The Tao of Paleo: Finding Your Path to Health and Harmony

CHAPTER ELEVEN: FAT

“I guess I don’t mind so much being old, as I mind being fat and old.” ~ Benjamin Franklin

JS: “Let’s talk about fat, bay-bee, let’s talk about you and me…”

JG: Plying me with the sublime musical stylings of Salt ’N’ Pepa?

JS: Ahhh…no. Just throwing another bone to all those fans who enjoy our pop culture references mixed in with the paleo knowledge we be droppin’.

JG: That WE ARE dropping.

JS: I’m never hanging out with you again after we’re done with this book, you know that?

JG: I’m profoundly sad.

JS: Have some fat then. It is, amongst other things, a mood elevator.

JG: Right. So this is the chapter on Fat, I surmise?

JS: Precisely. Fat is another macronutrient, along with protein and carbs. If you forgot what that means, your memory isn’t too good. So maybe you need some fat which can help your brain function better.

JG: Let’s get the sciencey definition stuff out of the way. A fat molecule, in a nutritional sense, is composed of glycerol bonded to a number of different fatty acids. An oil is just a fat which is typically liquid at room temperature, although there are exceptions.

JS: I suppose it’s time for the obligatory introduction of the special guest out in the hall, right?

JG: It’s like magic, the way you see things coming. Please meet Mr. Albert Adiposian.

AA: Yo.

JG: Wow, Albert. Great outfit.

AA: It’s all from Phat Farm.

JG: How apropos. In a typical display of irony, I do note that you are extremely skinny.

AA: I stay skinny by avoiding eating fats.

JS: Ah. I see. How unfortunate.

AA: We all know that you should eat a low cholesterol diet, low in saturated fats, if you want to stay lean and heart healthy.

JG: Yes, we do all “know” that.

AA: Ok, what’s with the “” marks?

JG: Glad you noticed. It’s the only way I can convey sarcasm because the readers can’t see the smirk on my face. Let me ask you this: Why do you think that a low cholesterol diet that is low in saturated fats is good for you?

AA: Ummm…because everyone is always selling “heart heathy” stuff that is high in grains and low in saturated fat…? Because my heart doctor told me that is how to eat…? Because the American Heart Association says the same thing…?

JS: So you are telling us you know all of this because you rely upon and trust other people who told it to you.

AA: I sure do. I am not a biochemist or a nutritionist.

JG: Nor, obviously, accurately informed.

JS: Is it time to trot out Dr. Chowdhury and his saturated fat meta-study?

JG: Indubitably.

JS: As we mentioned before…

JG: And will surely mention again…

JS: Dr. Rajiv Chowdhury, a cardiovascular epidemiologist from Cambridge University, led an international team that examined eighty saturated fat studies, including over half a million subjects. They then looked at the data from twenty-seven actual randomized controlled trials. The team concluded that people who eat higher levels of saturated fat do not face a higher risk of heart disease or stroke, and that those who eat higher levels of polyunsaturated “heart-healthy” fats do not enjoy a lower risk of the same diseases.

JG: The study did, however, draw a correlation between consuming trans fats and a higher risk of heart disease. More on that later.

AA: If Dr. Chowdhury and his team are right, why were we told to avoid saturated fats for so many years?

JS: Glad you asked. We’ve got a story to tell you.

AA: Ok, I am all ears.

JG: Let me take you back to the enlightened era of the 1950s. People drove cars with big fins, wore leather jackets, and said “Ayyyyy!” while giving the double thumbs-up sign.

JS: They also hung out at Arnold’s Diner and ate cheesburgers and fries.

JG: Yep. Back in the fifties, there was a scientist by the name of Ancel Keys.

JS: If there is a Sauron of the paleo world, Ancel Keys is he. Anyway, Keys produced a famous study called The Seven Countries Study which showed, quite convincingly, that a diet high in saturated fats led to heart disease.

JG: As a result of this study, in 1956 representatives of The American Heart Association appeared on television to inform people that a diet which included large quantities of butter, lard, eggs, and beef would lead to coronary heart disease. This resulted in the American government recommending that people adopt a low-fat diet in order to prevent heart disease.

AA: Sounds like a good reason not to eat saturated fats.

JS: The problem is that Keys started out the study with 22 countries and then just tossed out the results from the 15 countries that didn’t fit his hypothesis.

AA: Whoa. Not cool.

JS: It’s very cool if you are Ancel Keys and you’re interested in proving your theory at any cost…but yeah, not too cool if that’s the basis for the modern jihad against saturated fat. Very not cool if you have heart disease and you are under the mistaken assumption that saturated fat is what’s killing you.

AA: So you are telling me that saturated fat - animal fat, for example, or coconut oil - is good, and that that I should eat it?

JG: We are telling you that the paleo community believes saturated fat is healthy, and that this belief is supported by thousands of testimonials and also the best science, such as Dr. Chowdhury’s saturated fat study. In the testimonial department, in his book Joe has stories of several people who cured their heart disease and got off statins and other drugs in a matter of a couple of months by adopting the paleo lifestyle, which of course, includes increased consumption of saturated fatsBut we are also telling you that you should figure it out for yourself - don’t take our word for it.

JS: We strongly doubt any doctor in the world would tell you that eating a diet rich in saturated fat for one month will kill you. Go get a thorough physical, complete with blood work and a cardiovascular profile, change your diet for a month, then get tested again. The results will astound you. Just make sure to always demand a VAP test, which is a direct measurement of the LDL. And when the results come back, don’t rely on a reading that just looks at the total cholesterol number - it is more important to look at the ratio of LDL, HDL, and triglycerides. Pick up a copy of Jimmy Moore’s book Cholesterol Clarity: What the HDL is wrong with my numbers? if you need more explanation - for your own knowledge or to educate your physician.

AA: Ok, I’ll think about it. Then what causes heart disease? Isn’t it cholesterol?

JG: Ok, let’s first take a step back and talk about cholesterol - the alleged bad guy.

AA: Alleged?

JG: Is there an echo in here?

JS: Yeah. Cholesterol is absolutely necessary for human life. Cholesterol buildup is just your body’s attempt to patch the walls of arteries that are structurally weak.

AA: So you are saying that the cholesterol is only a symptom and not a cause?

JG: Exactamundo.

AA: So then why do doctors prescribe drugs like statins designed to lower cholesterol?

JS: I’ll give you one guess.

AA: Ummm…because the drug companies make billions of dollars from manufacturing them, and doctors keep giving them to patients because they don’t understand the root cause?

JS: Bingo.

AA: Didn’t I read about some famous study that fed a high- cholesterol, animal-fat-rich diet to rabbits? Didn’t they die of heart disease?

JG: Yes. But rabbits don’t eat meat.

JS: And by the way, if you weren’t aware, you are not, in fact, a rabbit.

AA: I feel like an idiot.

JG: Stop feeling like an idiot. Millions of Americans are similarly misinformed, including a large chunk of the medical community. Again, Dr. Chowdhury’s study had a lot of interesting things to say about cholesterol.

JS: Basically, total cholesterol levels don’t correlate to heart disease risk. Also, it’s beneficial to have higher levels of HDL-type cholesterol. Eating saturated fat elevates total and HDL cholesterol.

AA: Doesn’t it raise LDL levels too? Isn’t that the “bad cholesterol?”

JG: Dr. Chowdhury’s study indicated that the only kind of LDL elevated by saturated fat consumption is the “A” type, which is benign. Saturated fat has no effect on levels of the “B” type, which does increase risk of arterial blockage.

AA: Ok, so what raises LDL type B, levels, and you didn’t answer my question, what causes heart disease?

JS: In order to answer your question completely, we need to take a step backward and go over the various types of fats. First, let’s deal with monounsaturated fats.

AA: Do I have to pay attention to this part? Sounds like high school biology class - BORING!

JG: Another pilgrim just thirsting for knowledge.

JS: I’ll make it quick and easy for you, trust me.

AA: Fine. Shoot.

JS: Monounsaturated fat molecules have a single double bond. They are liquid at room temperature and solid when refrigerated.

AA: ZZZzzzzzzz…

JG: You in the back row! Pay attention! Here comes the good part!

JS: Polyunsaturated fats have more than one double bond. They are liquid both at room temperature and when refrigerated. The problem with these fats - and we call them PUFAs (polyunsaturated fatty acids) - is that they are relatively unstable. They can oxidize easily when exposed to light, heat, or air, and they can also change when heated. They tend to break down into free radicals, meaning that the atoms in the molecules can have extra electrons. Free radicals can cause both cell membrane damage and also contribute to plaque buildup on arterial walls.

AA: That doesn’t sound good at all.

JG: We would not recommend any of that.

JS: Right. PUFAs are found in abundance in grain products, soybeans, peanuts, and fish oil.

AA: I thought fish oil is good for you…?

JG: You also thought fat was bad for you. You also probably believe in the tooth fairy. Fish oil is good for you. We need to explain further.

AA: There’s no tooth fairy?

JS: Let’s move on to two subcategories of PUFAs - essential fatty acids. They are so named because the body doesn’t manufacture them on its own. The essential fatty acids we are interested in are omega-3 and omega-6 fatty acids.

AA: There’s an omega-6 now? Sheesh, where have I been! I just upgraded to the omega-3 last year.

JG: Yeah, omega-6 needs better marketing.

JS: They are both important for human health. Omega-6 is found in corn, grains, and in grain-fed animals. Omega-3 is found in fish, grass-fed beef, algae, nuts, flaxseed, and chia seeds.

AA: So we need these PUFAs?

JG: In the correct amounts. What is important is the RATIO of omega-3 to omega-6. Anywhere from 1:1 to 1:4 is excellent. Unfortunately the modern American diet produces a ratio of 1:30 or worse. A big part of that is our bias toward grain- feeding our meat animals and our dependence on vegetable oils. Grain-fed ruminants, like cows and lambs, lose almost all their omega-3 fat when they are fed grains, even if it is only for a few months before slaughter. When they are fed grass, what they would otherwise naturally eat, their fat is mostly omega-3. Pastured pigs have high omega-3 levels and low omega-6 levels, but pork from factory farms have astronomically high levels of omega-6 and low levels of omega-3.

Vegetable oils generally have poor ratios. The omega ratio of corn oil, for example, is something like 1:46.

AA: Ok, so we need to watch out for PUFAs AND watch out for our omega ratios?

JS: Yes. Basically, most of us get way too much omega-6 - so we need to try to eliminate foods that have a lot of omega-6 in them. And at the same time, we need to eat more omega-3 foods to help our ratios. Dr. Chowdhury’s study correlated the omega-3 found naturally in fish to lower risk of heart disease and stroke.

AA: But you also mentioned other omega-3 sources like chia and flax, right? So those foods are as good for you as people say they are?

JS: Unfortunately the research suggests that the omega-3 in flax and chia is not bioavailable to us.

AA: I have no clue what bioavailable means.

JG: It means our bodies can’t absorb it. Let me give you an example. One of the goals of eating omega-3 fat is to produce DHA.

AA: What does DHA stand for?

JS: Docosahexaenoic acid.

AA: Sorry I asked.

JG: DHA is really, really important. It’s a major structural component of the brain, skin, testicles, cerebral cortex, and retina. Low DHA has been connected to many degenerative diseases and results in poor brain function. When I say that the omega-3 in chia and flax is not bioavailable, I mean that you can eat all the chia and flax that you could possibly tolerate and your DHA levels won’t go up at all.

JS: Consuming animal sources of DHA on the other hand - fish and grass-fed beef - DOES result in DHA levels rising.

AA: So fish oil IS good then?

JG: Well, yes, when you get it from the fish directly, sure. However, if you take fish oil in supplement form, the oils may have gone rancid, and the healthy omega-3s have become not-so-healthy PUFAs. Make sure you vet a good fresh source.

JS: The best thing to do is eat good, clean, wild-caught fish a couple of times a week - about a pound of fatty fish a week. Good quality fish can be expensive, but when you think about how much money you are saving in potential medical bills, it’s a good investment.

JG: Not to mention that eating clean will make you feel freaking amazing.

JS: By fatty fish I mean sardines, mackerel, salmon, and shellfish - they have the highest omega-3 content.

AA: Sardines are nasty and I have no idea what a mackerel is, except that they are sometimes holy. I will stick with the salmon and shellfish.

JG: Let’s pivot and touch on saturated fats.

AA: So are saturated fats monounsaturated or PUFAs?

JS: Neither. Saturated fat molecules don’t have any double bonds. They are extremely chemically stable and also important components of the human body.

JG: Saturated fat makes up 1/2 of human cell membrane structure. Consuming it enhances mineral absorption and immune function. It is necessary to process fat-soluble vitamins and to produce the cholesterol necessary for proper body function.

JS: We like saturated fats. They are our friend. We recommend that you eat them.

JG: Lastly, and definitely leastly, there are trans fats.

AA: Trans fats? Those are bad, right?

JS: You are absolutely correct. They are pretty much poison.

JG: They are kind of a Frankenfat.

JS: Yep. Trans fats - hydrogenated fats and oils - were artificially created to give products a longer shelf life.

JG: They are a nasty piece of biochemistry and have been linked to inflammation, atherosclerosis, diabetes, obesity, and immune system disorders. Dr. Chowdhury’s study established a link between eating trans fats and elevated risk of heart disease. Trans fats have even been extensively banned in some places.

AA: Ok. Got it. No trans fats. So now that I understand the whole fat spectrum…can we move back to cholesterol and heart disease?

JS: Sure.

AA: Ok, so if I understood you earlier, lowering your overall cholesterol doesn’t improve your chances of avoiding heart disease.

JG: Not in and of itself, no.

AA: And that is because cholesterol is the band aid that the body applies to weakened arterial walls.

JS: Yep, amongst other things. Also, higher total cholesterol, HDL, and LDL-A levels don’t correlate to risk of heart disease.

AA: Well, what causes the artery walls to weaken the first place?

JS: The short answer, and the most important factor, is oxidation.

AA: You used that word before when we talked about PUFAs. What the heck does it mean?

JG: Well, technically it means a chemical change resulting from exposing something to oxygen. Like when metal oxidizes and turns to rust.

AA: So that’s going on in your heart?!?

JS: Well, not exactly. Oxidation occurs when certain types of cholesterol - mostly the LDL-B - reacts with free radicals.

AA: That’s the second time you’ve mentioned free radicals. Shouldn’t they do a better job of keeping those radicals imprisoned??

JG: Oh boy. Here we go.

JS: Let me back up a bit. So there’s that stuff called low density lipoprotein cholesterol type B, that’s LDL-B, or what we’ll call the bad cholesterol - combines with free radicals, then it oxidizes and causes heart and blood vessel tissue damage.

AA: What are free radicals you keep talking about?

JG: Free radicals are atoms or groups of atoms with an odd (unpaired) number of electrons and can be formed when oxygen interacts with certain molecules.

AA: This isn’t helping at all.

JS: Ok, lets make it simpler. First, you need to stop eating trans fats - those chemical Frankenfats we talked about - because they are a chief culprit in this heart-damaging scenario. Don’t put anything in your mouth that is hydrogenized or partially hydrogenated, because those are trans fats. You want to eat lots of anti-oxidants - lots of them in veggies and fruits, nuts, olive oil, and even dark chocolate, for example - to counteract the effect of trans fats and free radicals as much as possible.

JG: You’d also be wise to avoid eating some of those PUFAs we discussed earlier. They can also easily oxidize. Seed and vegetable oils like canola, grapeseed, sunflower, peanut, and soy oils are good examples of PUFAs to avoid. They easily go rancid as well, which only increases the danger of eating them. Also, avoid fish oil supplements unless you are sure they are fresh and haven’t gone rancid - when that happens, the healthy omega-3s turn into omega-6s and can also oxidize. Generally, omega-3s consumed directly from animal sources are more stable and don’t oxidize or turn rancid.

AA: Ok, so I understand that oxidation, brought on by the consumption of unhealthy fats, is one cause of heart disease. Anything else?

JS: Yep. Inflammation also contributes to heart disease.

AA: You mean like swelling?

JS: Yes, in the sense of internal, systemic inflammation in your body.

AA: What causes this type of inflammation?

JG: Eating processed sugars, processed carbs, excessive omega-6 PUFAs, trans fats, and grains. Levels of LDL-B, the bad cholesterol, rise in your body the more you eat these things in response to this type of systemic inflammation.

AA: So we finally get to the answer to the question I was asking all along. Eating trans fats, PUFAs, processed sugars, processed carbs, and grains can cause heart disease?

JS: Bingo.

AA: I thought that heart disease was hereditary.

JS: It is - in the sense that there’s a hereditary component of susceptibility. The level of inflammatory response to eating trans fats, sugars, processed carbs, and grains is hereditary. We have a genetic level of response to these foods that varies based on heredity. But whether or not the genetic potential is ultimately expressed depends on, in large part, what you eat.

AA: So this all just confirms exactly what I believed was true. If fats are so dangerous, then I shouldn’t eat them. Yay! Adiposian for the win!

JG: Hold your horses.

JS: That’s not what we meant at all. Certainly there are types of fat that are not healthy to eat, like trans fats and excessive amounts of omega-6 PUFAs. However, there are a number of fats that are very healthy, and you need to eat them.

AA: So what fats are good? And why are they good?

JG: We recommend saturated fats, like those found in animal flesh, and those found in stable oils like coconut oil, avocado oil, and ghee. Certain monounsaturated fats are good too, like olive oil, as long as they are consumed unheated. You should also consume the omega-3 polyunsaturated fats directly, by eating fish, certain nuts, and properly raised animals.

AA: But saturated fat is terrible! Didn’t that guy Ancel and Gretel say so, right before he put the witch in the oven and cooked her to death?

JS: Ancel Keys. Yeah, but remember, that study was a complete sham. And it was totally wrong.

JG: Yep, in fact, even before Dr. Chowdhury’s saturated fat meta-analysis was published in there was a landmark analysis of research on saturated fat published in the American Journal of Clinical Nutrition in 2010. This analysis looked at 21 studies, and those studies tracked over 350,000 people. Do you know what that analysis found?

AA: That Albert Adiposian is the most awesome dude ever?

JS: That there was insufficient evidence to link saturated fat consumption to heart disease or stroke.

JG: This was hot on the heels of a 2006 Women’s Health Initiative study that found that reducing saturated fat failed to reduce the rate of heart disease.

JS: The truth is that the whole heart disease from saturated fat argument isn’t backed by scientific evidence. There is a correlation between high LDL-B levels and heart disease, but as we mentioned before, eating saturated fats doesn’t raise LDL. In fact, it can lower it, and raise levels of the good HDL cholesterol. It can also reduce levels of lipoprotein (a), which is a key marker for heart disease.

AA: Wow. Anything else I need to know about fats, besides that eating the right ones don’t cause heart disease?

JG: Yes. Eating fats doesn’t make you fat.

JS: In fact, eating the right types of fat (saturated fats, omega-3 polyunsaturated fats from good sources, and unheated monounsaturated fats) will promote overall general health. Consuming fatty cuts of meat and cooking in coconut oil, ghee, and unheated olive oil are good for you in many other ways besides heart health. Fat helps brain and lung function and it is a natural mood elevator. Fat helps keep your liver healthy and aids in tuning your nervous system.

In a dietary sense fat is a high satiety macronutrient, like protein, and helps satisfy your appetite, preventing you from over eating.

Remember it’s intake of grains, sugary carbs, and other processed foods that leads to body fat retention, not the consumption of healthy fats.

AA: So you want me to eat fat.

JG: Yes, the right kinds of fats. In significant quantities. We want you to cook with them, too, and add them to food for additional flavor as well.

AA: You want me to eat meat as well, to get more of that fat.

JS: Grass-fed and pastured meat, yes. And eggs, too. And fatty seafood.

AA: And eating all this fat won’t make me fat. It won’t give me heart disease, strokes, or anything.

JG: Nope.

AA: And what was it you said about eating certain oils, like avocado, unheated olive oil and…

JS: Coconut oil.

AA: Yeah, I just saw a can labeled “Coconut Oil” over there! Can I

taste some?

JG: Wait. No. Don’t. Stop.

AA: MMMMM! Delicious!!! You guys were right. It’s absolutely scrumptious!! I feel great!!!

JG: Uh oh. Too late.

JS: What did you do now?

JG: Albert, if you had read the label on other side of the can, it says “Experimental! Dangerous!! Do Not Consume!!”

AA: What’s happening to me?

JS: You appear to be inflating, kind of like a hot air balloon. What’s in the can, Jason?

JG: Oh, just a little experiment of mine. It’s highly concentrated coconut oil, I’m trying to develop a formula that will lower LDL-B cholesterol with just one teaspoon a week. There are still some bugs to work out.

AA: AAAAAAGHH!

JS: I can see that. Albert appears to have blown up to the size of a human beach ball. And he’s turned brown and sprouted hairs like…

JG: A coconut. There isn’t much time either.

JS: Until?

JG: Until he bursts, spraying coconut oil all over our nice clean book. Don’t worry, though.

JS: What’s with that little harmonica you just blew?

JG: I’m calling for help.

JS: Who are all the fat little midgets??

JG: PUFA-Looofas. They will take him to the cracking room, and hopefully de-oil him before he bursts.

JS: They are singing a little song as they roll him away!

JG: Yeah, they won’t work unless they get to sing their little songs.

JS: Strong union.

JG: Yep. Let’s listen:

PUFA-Looofah, looofity do… 

Don’t avoid fat or you’re gonna be screwed,

It’s good for your brain and it helps to you see, 

to be good in bed and to easily pee,

Fat is your friend, so eat a whole slew, 

like the PUFA-Looofahs loofity do!

JS: Catchy.

JG: No doubt.

JS: Is he going to be ok?

JG: Who knows? Do you really care?

JS: Nah. Not really.

JG: Me neither.



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