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THE SKINNY ON FATS

THE MYTHS AND FACTS ABOUT DIETARY FATS

TIM HARDWICK

The Skinny on Fats

First Edition (2019 )Copyright © Tim Hardwick (2019 )

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INTRODUCTION

In recent times, there has been an epidemic of fat phobia, with so-called low-fat diets and fat-free foods. Diets that restrict fats orvirtually eliminate them are depriving us of essential nutrientsthat are required for a myriad of important functions. Let’s take acloser look at why we need fat and what it does.

The scientific terms for fat are triglycerides, fatty acids andcholesterol. The body cannot synthesise fatty acids on its own sothey need to come from the diet. Fat helps to absorb vitamins andminerals; for example, vitamins A, D, E, and K are all fat soluble.Fat is also needed to build cell membranes and the myelinsheaths surrounding nerves. In fact, the human brain iscomprised of nearly 60% fat, with fatty acids that are essential inboth brain development and performance.

Fat in the diet is a major source of energy. Our systems will tapinto our fat stores, our backup energy, when carbohydrates arenot available. However, this does not necessarily mean that eatingfat makes us fat! Eating an excess of calories over and above your

daily energy requirements, will pack on the pounds. But this is atopic for another book.

Fat also provides a layer of insulation just under the skin calledthe subcutaneous layer and helps to regulate our body tempera‐ture. It also surrounds our vital organs to provide a cushion thatprotects them from external impact and also holds them in place.It has to be said that we can have too much protection around ourinternal organs, which leads to other health risks.

As we can see, fats make up an important macronutrient in ourdiets. There are various types of fats, including saturated fats,monounsaturated fats, polyunsaturated fats and trans fats. Weshould avoid trans fats at all costs as these are very unhealthy.Let’s take a closer look at each of the categories of fat to get abetter understanding of how they work in the body and how theyaffect our health.

iv INTRODUCTION

1

SATURATED FATS

Saturated fats, or saturated fatty acids (SFA), have been slated asone of the big villains of modern society, with claims that they areresponsible for the majority of cardiovascular disease. However,more and more research on this subject is showing that all isn’tquite as it seems with saturated fat. So what is the real deal here?Who should we listen to? What is fact and what is myth? Let’stake a closer look.

In the twentieth century, there was an epidemic of heart diseasethat became the number one cause of death in America. In fact, itstill is. The research at the time showed an association betweenthe consumption of saturated fats and an increased cholesterollevel in the bloodstream. Back then, it was thought that a highcholesterol level was linked to an increased risk of heart disease.Therefore, an assumption was made that saturated fats causedheart attacks. This became known as the ‘diet–heart hypothesis’and was adopted as public policy in 1977, despite there not beingany conclusive evidence to prove the hypothesis.

Despite the mountain of scientific evidence disproving the diet-

heart hypothesis, there is still guidance out there to avoid satu‐rated fats in order to reduce the risk of heart disease. In fact, thereis an increasing amount of research that shows there is anincreased risk of cardiovascular disease by actually lowering yourintake of saturated fats! A recent analysis of data from seventy-sixstudies, and more than half a million people, found that thosewho consume more saturated fats have no more risk of heartdisease than those who consume less.1 A recent review publishedin 2010 pooled together data from twenty-one unique studiesthat included almost 350,000 people, approximately 11,000 ofwhom developed cardiovascular disease (CVD), tracked for anaverage of fourteen years. The review concluded that there is norelationship between the intake of saturated fat and the incidenceof heart disease or stroke.2

Indeed, the body needs saturated fats and cholesterol to functioncorrectly and millions of years of evolution support this. Manyexperts believe that since the Palaeolithic era, we have evolved ashunter-gatherers, and that we have eaten animal products formost of our existence on Earth. Our diet has consisted of meat,fish, berries, plants, nuts, etc, so our bodies are designed for awide range of nutrients, including saturated fats. Eliminating orrestricting saturated fats in our diets just doesn’t make sense froman evolutionary perspective.

Saturated fats are derived from both animal sources and plant-based food. Common foods containing saturated fats are redmeat, eggs, cheese, milk, coconut oil, cocoa and avocados. Thereason it is called saturated fat is that it is has a chemical structurewhere its carbon atoms are saturated with hydrogen atoms and donot contain any double bonds between the carbon atoms. We’llsee, as we learn about other fatty acids, that apparently smallchanges in the chemical structure significantly change the natureof the fatty acid.

2 THE SKINNY ON FATS

The concern with saturated fat is that it is alleged to increasecholesterol levels and increase the risk of heart disease. However,as we have seen above, there is no conclusive evidence if this. Infact, replacing saturated fats with highly refined carbohydrateshas been found to be a bigger contributing factor to manydiseases. A study published in 2010 found that a reduction insaturated fat must be evaluated in the context of what you arereplacing it with. Replacing saturated fats with a higher carbohy‐drate intake, particularly refined and processed carbohydratescan increase triglycerides and small LDL particles, as well asreduce HDL cholesterol.3

Basically, our bodies need saturated fats to function properly.They perform many crucial functions:

Provide building blocks for cell membranes andhormonesAbsorb minerals, such as calciumCarry fat-soluble vitamins, such as vitamins A, D, Eand KProvide essential fatty acids

There are various fatty acids in saturated fats and each of thesealso has its own important biological functions:

Butyric acid is typically found in butter and dairy fat. Itis known to regulate the expression of several genes andmay play a role in cancer prevention by stopping thedevelopment of cancer cells.

SATURATED FATS 3

Lauric acid is found in coconut oil. It is an antimicrobialfatty acid and also has the function of stabilisation whenit is attached to certain proteins, in a similar fashion tomyristic acid.Myristic acid is found in coconut oil and dairy fat. Thebody uses myristic acid to stabilise many differentproteins, including proteins used in the immune systemand to fight tumours. It may also regulate the availabilityof polyunsaturated fatty acids, like docosahexaenoicacid (DHA).Palmitic acid is found in palm oil, meat and dairy fats.This fatty acid is involved in the regulation ofhormones, as well as cell messaging and immunefunction.Stearic acid is found in meat fat and cocoa butter. It isinvolved in cell messaging and immune function.

The bottom line is that saturated fats are important to our healthand provide many benefits. However, as with everything in life,too much of it can tip the scales the other way – it’s about balanceand moderation. We’ll talk more about the optimal ratio of fats inChapter 5.


2

CHOLESTEROL

As part of the discussion on saturated fats, we need to take acloser look at cholesterol. We absolutely need cholesterol to carryout essential functions in the body, including the production ofcell membranes and hormones (testosterone, progesterone andoestrogen), as well as bile acids that help to digest fat. It is alsoimportant in the production of vitamin D, which we know isimportant for good health. Cholesterol is also important for itsrole in brain health because it is critical for synapse formation,the connections between neurons and these allow us to think,learn and form new memories. There is a lot of talk about ‘good’and ‘bad’ cholesterol but, essentially, there is just cholesterol.You’ll often hear about HDL being the good cholesterol andLDL being the bad cholesterol. However, these are actually bothlipoproteins that carry cholesterol around the bloodstream andthere is nothing inherently good or bad about them. Cholesterolis not water soluble and as the blood is mainly water, cholesterolneeds these lipoproteins to carry it around the bloodstream.

These lipoproteins also carry other substances, such as triglyc‐

erides and phospholipids, but for now we’ll focus on their rolewith cholesterol. These protein ‘carriers’ are categorised by theirdensity: high-density lipoprotein (HDL), intermediate-densitylipoprotein (IDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and ultra low- density (ULDL), alsoknown as chylomicrons. LDL or low-density lipoprotein carriescholesterol from the liver to the rest of the body. Cells then attachto these particles and extract fat and cholesterol. Large LDLparticles are not harmful but the small, dense LDL particles canpotentially be a problem because they can squeeze through thelining of the arteries and, if they oxidise, cause inflammation anddamage. Recent research has shown that this inflammationincreases the risk of arteriosclerosis.4 Large LDL particles are notable to penetrate the walls of the arteries and so there is lower riskassociated with these.

HDL, or high-density lipoprotein, scavenges cholesterol from thebloodstream, from LDL and from artery walls and carries it backto the liver for recycling. It is easy to see why HDL is seen asgood because it is taking cholesterol away from the arteries. Butwhy does HDL take cholesterol away from the arteries? It isbeing taken back to the liver for recycling so that it can be loadedback into other protein carriers and sent out to other cells in thebody where it is needed. The body is very efficient with itsresources, particularly as cholesterol is so vital to life.

Does the consumption of saturated fats and foods high incholesterol actually increase the level of cholesterol in thebloodstream? Let’s take eggs as an example because they havecome under fire in the past due to their high cholesterol content.One particular study involved people with metabolic syndromewho ate three whole eggs daily for twelve weeks. The studyfound that plasma triglycerides decreased and HDL cholesterolincreased. Furthermore, there were increases in large HDL and


large LDL particles, and there were reductions in total VLDLparticles.5 This study shows that the consumption of eggschanges the profile of cholesterol in the blood favourably, so thatwe have fewer of the small, dense particles of LDL and more ofthe larger particles of both LDL and HDL. As we have seenearlier in this chapter, it is the small, dense particles of LDLthat increase the risk of atherosclerosis. The researchersconcluded that whole-egg consumption, along with a moder‐ately carbohydrate-restricted diet provides improvements inlipid profiles and insulin resistance in individuals with meta‐bolic syndrome.

The fats that we eat are transported in the bloodstream mainly astriglycerides and this is the vehicle used for transporting fats tocells. This is healthy but, as with all things, when it gets out ofbalance, then we start to see problems. It is the liver that producescholesterol, so the amount of dietary cholesterol that you eat has alimited effect on your body’s cholesterol levels.

So why does the liver create more cholesterol? One hypothesis isthat this happens as a result of the inflammation in the arterywalls caused by the small, dense particles of LDL becominglodged and oxidised. We know that part of the inflammationprocess is that new cells and tissue are created, and we also knowthat cholesterol plays a role in the formation of new cells. If thereis chronic inflammation, not only in the arteries but elsewhere inthe body, then it makes sense that cholesterol levels would beelevated.

Where do triglycerides fit into the equation? Well, this is how fatis transported through the bloodstream and a person with hightriglycerides has a lot of fat travelling through the bloodstream tothe cells. This could be a result of manufacturing too manytriglycerides, which essentially means the body is making too

CHOLESTEROL 7

much fat, or it could mean that the body is not burning enoughfat as energy.

Is high cholesterol actually bad for us? What does the evidenceshow? There is an increasing body of evidence showing thatcholesterol is not the villain it was once thought to be. It seemsthat cholesterol has been wrongly accused; however, it isn’tcompletely off the hook. The evidence does point the finger at thesmall, dense particles of LDL triggering the inflammatory processin the artery walls. In addition, it is thought that it is not only thepresence of these small, dense LDL particles, but also the quan‐tity of them in the bloodstream that increases the risk factors.

Let’s use an analogy to make this a little easier to digest. We’vetalked about cholesterol being carried in the bloodstream by theselipoproteins. Let’s imagine that these lipoproteins are cars. We’vegot large cars for the regular LDL particles and small cars for thesmall, dense LDL particles. The bloodstream is the highway ormotorway. All of the cars on the highway have passengers, whichare cholesterol and fats being transported to various parts of thebody. In days gone by, scientists thought it was the number ofpassengers – the amount of cholesterol – that was a risk factor forheart disease. However, the research now shows that it is actuallythe number of small cars on the road – the small, dense LDLparticles – that is more indicative of increased risk of cardiovas‐cular disease. The more small cars we get on the highway, thebusier it gets, and the more chance of these cars crashing into thesides – the blood vessel linings. It is when these small, denseparticles of LDL get lodged in the blood-vessel lining that theycan then oxidise and cause inflammation.

Bringing this discussion full circle back to saturated fats, does theconsumption of saturated fats increase the number of LDL parti‐cles in the blood? The answer is that saturated fat has a limited


effect on LDL levels in the blood. The research shows that satu‐rated fat, in its limited capacity to affect LDL and cholesterol,actually lowers the number of small, dense LDL particles.6,7Research now provides the evidence that the culprits forincreased amounts of small, dense LDL particles are, in fact,sugars and refined carbohydrates.3 In addition, these also lowerthe amount of HDL and raise the levels of triglycerides. It’s ironicthat the dietary guidance of low fat and high carbohydrates,particularly refined carbs, that has been prevalent for decadesand still remains to this day, is being proven to actually increasethe risk of cardiovascular disease!

In the mainstream, current cholesterol testing determines thetotal levels of LDL, HDL and triglycerides, from which assump‐tions can be made. However, we are now starting to see the avail‐ability of lab tests that can determine the amount of small, denseLDL particles in the blood, using lipoprotein sub-fraction testing,which is helpful in evaluating an individual’s risk of CVD.

CHOLESTEROL 9

3

POLYUNSATURATED FATS

From a chemical perspective, polyunsaturated fats are simply fatmolecules that have more than one unsaturated carbon bond inthe molecule or double bonds. Remember we talked about satu‐rated fats having no double bonds between carbon atoms? Well, asmall molecular change creates a different fatty acid withcompletely different properties! Today, most fats in the diet arefrom polyunsaturated fats and these come from vegetable oilsderived from soy, corn, sunflower and canola. Modern diets cancontain as many as 30% of calories from polyunsaturated fats,which is way too high and is knocking our balance of omega-3and omega-6 way out of kilter.

Over the past thirty years, there has been a dramatic increase inthe consumption of foods that are high in omega-6 fatty acids,due to the increased intake of vegetable oils from corn, sunflowerseeds, safflower seeds and soybeans. Research estimates thatpeople are eating as much as twenty times more omega 6 thanomega 3. From a biochemical perspective, this is a huge imbal‐ance and it sets the stage for chronic inflammation. Based on

studies in palaeolithic nutrition, we can see that humans evolvedconsuming a diet that had approximately equal amounts ofomega 3- and omega-6 fatty acids.

Research has shown that excessive consumption of polyunsatu‐rated fats contributes to a large number of inflammatory diseases,and there is a high correlation with cancer and heart disease.8,9

One reason for this is that these fats become oxidised and rancidwhen subjected to heat, light and oxygen (as in cooking andprocessing), and rancid oils produce free radicals that causedamage in the body. For example, free-radical damage to the skincauses wrinkles and premature ageing, and free-radical damagein the blood vessels contributes to the build-up of plaque.

The fatty acids in polyunsaturated fats are known as PUFAs(polyunsaturated fatty acids). Omega 3 and omega 6 are the mainfatty acids in PUFAs, which are essential for our health, but thekey here is the ratio of omega-6 to omega-3. The ideal ratio isratio of omega-6 to omega 3 is 2:1 and 1:1 is even better. Therequirement for PUFAs in our body is quite small, but we don’tproduce any ourselves so we need to get even these small quanti‐ties entirely from our diet.

Inside the body, PUFAs react to proteins and sugars and createtoxic by-products, such as AGEs (advanced glycation end prod‐ucts), also known as glycotoxins. These AGE’s can negativelyaffect cells, tissues and organs and contribute to inflammatorydiseases.10 Hang on a minute, didn’t I say that PUFAs are anessential fatty acid? Yet they can become toxic in the body? Yes,they are an essential fatty acid and they play a critical role incertain processes in the body, but the differentiation here is‘excessive consumption’.

PUFAs are used in the body to modulate and regulate inflamma‐tory eicosanoids. Eicosanoids were essentially the first hormones

POLYUNSATURATED FATS 11

developed by living organisms and are produced by every cell inthe human body. There are pro-inflammatory eicosanoids andanti-inflammatory eicosanoids, and we need to have the rightbalance between these. If we don’t, and the scale tips too far overto the pro-inflammatory eicosanoids, then that is when problemsstart with silent and chronic inflammation, which is at the heartof many of today’s diseases. How does the balance of theseeicosanoids get out of balance? One reason is the excess of omega-6 fatty acids in the modern diet, which increases the productionof pro-inflammatory eicosanoids. In conjunction with the lack ofomega-3 in the modern diet, which produces the anti- inflamma‐tory eicosanoids, it is easy to see how the balance tips in thewrong direction.

This balance can be measured in the form of the AA/EPA ratio.What is the AA/EPA ratio? It is an indication of the levels ofcellular inflammation in the body. AA is arachidonic acid and isderived from omega-6 or, more specifically, from gamma-linolenicacid (GLA), which is a fatty acid found in omega-6. The pro-inflammatory eicosanoids that we discussed previously arederived from arachidonic acid (AA). EPA is eicosapentaenoicacid, which is an essential fatty acid in omega-3. You may haveseen this on the label of cod-liver oil and omega-3 supplements.EPA provides the building blocks for the anti- inflammatoryeicosanoids that we discussed previously.

When the AA/EPA ratio becomes too high, it indicates anincreased level of silent inflammation, which leads to chronicinflammation and disease. The best way to address the balance ofthese fatty acids is through diet. Therefore, it makes sense tomoderate our consumption of food sources that are high inomega-6 and increase our consumption of food sources that arehigh in omega-3. However, omega-3 is not always abundant in


the modern diet, and so supplementation with high-qualityomega 3 is a good option to boost our intake on a daily basis.

With this in mind though, let’s not run away with the idea thatomega-6 fatty acids are bad for us. Just like anything else, it iswhen we consume an excess that problems start. Omega-6 fattyacids, in the right amounts, are essential for our health, and thekey is to get the ratio of omega-6 to omega-3 right. In practical,everyday terms, what does this mean? It is more than likely thatyou are getting more than enough omega-6 in your diet, but it ishighly unlikely that you are getting enough omega-3, unless youare eating a lot of oily fish. To remedy this, think about reducingfoods containing vegetable oils and consider using oils such asextra-virgin olive oil and coconut oil instead. Also consider eatingmore foods that are rich in omega-3 and taking a high-qualitysupplement.

POLYUNSATURATED FATS 13

4

MONOUNSATURATED FATS

From a chemical perspective, monounsaturated fats are simplyfat molecules that have one unsaturated carbon bond in themolecule, called ‘a double bond’. Olive oil is a good example of atype of oil containing monounsaturated fats, with other foodsources being avocados and nuts. These fats are also known asMUFAs, or monounsaturated fatty acids, and are generallyknown as the good fats. In the 1960s there was a study called theSeven Countries Study, which revealed that people in Greeceand other parts of the Mediterranean region enjoyed a low rate ofheart disease despite a diet that was high in fat. The main fat inthis diet is the monounsaturated fat from olive oil.11

Today, there is a lot of interest in the Mediterranean diet becauseof its health benefits. Studies have shown that long-termconsumption of high-MUFA diets decreased systolic blood pres‐sure by 2.26 mmHg and diastolic blood pressure by 1.15 mmHgcompared to low-MUFA diets. This reduction is estimated todecrease cardiovascular mortality by 6%.12

There are a number of fatty acids that make up monounsaturated

fats, with oleic acid being the primary one, followed by palmi‐toleic acid, erucic acid, gadoleic acid and myristoleic acid. That isan interesting bunch of tongue-twister names, but what do theydo? Well, first we need to make a distinction between two typesof MUFAs. The first type are ‘cis’ MUFAs and the second typeare ‘trans’ MUFAs and these relate to the molecular compositionand position of hydrogen atoms in the fatty acid. Oleic acidmakes up approximately 92% of the cis MUFAs, so let’s take acloser look at this.

In a study published in 2000, researchers found that diets rich inoleic acid improved the participants’ fasting plasma glucose,insulin sensitivity and blood circulation.13 There are also studiesthat show that oleic acid has the ability to boost memory and toincrease the speed of neurological transmission.14 There is a largeamount of evidence from studies that demonstrate that a healthyeffect of the Mediterranean diet is the reduction of risk factors forcardiovascular disease (CVD). Olive oil plays a large part in thisbecause it is a key component of the Mediterranean diet and it isrich in oleic acid. Research shows that olive oil can reduce theprocesses involved in the development of atherosclerosis,including inflammation, LDL oxidation, blood-sugar dysregula‐tion and dyslipidemia, which is an abnormal elevation of choles‐terol and triglycerides.15

With regard to inflammation, a study on oleic acid and peanut oilshows that a diet rich in oleic acid can have a beneficial effect ontype 2 diabetes and it can, ultimately, reverse the negative effectsof the inflammatory cytokines observed in obesity and type 2diabetes. This study shows the importance of regulating inflam‐mation naturally with certain foods, and the potential of unsatu‐rated fatty acids to regulate inflammation.16

Researchers have found that oleic acid restores the proper

MONOUNSATURATED FATS 15

metabolism of fuel in an animal model of heart failure.17 TheAmerican Heart Association reports that heart failure affects 5.1million Americans a year!18 Heart failure is not the same thing asa heart attack. It is a chronic disease where the heart becomesenlarged in response to high blood pressure and, therefore, has towork harder to pump the blood around the body. As the heartwall grows thicker, it cannot pump as much blood and thereforeit is unable to supply the body with enough nutrients includingoxygen. We’ll come back to this later in the book.

The heart’s primary fuel source is fat and with this chronicdisease the heart cannot utilise fats properly, so the heart, whichis a muscle, becomes starved of energy. This particular studyshowed through animal studies that supplying oleic acid toanimals with heart failure led to an immediate improvement inhow the hearts contracted and pumped blood. It was alsoobserved that the metabolism of fats within the cardiac cells ofthese hearts became normalised. The researchers concluded thatconsuming healthy fats like oleic acid can have a significantlypositive effect on cardiac health, even after the disease has begun.These are significant findings, and they support the evidence fordiets rich in oleic acid, such as the Mediterranean diet.

Let’s take a look at another one of the fatty acids in MUFAswhich has been receiving some attention recently. Omega-3 hastaken the limelight for many years, given its health benefits, butthere is a new kid on the block that is drawing attention and thatis omega-7. Palmitoleic acid is an omega-7 fatty acid that comesunder the MUFA umbrella. It is commonly found in foods suchas macadamia nuts or oils from sea buckthorn berries, which aregrown in the Himalayan mountains. Scientists are now starting topay more attention to omega-7 and its potential health benefits.

In 2008, scientists discovered that palmitoleic acid plays an


important role in regulating metabolism and claimed it was thefirst fatty acid that acts as a hormone.19 They coined the term‘lipokine’ to describe this new class of hormone. In a study inJapan, diabetic mice were fed with palmitoleic acid for fourweeks and gained less weight compared to those given aplacebo.20 The results showed that the mice on palmitoleic acidhad lower levels of triglycerides, which are blood fats thatincrease the risk of heart disease. These mice also had lowerblood-sugar levels and improved sensitivity to insulin, which canhelp to protect against type 2 diabetes.

There have been limited studies in humans, however, but whatresearch we do have shows similar findings, in that people withhigh blood levels of palmitoleic acid have shown more insulinsensitivity. However, other studies have not been so positive andhave shown increased levels of triglycerides. Much more researchis required before we reach for the omega-7 supplements. Palmi‐toleic acid is not an essential fatty acid, which means that thebody can produce its own. In light of this mixed research, I thinkit is worth trusting our bodies on this one. After all, the humanbody is incredibly smart and will produce what it needs.

So back to our original question. How much fat should we beeating on a daily basis? There seem to be conflicting recommen‐dations, so who should we believe? The American Heart Associa‐tion recommends that 10% of our calories come from saturatedfats, up to 10% from PUFAs and as much as 15% from MUFAs,so that is a total of 35% of our daily calorie intake.17 We’ve alsogot some nutritionists, scientists and doctors saying we should beincreasing our total fat to 50–70%. How do we make sense of allof this conflicting advice? Is there an optimal ratio of PUFAs,MUFAs and saturated fatty acids (SFA)?

MONOUNSATURATED FATS 17

5

OPTIMAL RATIO OF FATS

Global food-consumption data indicates that the level of total fatconsumed is, on average, within the range of 20–35%. However,there are large country differences, with levels ranging from11.1% in Bangladesh to significantly higher intakes in Europe,such as 46.2% in Greece.21 Global SFA intake was less than therecommended maximum of 10%, with highest intakes beingnoted in the palm-oil-producing island nations of SoutheastAsia.22

Looking at the breakdown of different regions, in the US, fatmakes up 34% of the total calories of the American diet. At aEuropean level, food consumption data indicates that the level oftotal fat intake is generally higher than the recommended 20–35%, with maximum intakes ranging from 37–46%.21 Interest‐ingly, in Mediterranean countries, the intake of MUFAs, inaccordance with the predominant use of olive oil, is the highest inEurope.21 The total calorie intake from fat in the traditionalMediterranean diet in Greece is approximately 46% with themajority of these fats being MUFAs. There are no hard-and-fast

rules on how much of each type of fat should be in the diet and,whatever you read, the guidance is conflicting. However, basedon the research and evidence so far, we can make our owninformed decisions about this.

Let’s take an example using 30% as the maximum amount of totalcalories from fat. We know that, ideally, we need to achieve aratio of 2:1 in our omega-6 to omega-3 ratio and that omega-6 isderived from PUFAs such as vegetable oils. Walnuts pistachios,pecans and sunflower seeds are healthier sources of omega-6. Sowe need to ensure an adequate consumption of the right kind ofPUFAs so that we get our omega-6 to omega-3 ratio in balance. Inaddition, we know that SFAs, or saturated fats, are not the badguys they’ve been made out to be in recent history.

My personal approach to this is quite simple. Given the healthbenefits of MUFAs, I want to prioritise these and so 50% of myfat intake is comprised of MUFAs. Then I simply split theremaining half between SFAs and PUFAs, ensuring that thePUFAs consist primarily of omega-3s. Table 5.1 shows anexample of fat intake.

Table 5.1. Example of fat intake

Table 5.2 below represents these numbers as a percentage of totaldaily calories and we can see from this that the combination of allthese fats adds up to 30%. This is just an example and your totalfat intake will be dependent on your goals and physical activity.

OPTIMAL RATIO OF FATS 19

You may have a goal to lose some body fat and you are involved inregular exercise such as running, swimming or cycling so 20%total fat intake may be more appropriate in this scenario. Forthose involved in sports, your macronutrient profile will bedependent on energy, performance, growth and recoverydemands and can vary between 15% and 25%. In some cases, itmay even be more, particularly of you are following a low-carbo‐hydrate, high-fat diet such as the ketogenic diet which we’ll lookat in Chapter 7.

Table 5.2. Fat intake as a percentage of total calories.

It does take a bit of work to get these levels right in your diet.Having said that, it is not an exact science and using your calcu‐lator when preparing your meals isn’t much fun. So use them asguidelines to help you choose your fats with more thought. At aminimum, we now know that MUFAs are our most importantfats and we should be making a daily effort to incorporate theseinto our diet. You can use extra-virgin olive oil as an easy way todo this, by using it in your meals daily. It’s great on a fresh, crispysalad. For saturated fats, you could use coconut oil, avocados anda little bit of organic butter from grass-fed cows. For PUFAs, youcould focus on omega-3 from fatty fish such as wild-caughtsalmon or you could take a high-quality omega-3 supplement.


6

THE FRENCH PARADOX

The French diet is known to be high in saturated fats, from redmeat and cheese, for example, yet the French population, as awhole, enjoys low levels of coronary heart disease. This observa‐tion is called the French paradox.23 However, given what thelatest research is showing, the French paradox may not be aparadox at all! I think it is worth exploring this French paradox inmore detail. There are many theories as to the reasons for this so-called paradox and if one still holds onto the belief that saturatedfats cause cardiovascular disease and heart disease, then none ofthis makes sense and, therefore, it seems to be a paradox. The factthat the French diet is high in saturated fats supports the researchand evidence that saturated fats do not raise cholesterol levels orcause cardiovascular disease. However, let’s looks at some of theother contributing factors.

Red wine has been heralded as the primary reason for the lowincidence of cardiovascular disease in France. But does it deserveall of this credit? Certainly, there are some health benefits to amoderate consumption of red wine due to its polyphenols, but

this alone is not a primary factor. This is because the amount ofwine you’d need to drink to get enough polyphenols to produce asignificant effect would increase your alcohol consumption totoxic levels.

Another French staple, cheese, has also been identified as apossible contributing factor to a lower incidence of obesity andcardiovascular disease in France. One study, published in 2015,has shown that cheese reduced LDL cholesterol because of theway in which cheese is metabolised in the body.24 Theresearchers found significantly higher levels of the microbiota-related metabolite hippurate in the group eating cheese,compared to the group drinking milk. Butyrate levels were alsoincreased significantly after cheese consumption, which is associ‐ated with an increased level of short-chain fatty acids in the gut.It is thought that this is induced by the stimulation of beneficialgut microbiota, which has beneficial effects on cholesterolmetabolism.

Another study, in 2012, reported that moulded cheeses, such asRoquefort cheese, are a key factor in protecting against cardiovas‐cular disease amongst the French population.25 The researchersidentified metabolites produced by Penicillium roqueforti as thepotential mechanism at work here. Penicillium roqueforti andPencillium glaucum are the blue moulds used for cheese. Theseare not like the moulds that are found in damp buildings whichare fungal biotoxins. Far from it, the moulds used in cheese havebeen considered safe to eat for the last nine thousand years,because they contain natural anti-bacterial properties. However,it is worth balancing this with other factors when viewing thevariety of moulded cheeses at your local deli. Considerations,other than taste of course, are the high salt content and potentialallergy to the mould.


So while the debate and theories continue about the French Para‐dox, it seems, to me at least, that there is no paradox at all. Satu‐rated fat, as part of a healthy and balanced diet, is not the villainof modern society as once thought. Including red wine in moder‐ation and eating cheese may contribute to this balancedapproach, but my belief is that it is much more than this. It is aholistic approach to our diets and lifestyle that keep us healthy.

THE FRENCH PARADOX 23

7

A BRIEF WORD ON THE KETO DIET

There are a number of diets that advocate a much higher fatcontent than the example above. One such approach is the keto‐genic diet which is a high-fat, moderate-protein, low-carb diet.Restricting carbohydrates means the body has to find an alterna‐tive source of energy and this is achieved by switching to aprocess called ketogenesis. This creates ketones which areproduced by the liver, shifting the body’s metabolism away fromglucose and towards fat utilisation. Ketogenesis will occur notonly with restricted carbohydrate intake but also during fasting,starvation or prolonged physical exercise. These ketone bodiescan be used as fuel for the brain, heart and muscles.

While this book doesn’t go into the details of the various dietmethodologies and approaches, it is worth noting that these low-carb, high-fat diets do have some health benefits which have beenbacked up by research. In fact, the ketogenic diet has been shownto reduce insulin levels and improve a number of metabolicmarkers which results in multiple health benefits in the shortterm. During recent years, there has been an increasing amount

of evidence suggesting that very low-carbohydrate ketogenic dietscould have a therapeutic role in numerous diseases. However, theprocess of switching to ketogenesis can be very uncomfortable.When you dramatically cut your carb intake, you experience anumber of unpleasant symptoms such as headache, brain fog,tiredness and low mood. This is known as ‘carb flu’ and it can feellike you are literally coming down with the flu. However, you arenot ill, it’s your body throwing an ‘I want carbs’ tantrum! Thegood news is that it doesn’t happen to everyone and it is a short-term transition phase. It can take two to three weeks for the bodyto switch to ketosis. While it seems that there are many benefitsto the ketogenic diet, it is not for everyone and indeed, there aresome inflammatory conditions that can potentially be madeworse by restricting certain types of wholesome, fibrous carbo‐hydrates.

My personal approach to diet is that I want to include a balancedbreakdown of macronutrients that includes, for example, 50% ofmy calories coming from wholesome, complex carbs, 20% comingfrom fats and 30% coming from quality protein sources. I’llmodulate my macronutrient intake through the year dependenton my activity and training routine. In addition, I’ll vary mycarbohydrate intake through the week depending on my activitylevel on a given day, so that on days where I’m doing moderate-intensity cardio, I’ll eat fewer carbs and on days where I’m in thegym doing a high-intensity workout, I’ll increase my complexcarbs. This is called ‘the zigzag method’ and prevents the basalmetabolic rate (BMR) from dropping when reducing calories.The zigzag method is incredibly effective when your goal is toreduce body fat and avoid those all too common plateaus. I alsolike to include lots of fruits and vegetables in my diet so that I getan abundance of phytochemicals that have potent anti-inflamma‐tory and antioxidant properties. You can learn more about this in

A BRIEF WORD ON THE KETO DIET 25

my book “The Anti-Inflammatory Blueprint”. The keto dietwouldn’t work too well for me as I love Mediterranean food and Ienjoy pasta dishes, wholewheat breads, and a wide range offruits, particularly berries. I like to include wholesome, high-fibrecomplex carbs such as wholewheat pasta, brown rice and oatsthat provide a slow release of energy and help to keep my diges‐tive system in good health. Again this works for me and I knowthat many people cannot tolerate certain types of carbohydratessuch as wheat, gluten and FODMAPs. So for some people, theketo diet works very well and fits into their lifestyle. That’s greatand this is an important point because not only does your dietneed to be healthy for you, but it has to be enjoyable as well, andbecome part of your lifestyle so that it becomes sustainable.


8

PALAEOLITHIC CONSIDERATIONS

Another diet that has been gaining a lot of interest in recent timesis the paleo diet. This emulates the diet of our hunter-gathererancestors and it has become very popular in recent years.However, it is still controversial amongst health professionals andnutritionists. This diet consists of unprocessed meat, fish, eggs,vegetables, fruit, nuts and seeds. There are no sugars, dairy orgrains in the paleo diet. Research that was published in 2009,showed some remarkable results.26 In this metabolicallycontrolled study, nine healthy individuals consumed a Palae‐olithic diet for ten days. Calories were controlled to ensure thatthey wouldn’t lose weight. The diet led to the following results:

Total cholesterol decreased by 16%LDL cholesterol decreased by 22%Triglycerides decreased by 35%Insulin AUC decreased by 39%*Diastolic blood pressure decreased by 3.4 mmHg

*Insulin AUC, or insulin ‘area under the curve’, is a method ofmeasuring insulin sensitivity.

In another study, published in 2009, the beneficial effects of thePaleo diet on cardiovascular risk factors in type 2 diabetes wereshown.27 The study was a randomised, crossover pilot study withthirteen individuals who had type 2 diabetes. This group wasplaced on either a Paleo diet or a typical diabetes diet for threemonths at a time. On the Paleo diet, the participants lost threekilograms (6.6 pounds) more weight and lost four centimetres(1.6 inches) more off their waistlines, compared to those on thediabetes diet. The following results were also observed:

HbA1c (a marker for three-month blood-sugar levels)decreased by 0.4% more on the Paleo diet.HDL increased by three mg/dL on the Paleo diet,compared to the diabetes diet.Triglycerides decreased by 35 mg/dL on the Paleo diet,compared to the diabetes diet.

Other studies show similar results and look very promising.However, all studies that I have seen have been too small and tooshort in duration to be absolutely conclusive. Once again, this isgood research that we can use to help us make informed decisionsabout our food choices and create a balanced diet that makessense, reducing foods that are known to be unhealthy or inflam‐matory and increasing foods that are healthy, nutritious and haveanti-inflammatory and antioxidant properties.

Do we really have to eat a diet with 50–85% of fats, as wediscussed earlier in this chapter? There are some diets out there


that certainly recommend this amount of fat but, as we’vediscussed, a more practical percentage of fat in our diet is 20–30%. Do we have to give up all our favourite foods too? No. If wewere to completely give up our favourite foods and not replacethem in any way, then we probably wouldn’t stick to the changeswe are making, regardless of the health benefits, because oureating habits have been built up over the course of many years.

Ultimately, the focus should be around decreasing refined carbo‐hydrates and sugars, processed foods, and foods with lots of addi‐tives, and also getting our healthy fats in balance. Then we canstart to replace these foods for more healthy alternatives.

PALAEOLITHIC CONSIDERATIONS 29

9

CONCLUSION

In this short book we’ve learned that fat is not the villain it wasonce thought to be. We have learned that we need fats in our dietto be healthy, but that not all fats are good for us. We learnedabout saturated fats, monounsaturated fats, polyunsaturated fatsand trans fats, and we know that we should absolutely avoid transfats.

Saturated fats are important for our health and provide manybenefits, however, it makes sense to moderate how many of thesefats we consume. A good rule of thumb here is to keep saturatedfats to approximately 10% of our total calorie intake.

Diets that are rich in monounsaturated fats, such as the Mediter‐ranean diet, are high in oleic acid. Olive oil is a key component ofthis diet and has many health benefits. We’ve seen how adher‐ence to the Mediterranean diet can reduce risk factors for cardio‐vascular disease. Based on research, the optimal percentage ofmonounsaturated fats is 20% of your total daily calories, so enjoythat extra-virgin olive oil on your salad!

We know that we are probably getting more than enough polyun‐saturated fats in our diets already and, while we need someomega-3, the balance of omega-3 and omega-6 is way out of kilterin the modern diet. By reducing consumption of vegetable oilsthat are high in omega-6 and eating more food rich in omega-3,we can readdress this balance. Taking a high-quality omega-3supplement is also a good way to increase our intake.

We’ve taken a look at cholesterol and debunked the myth thatsaturated fats are bad for us. We’ve seen that the biggest culpritsfor increases in the small, dense LDL particles are, in fact, sugarsand refined carbohydrates! It’s ironic that the dietary guidanceadvocating a low-fat, high-carbohydrate diet that has been preva‐lent for decades, and remains so to this day, is being proven toincrease the risk of cardiovascular disease!

When it comes to changing our eating habits to be more healthy,it is a journey and a lifestyle change, rather than a just a diet. Wehave to develop new habits of shopping, cooking and eating, aswell as other lifestyle changes. Sometimes, developing these newhabits can be challenging, particularly if we don’t have enoughcompelling reasons to do them. When results don’t come fastenough, or we get caught up doing other things in life, or maybethere is additional pressure at work and we come home tired, thisis when new dietary changes tend to fizzle out. We just need tobe ready for this and plan for it accordingly.

I think it makes sense to make changes incrementally too, so thatwe don’t have a forklift upgrade to our diet. Rome wasn’t built ina day, so let’s not make this hard for ourselves. This is a journeythat we are embarking on for the rest of our lives, and habits takea little bit of time to develop. A lot of people may well have beeneating a fairly typical diet up to this point, which may include toomany unhealthy fats, too much sugar, too many refined carbohy‐

CONCLUSION 31

drates with a high glycaemic index, too many food additives andso on. We can get addicted to these foods and so it makes it moredifficult to give these things up. If we had to bin all of these foods,we might feel deprived after a period of time and this can alsolead to reverting to old dietary habits. So let’s take this one step ata time and make incremental and long-lasting change in ourdietary habits that have a positive impact on our health.


ABOUT THE AUTHOR

Tim is a nutritionist, training coach and author bringing togetherevidence-based research on nutrition, fitness and mindset. Heholds the Elite Trainer certification with the International SportsSciences Association (ISSA) and specialises in sports and fitnessnutrition, as well as performance psychology. Tim is also anentrepreneur and the founder of Project Big Life which helpspeople to be more empowered and to make a difference in theirown lives and others.

Connect with Tim Online

Project Big Life

ALSO BY TIM HARDWICK

The Anti-Inflammatory Blueprint

Research shows that inflammation is the root cause of many diseases.The Anti-Inflammatory Blueprint is a comprehensive guide to

reducing inflammation and decreasing the risk of disease to live a longand healthy life. The result of two years of research and over 470research papers, this is the most comprehensive resource available

today. This book is designed to educate and empower you withevidence-based information so that you can make more informed

decisions about your health, well-being, and longevity.

Indeed, health is wealth, and often, we only truly appreciate this whenstruck by illness. Rather than take our health for granted, we should actto protect our greatest asset. Readers will discover how anyone can startto change their lifestyle today to prevent inflammation, reduce the risk

of disease and enjoy a healthier life.

In this book you will learn:

How to reduce the risk of disease.How to reduce the symptoms of chronic inflammatoryconditions.How to recover quicker from illness or injury.Which foods to avoid that are known to promoteinflammation.Which foods have the most potent anti-inflammatoryproperties.The top 15 anti-inflammatory supplements.How exercise can reduce inflammation and the bestexercise to do.How to optimise your energy levels and manage yourenergy budget more effectively.How your mindset affects your physical health.How stress affects the body.How to manage stress more effectively.

The Anti-Inflammatory Blueprint is based on three basic pillars:nutrition, exercise and mindset, and by following this blueprint, you

can reduce inflammation and pain naturally to live a long and healthylife.

Mind the Stress

Mind the Stress is a comprehensive guide to managing stress, based onthe latest research in nutrition, exercise and psychological techniques.

This book, with over 200 pages, educates and empowers you withevidence-based information so you can effectively take control of stress

to achieve more balance in your life.

In this book you will learn:

The best nutrients for reducing stressEating habits and foods to avoid to minimise stressHow much exercise we need to control stressHow to manage overwhelmHow to deal with worryHow to create a relaxed stateHow to use mindfulness for stress controlHow Yoga reduces stressHow to build resilienceHow to develop perseveranceHow gratitude can reduce stressThe biology of stress and the impact on health

In "Mind the Stress" we explore strategies and techniques to create anoptimal balance of stress using nutrition, exercise and psychology that

will help to reduce worry and anxiety as well as build greater resiliencefor a healthier life.

PROJECT BIG LIFE

What is Project Big Life? Well, it’s about living life to the full andrealising our full potential. It’s about nutrition, fitness, andmindset that all contribute to a healthy long life. It's ultimatelyabout freedom to live life on our own terms and follow our ownpath to fulfilment, being authentic to ourselves. There is a famoussaying by Nelson Mandela that really resonates with me.

There is no passion to be found playing small, in settlingfor a life that is less than the one you are capable of living.

NELSON MANDELA

This is the essence of Project Big Life. Live the life that you arecapable of living and don’t settle for anything less. We only get somuch time on this beautiful planet and time flies by so quickly.We simply can’t waste our most precious resource, settling foranything less, than a big life!

Project Big Life is based on five main pillars:

Diet and NutritionStrength and Fitness

Mindset and PerformanceHealth and Wellbeing

Environment and conservation

Maybe there is an area of your life that you would like toimprove. Maybe you want to become healthier and you want tolearn about evidence-based nutrition. Perhaps you want to get inbetter shape whether you are 20 or 60 years young and you wantto learn about the most effective ways to get stronger and fitter tobuild a better physique. Perhaps you want to adopt more of ahigh-performance mindset to help you be more productive and toachieve your goals, or maybe you want to set better goals that arealigned to your values, and that truly inspire you. Whatever it isyou are striving for, and wherever you are in your life right now,Project Big Life explores strategies and techniques that will helpto get you moving in the right direction and making progress.

The Project Big Life website provides evidence-based informa‐tion and free resources on these five pillars that will help youmake more informed decisions about your health and wellbeing.

Project Big Life

40 PROJECT BIG LIFE

BIG LIFE NUTRITION

Big Life Nutrition is a family run business based in Wiltshire,UK. Health and well-being are at the heart of what we do, soproviding the purest and highest quality supplements is reallyimportant to us. We sell a broad range of supplements from care‐fully selected brands as well as manufacture our own supple‐ments backed by scientific research. Wherever possible, wechoose supplements that don’t use artificial additives, fillers orbinders.

With our own brand, we carefully formulate our supplements tocreate nutritional synergies that are simply not present in thetypical western diet. There are no artificial additives in oursupplements as we fill them to the max, with just the active ingre‐dients. Pure and simple.

TRANSPARENCY

Big Life Nutrition believes in transparency and clean supple‐ments focusing on providing high-quality products withoutunnecessary heating, excipients and binders. This allows us to

provide our customers with supplements that only contain theingredients that provide benefit to the human body. We alsobelieve in honesty and integrity so that our products are nevermisleading. We ensure that our product labels are easy to under‐stand, and are not written or designed in a way to misrepresentthe product contents.

QUALITY

We have a strict quality control procedure in place with qualitychecks throughout the production process to ensure completecompliance with our product specification and accepted qualitystandards. Documentation of every batch is kept for completetraceability.

PURITY

The purity and sustainability of ingredients are of the utmostimportance us and sourcing good quality, non-GMO ingredientsis a primary focus when formulating our nutritional supplements.If ingredients don’t meet these standards, they will not be used.Big Life Nutrition focuses on where raw materials come fromand we do extensive research to verify the quality, purity andsource of all of our ingredients.

For example, Fusion3 is a unique formula that combinesturmeric, ginger and Boswellia with BioPerine to create powerful

42 BIG LIFE NUTRITION

nutritional synergy. There are no artificial additives in thisformula as we fill it to the max with just the active ingredients.

Pure Nutritional Synergy Backed by Scientific Research

When looking for a high-quality turmeric, ginger or Boswelliasupplement, we recommend that they contain a certain level ofactive ingredients. Turmeric extract should contain 95% curcum‐inoids. Ginger extract should contain 5% gingerols and Boswelliashould contain 65% boswellic acids. These are the active ingredi‐ents that provide all of the health benefits.

With Fusion3, we’ve done the work for you and combined theseingredients into a single, convenient capsule. Each daily dose ofFusion3 contains 500 milligrams of natural turmeric extract with95% curcuminoids, 500 milligrams of ginger with 5% gingerolsand 190 milligrams of Boswellia containing 65% boswellic acids.

For information on our supplements and the science behindthem, visit our website at Big Life Nutrition.

BIG LIFE NUTRITION 43

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2. Meta-analysis of prospective cohort studies evaluating the asso‐ciation of saturated fat with cardiovascular disease. Am J ClinNutr. 2010;91(3):535–546.

3. Saturated fat, carbohydrate , and cardiovascular disease. Am JClin Nutr. 2010;(5):502–509.

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change in mass of large low-density-lipoprotein particles in men.Am J Clin Nutr. 1998;67(5):828–836.

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8. Evolutionary aspects of diet, the omega-6/omega-3 ratio andgenetic variation: Nutritional implications for chronic diseases.Biomed Pharmacother. 2006;60(9):502–507.

9. Health implications of high dietary omega-6 polyunsaturatedfatty acids. J Nutr Metab. 2012;539426(16).

10. Advanced glycation end products in foods and a practicalguide to their reduction in the diet. J Am Diet Assoc.2013;110(6):911–916..

11. About the Seven Countries Study. www.sevencountriesstudy.com/about-the-study

12. Effects of monounsaturated fatty acids on cardiovascular riskfactors: A systematic review and meta-analysis. Ann Nutr Metab.2011;59(2–4):176–186.

13. Diabetes and the Mediterranean diet: A beneficial effect ofoleic acid on insulin sensitivity, adipocyte glucose transport andendothelium-dependent vasoreactivity. QJM. 2000;93(2):85–91.

14. Fat-induced satiety factor oleoylethanolamide enhances memoryconsolidation. Proc Natl Acad Sci U S A. 2009;106(19):8027–8031.

15. Mono unsaturated fatty acids for CVD and diabetes: Ahealthy choice. Int J Nutr Pharmacol Neurol Dis. 2013;3(3):236.

12. Lipids in health and disease oleic acid and peanut oil high in

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oleic acid reverse the inhibitory effect of insulin production of theinflammatory cytokine TNF-α both in vitro and in vivo systems.Lipids Health Dis. 2009 Jun 26;8:25.

16. Dietary fat supply to failing hearts determines dynamic lipidsignalling for nuclear receptor activation and oxidation of storedtriglyceride. Circulation. 2014;130(20):1790–1799.

17. Heart disease and stroke statistics 2013 update: A reportfrom the American Heart Association. Circulation.2013;127(1):e6–e245.

18. Identification of a lipokine, a lipid hormone linking adiposetissue to systemic metabolism. Cell. 2008;134(6):933–944.

19. Chronic administration of palmitoleic acid reduces insulinresistance and hepatic lipid accumulation in KK-Ay Mice withgenetic type 2 diabetes. Lipids Health Dis. 2011;10:120.

20. Dietary Guidelines for Healthy American Adults. Circula‐tion. 1996;94(7):1795 LP–1800.

21. Intake of fatty acids in general populations worldwide doesnot meet dietary recommendations to prevent coronary heartdisease: A systematic review of data from 40 countries. Ann NutrMetab. 2013;63(3):229–238.

22. Global, regional, and national consumption levels of dietaryfats and oils in 1990 and 2010: A systematic analysis including266 country-specific nutrition surveys. BMJ.2014;348(apr14_18):g2272.

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possible piece in the French paradox puzzle. J Agric Food Chem.2015;63(10):2830–2839.

25. Could cheese be the missing piece in the French paradoxpuzzle? Med Hypotheses. 2012;79(6):746–749.

26. Metabolic and physiologic improvements from consuming apaleolithic, hunter-gatherer type diet. Eur J Clin Nutr.2009;63(8):947–955.

27. Beneficial effects of a Paleolithic diet on cardiovascular riskfactors in type 2 diabetes: A randomized crossover pilot study.Cardiovasc Diabetol. 2009;8(1):35.

48 REFERENCES

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