Is that pepperoni pizza fair game?

About half of all men who suffer heart attacks have normal cholesterol, says Professor Peter Clifton.

What’s happened?

The issue of what is and what isn’t good for you just got murkier, with a new study finding no link between high sat-fat consumption (aka a diet loaded with pork, bacon, cheese, cream) and your risk of keeling over from a heart attack.

Is this credible research?
Sure, as far as it goes. Having reviewed nearly 80 studies of more than half a million people, a team of international scientists found people who ate higher levels of saturated fat had no more heart disease than people who ate less. “My take on this would be that it’s not saturated fat that we should worry about,” concluded cardiovascular epidemiologist Rajiv Chowdhury, the study’s lead author.

Isn’t the link between sat fat and heart attack medical fact?
It’s pretty much been presented that way since 1953, when American scientist Ancel Keys connected the two in a study that spawned his diet-heart hypothesis, landing him on the cover of TIME magazine.

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So this latest study is a turn-up, then?
Well, not really. Being what’s known as a meta-analysis, it’s just bringing together a bunch of other, smaller studies whose findings have pointed in the same direction. Within the scientific community – though more so on its fringes – many have argued for years that the diet-heart hypothesis is bunkum.

Are the experts now admitting they got it wrong?
Absolutely not. They’re sticking solid to the position that saturated fat drives up LDL cholesterol and should be consumed sparingly.

According to Professor Peter Clifton, head of nutritional interventions at Baker IDI Heart and Diabetes Institute, the methodology of these contrarian studies (in which participants self-report what they eat) hasn’t been sensitive enough to detect “subtle relationships”.

On the other hand, Clifton notes, there have been “about eight or nine intervention studies that have attempted to lower LDL cholesterol with big reductions in saturated fat – and big increases in polyunsaturated fat – and when you put all those studies together you will see about a 19 per cent reduction in heart-disease risk”. Clifton concedes these studies are decades old. “But they prove the point.” Likewise, Mediterranean-style eating (partly defined by low sat-fat intake) is a proven heart disease and cancer preventer.

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So, can I scoff that lamb kebab?
Is it all right to bury my bolognaise under parmesan?
Based on the weight of evidence, the dictates of common sense and, yes, the credentials of those urging caution, MH advises continuing to be wary of sat fat and following these six steps:
1. Trim obvious fat and skin from all meat
2. Restrict red-meat consumption to four serves per week, or fewer
3. Avoid all processed meat, or indulge rarely
4. Take opportunities to have vegetarian meals
5. Favour avocado, nuts, seeds and extra virgin olive oil as sources of healthy fats over cheeses, cream and coconut milk
6. Severely limit consumption of fried food, as well as packaged cakes and biscuits.

Just the fats

• Your cholesterol levels are determined mainly by genetics. Diet affects them slightly, but potentially significantly.
• It’s true that sat fat also drives up “good” HDL cholesterol. “But no one has ever shown that putting up HDL cholesterol with saturated fat is beneficial,” says Clifton. “You can take drugs that will double your HDL cholesterol and you don’t get any benefit with heart-disease risk.”
• Your LDL reading is more important. “Because tests have proven that if you lower it by any means, whether it’s drugs or diet or weight loss, you’ll get heart-disease reductions,” says Clifton.
• About half of all men who suffer heart attacks have normal cholesterol. “Cholesterol is a relatively weak risk factor, but as strong as smoking, physical inactivity and being fat,” explains Clifton. It’s your status across all risk factors that counts.