the 1940’s, noticed that rates of cardiovascular disease had fallen off sharply in post-war Europe. Keys postulated that reduced animal-fat consumption, due to post-war scarcity, caused a significant decrease in average cholesterol levels and could be directly related to this decline. In 1947 he began a study of Minnesota businessmen that would eventually culminate in a massive research project known the “Seven Countries Study.” The SCS was the first major study to show a direct relationship between cholesterol levels and the risk of heart-attack and stroke.

With early results already showing a strong correlation, the American Heart Association took to the airwaves in 1956 to tell people that a diet which included large amounts of butter, lard, eggs and beef would lead to coronary heart disease. People listened. By 1961 dietary habits were starting to change and Keys was so widely regarded he landed on the cover of Time Magazine.

As mentioned before, by this point hydrogenated fats had already moved into broader use for multiple reasons. However, for the total dominance of hydrogenated fats, this research pretty much sealed the deal. Now there was a legitimate medical reason to encourage the use of trans fat. By the early 60’s the age of margarine was in full force. It would be another forty years before a serious sea change in our notions of “good” and “bad” fat and what they mean for our health would start to emerge. Which brings us to our final chapter…

FAT, YOUR FAT HEART, AND YOU!

By the end of the 20th century, with heart disease still as serious an issue as ever, researchers were taking a new look at trans fats. A 1994 study concluded that 30,000 cardiovascular deaths a year could be attributed SPECIFICALLY to the consumption of trans fats. By 2006 that number had been revised to 100,000.

More and more research showed that a high intake of trans fatty acids potentially caused a variety health problems throughout one’s life: obesity, high blood pressure, diabetic issues, and a greater risk for heart disease overall.

In one 2007 study by the New York Dept. of Health, a diet high in trans fats was found to contribute to all these things. In the neighborhood of East Harlem – which has mostly fast food restaurants, bodegas, and few healthy alternatives – 31% of adults were obese compared to 22% in the whole of NYC, and only 9% in the Upper East Side, where quality food is much more widely available.

At the same time, along with the rise in the natural foods industry (…ahem…Mama Jean’s!….ahem..), a new take on old fats was starting to emerge. An increasing number of providers and consumers were simply looking to natural forms of foods as a superior alternative to their artificial counterparts. Once again, notions started to change.

So, where does that leave us? What are our “good” fat choices?

The current research and prevailing opinions have simply gone back to square one: eat quality, natural fats in reasonable amounts while avoiding artificial or highly processed substitutes. Translation: Eat the real stuff, don’t eat too much. Have an avocado and an egg or two, skip the margarine. Good fats in, bad fats out.

These sorts of dietary habits pay off in spades. As stated many times at this point, fat is an essential nutrient. When we, even moderately, increase our “good” fat intake we see improvements in everything from weight, to mobility, to cognitive function, to the appearance of our skin and hair. However, the really interesting thing is this: these same dietary guidelines have been shown to help reverse the cardiovascular issues we started cutting out fat to address in the first place!

Ever heard of the “Mediterranean Diet?” The same Ancel Keys who started the whole kerfuffle over fat in the first place defined this diet in 1945. To this day, the Mediterranean Diet are still considered to be one of the healthiest diets in the world.

That’s right. Before he had even really started what would be the most important research of both his career and a generation of nutritional study, he laid out a diet plan so famous Oprah’s talked about it. (He also developed the military’s famed “K-Rations” and lived to be 100. He might have been a good nutritionist.)

The Mediterranean diet is perhaps the most straightforward form of the concept of “good fats in, bad fats out.” Inspired by the traditional dietary elements of Greece, Spain, and Southern Italy, the principal aspects of this diet include proportionally high consumption of olive oil, legumes (peas, beans, peanuts, etc.) whole grains, fruits, vegetables, moderate to high consumption of fish, moderate consumption of dairy products (primarily cheese and yogurt), moderate wine consumption, and low consumption of meat and meat products. It is lower in (but NOT free of) saturated fat, high in both MUFAs and PUFAs, while also high in fiber, antioxidants, and salt.

The Mediterranean diet is based on what, from the point of view of mainstream nutrition, is considered a paradox: that although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found. (A parallel phenomenon is known as the “French Paradox”). This is attributed in large part to those high levels of unsaturated fats – both mono and poly – which help to moderate over cholesterol levels in the system.

Cholesterol is not the demon we once thought, but general consensus is we still have to maintain a balance. These dietary guidelines are our best route overall but, when these options aren’t always reasonable or available, dietary supplements can help take us in that direction as well. Fish oil supplements, specifically, have risen to become a billion dollar industry in the last decade for this exact reason. By providing us with the PUFAs that are most effective at managing serum cholesterol levels, any number of quality omega products can get you some of these desired benefits with a fair amount of ease.

THE FINAL WORD

Eat a little cheese, have some fish. Enjoy some cashews, don’t go crazy with the steak. Avoid excessive carbohydrates, believe that it’s not butter. Whether you’re doing it dietarily or supplementally – good fats in, bad fats out. By using a little common sense and enjoying some things that taste excellent anyway, maybe we can all live to be 100, keep our hearts beating, and look pretty great when we get there.

(At least we’ll get some butter along the way.)