I have a hobby. When I see a healthy patient over 90 years old, I always ask them about their diet, and the answer is almost always the same: They lean over and, sounding a little guilty like the kid who got caught with their hand in the cookie jar, say something like, “Well, I hate to tell you this, but I have eaten butter, eggs and bacon all my life.”

At which point I ask the female patients about their pie cooking – and they all agree they used lard.

Now this is not a rigorous scientific study, but I have been doing this for over 20 years, and the observation is remarkably consistent. The important fact, in my opinion is not what they ate, but what it implies about what they didn’t eat: They did not switch to margarine. They did not use Crisco for cooking. They did not wallow in corn oil. In short, they ate natural fats, not manmade ones. In their heartland, meat and potatoes, home-cooked diet, the ratio of Omega 3 to Omega 6 oils was generally high.

I hate to keep denigrating the food pyramid, but it deserves denigrating, and once again with regard to intake of “fats.” For at least 40 years, the policy wonks have pushed a low-fat diet, also promoting “heart-healthy” margarines in place of butter, and have recommended more complex carbs overtly as well as covertly (in most low-fat foods, artificial lab-derived filler carbs give the food “substance,” so low-fat foods are generally high-carb foods).

During this reign of the government nutritionists, Americans have become more obese with more diabetes, metabolic syndrome and Alzheimer’s dementia. The recommendations persist even in the face of massive data showing that oils derived from plants such as soybeans and corn – i.e. Omega 6 oils – create inflammation in the body and contribute to disease.

Studies on Paleolithic diets and diets in other historical periods have shown that primitive man ate a diet consisting primarily of grass-fed meat (with its fat), nuts, roots and berries. This resulted in an intake of fats fairly evenly balanced 1:1 between Omega 6 (generally vegetable oils) and Omega 3 oils (generally from fish and olive oil).

By the turn of the last century, with the Industrial Revolution giving us the ability to process foodstuffs, people were eating diets roughly 4:1, by World War II, 8:1, and today our Omega 6 to Omega 3 ratio is somewhere around 20:1.

As we progressed from our hunter-gather stage to pastoral life and early agriculture, we added milk and cheese, some breadstuffs, and still we did not see, in general, the diseases of modern civilization. But add industrial agriculture that allows us to process and modify grains (see December column on wheat) and squeeze corn and soybeans for their oil, and we have an explosion in cardiac disease, hypertension, cancer and dementia.

It is estimated that 20 percent of American calories come from soybean oil. One study looking at various populations, comparing rates of coronary artery disease to tissue levels of Omega 6 fatty acids, shows a nearly straight line graph of increasing cardiac death with increasing Omega 6 tissue levels – and of course the U.S. is on the top. On the other hand, the Inuit and other similar arctic tribes who subsisted on a diet of 90 percent whale blubber until joining “civilization” were not similarly plagued – and were not fat.

Why are these Omega 6, vegetable-derived oils damaging? Because they produce the chemicals responsible for inflammation in the body. And inflammation is implicated as a common pathway or at least a great inciter of artery clogging, as well as cancer, autoimmune diseases and dementia.

One of the most interesting and important aspects of all this is what Omega 6 oils, and Omega 3 oils do to our brains. The human brain is mostly cholesterol, which is vital to proper neurological function. It is the precursor of many hormones including serotonin, a major neurotransmitter in the brain associated with feeling happy and sleeping well. Cholesterol may be an antioxidant as well, and one study of IV injections of HDL cholesterol showed that it acted to actually clear clogged arteries.

The overall issues of the cholesterol hypothesis will be addressed in another column, but, in short, we have been sold on the popular notion that any cholesterol elevation is bad. This, in spite of the information that, in people over 60, the rates of death and dementia go up if cholesterol is lowered below the 250 range. And in the Melbourne Women’s Midlife Health Project, a group of 326 women aged 52-63 years were monitored for memory and cholesterol. They found that higher serum concentrations of LDL cholesterol and relatively recent increases in total cholesterol and LDL cholesterol were associated with better memory.

The manufactures of statins – the most common cholesterol-lowering drugs, and the financial powerhouse for the drug companies – contest that this memory loss is “transient” and resolves with removal of the drug, but concerns about this remain.

Polyneuropathy, a metabolic disease of nerves that gives patients numbness in their hands and feet, is clearly associated with statin use/cholesterol lowering, and this is not always reversible. For my money, something that damages nerves is risky for the brain. There is no doubt that some people benefit from statin drugs and cholesterol lowering, but we went from lowering levels of 350 to lowering levels of 200, which are now labeled “abnormal.”

For me, I have accepted a degree of cholesterol elevation with aging, but I am scrupulous about the fats I ingest. I avoid boxed processed food, since usually these are made from the bad oils. I make my Christmas plum pudding from gluten-free flour and suet, cook with butter and olive oil and take supplemental fish oil.

I had the opportunity of talking with Dr. Barry Sears, author of “The Anti-Inflammation Zone,” about fish oil. He and others now recommend three grams of good quality fish oil to supplement our American diets for people who are generally healthy. People with chronic disease may need more, and then I recommend his good book. Olive oil is the cooking staple, but I use coconut oil for cooking as well, and try to incorporate some into my daily diet. Coconut oil is thought to bypass a metabolic block in Alzheimer’s and is being used experimentally in treatment for that disease.

Finally, fat is insulin neutral – meaning it doesn’t raise or lower it. But fat moderates the degree to which carbs are absorbed. A full-fat ice cream has a lower glycemic index than a low-fat ice cream. And the fats in our diet decrease hunger. The French in this instance are right – they have never eaten “low fat” yet have lower cardiac problem rates than the U.S.

So fats are not the enemy, but should be eaten in their natural, not processed, forms. My rule of thumb for my diet in general: If my great-grandmother would not have recognized something as food – e.g. “Little Debbies,” “Cheetos” (and I love Cheetos!), microwave popcorn, etc., I don’t eat it. But my diet is rich and varied and delicious. Bon appetit.

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