WHAT THE FUSS?
Powered by all the hoopla with the recent promulgation from the American Heart Association (AHA) decrying coconut oil and saturated fats as components of a healthy diet AND the recently popular but biased Netflix documentary, WHAT THE HEALTH, I figure it’s prime time for me, the Medical Advocate to come forward.
WHAT THE FUSS is my response to a myriad of claims that are not all scientifically sound. Why is there so much controversy? Why make it so difficult? Why can’t we all get along?
Firstly, I have stated repeatedly that not one diet suits all. I generally am not a dogmatic person, but I will continue to stand by this principle until someone can convince me otherwise.
There are simply too many variables to consider when choosing an appropriate diet plan:
• Individual goals (performance, weight loss, enhanced energy, etc.)
• Pregnancy /nursing
• Food allergies or food sensitivities
• Lifestyle (career, exercise, travel)
• Medical history (heart disease, hypertension, cancer, diabetes, obesity, autoimmune disease, dementia etc.)
• Lipid profile (cholesterol, size of the LDL or lousy cholesterol particle, triglycerides)
• Metabolic profile (diabetes, prediabetes , metabolic syndrome, non-alcoholic fatty liver disease, polycystic ovarian syndrome)
• Gut function (leaky gut, small intestine bowel overgrowth (SIBO), irritable bowel disease, inflammatory bowel disease (eg. ulcerative colitis and Crohn’s disease)
So whether we are talking about a straight vegan diet, Mediterranean diet, paleo or keto-genic diet, all the variables listed above play critical roles in formulating diet plans.
WHAT THE HEALTH did indeed blow the whistle on prestigious professional organizations such as the American Heart Association (AHA), the American Cancer Society (ACS), and the American Diabetic Association. Yes folks, these organizations are backed by well-known processed food companies. These foods they produce are anything but healthy, but these giants in the food industry have mega bucks to fund such organizations.
But let’s be clear here; the bulk of this film was heavily biased and not backed by science. By urging viewers to turn vegan “to survive modern life”, this flick becomes overly-preachy. Perhaps the most ridiculous claim in the documentary occurs when the filmmakers equate egg eating to smoking!
What else do they preach?
• The most healthy way of eating is cutting out all meat, fish and diary
• Such food makes us fat, gives us cancer, and poisons us with toxins.
• Sugar is no big deal and has no role in the growing diabetic epidemic
In my opinion this is a poorly represented documentary. The filmmakers only interviewed doctors who shared their point of view. Even worse, the film resisted exploring actual science in depth.
Indeed the producers only spoke to experts in the field who promoted veganism to their patients. There is nothing wrong with being vegan. I happen to espouse a plant-based diet. However, I can assure you that it is not the end all, be all in regard to optimal nutrition.
But remember this; it is just as possible to be unhealthy when you are vegan as it is when you are eating animal products!
What I found shocking was that when physicians from the American Diabetic Association were interviewed, they refused to talk about studies that failed to yield positive results that support their research. Let’s be real here; there are many studies that are underfunded or have significant limitations. Negative results occur. Of course the “experts” don’t want to talk about such studies.
What you don’t know can hurt you!
Worse yet was that the film resisted exploring an in-depth view of science. Scare tactics were used instead of actual science to support their claims. They brought up topics such as how toxic the water is in our country, and that, therefore, fish are toxic. There may be some truth to that; however, the water fish are swimming in is no different than the water used to grow plants!
I truly think that all of us should eat more vegetables. But it’s not that simple. Furthermore, vegan and vegetarian diets don’t work for everyone.
Switching to the recent report from the AHA, we’ve been admonished to avoid all saturated fat. This includes coconut oil. 
Enter major chaos! I can’t tell you how many phone calls and inquiries I received! “Dr. Elkin, you told us it was ok to eat…”
If that wasn’t confusing enough, the AHA also stated that we need to be ingesting what they call healthy fats, which include polyunsaturated vegetable oils. These include sunflower oil, safflower oil, corn oil and soybean oil. These are known as Omega-6 fats.
Omega 6 fats constitute much of the fat in the average American diet, and are anything but healthy. They abound in essentially all processed foods. Such fats are pro-inflammatory in nature and should have no role in our diet. After all, we know that inflammation is the bane of our existence when it comes to aging.
The AHA report did espouse healthy monounsaturated fats such as olive oil, nuts and avocados. However, they included monounsaturated canola oil, which many of us believe has no role in a healthy fat diet. For more information about the impure nature of canola oil, I urge you to view a video on how this oil is commercially prepared for human consumption.
The AHA vehemently opposes saturated fat which includes coconut oil. I continue to ask why? On average, long term studies do not show an association between saturated fat intake and blood cholesterol levels.
Is saturated fat truly associated with heart disease? Well, perhaps in the early 60’s at which time 3 trials quoted by the AHA demonstrated an association. Oddly enough the AHA is still quoting these same studies, 50 years later! It’s as if they were cherry picking what studies to include in this recent advisory review.
I’d like to think that we’ve come a long way in 50 years, but you would never know it by reading their recent report. In contradistinction, a large meta-analysis of prospective studies involving close to 350,000 participants found no association between saturated fat and heart disease. 
The AHA continues to tell us that heart disease is the result of clogged arteries. They’ve been saying that for years. Today we know that the process is much more complex. That’s when we have to consider the role of inflammation.
Nowadays we need to look at factors such as the size of the LDL particle and inflammatory markers. What causes inflammation? Insulin resistance, metabolic syndrome, diabetes and obesity are starters.
The truth of the matter is that the saturated fat diet-heart hypothesis has been tested more than any other in the history of nutrition. Thus far, the results have not demonstrated a truly deleterious effect of saturated fat on heart disease.
The AHA, founded in 1926 has played a significant role over 90 years in educating both the public and the medical profession. I am the first to laud its many accomplishments.
Why they should be so resistant to updating its view of saturated fat, despite so much legitimate science, both eludes and disappoints me greatly. There is no role for outdated science.
My goals as the Medical Advocate is to help deflect confusion, set the record straight and encourage my patients, readers and audiences to do their homework. In turn they become they own best medical advocates by staying in the driver’s seat when it comes to their health.
1. Circulation, AHA Presidential Advisory June 15, 2017
2. Siri-Tarini Pw, et al. Am J Clin Nutr. 2010.
Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.
VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2017.
*originally published Wednesday, September 20, 2017