Is It Saturated Fat We Eat In Our Foods Or Is It The Starches That We Consume, Cause Heart Disease?

By Dr Harold Gunatillake
Health Writer
FRCS, FACS (US), FIACS (US),
AM (SING), MBBS (Cey)
One needs to differentiate between ‘hydrogenated fats’ (Trans-fats) and natural non-hydrogenated saturated fats, in this discussion. Most processed foods you purchase from the supermarkets, especially from the refrigerated container in the centre, are saturated with trans fats added to prolong the shelf life of those processed foods.
Trans fats are created by pressuring hydrogen vapour to fill in the vacant carbon links in unsaturated fatty acids to make them look more stable, solid and saturated.
Those foods include, frozen chips, snack chips, fried chicken, baked goods, confectionary fats, sausages, frozen seafood such as prawns, fish and other processed popular foods, including most processed cooking oils.
Hot foods you buy at the popular food outlets also contain trans fats. Pure margarine is a good example of a hydrogenated fat obtained from polyunsaturated fatty acids (oils) of vegetable seeds. Vegetable oils may be converted from liquid to solid by the hydrogenation reaction.
Trans fat has both the benefits and drawbacks of a saturated fat. On the plus side, it has a longer shelf life than regular vegetable fat and is solid at room temperature.
The major negative is that trans fat tends to raise ‘bad’ LDL- cholesterol and lower ‘good’ HDL-cholesterol, and further disturbs the fat metabolism in the body.
Our body cells and cell walls are saturated with the natural fatty acids, including cholesterol required for metabolic processes for survival.
Each cell needs nutrients and these fatty acids participate in the smooth diffusion and permeation of such nutrients through the cell walls.
The body finds it difficult to differentiate between artificial fat like trans fats and the natural fats (triglycerides), disturbing the equilibrium and confusing the diffusion process and normal metabolic mechanisms.
Even cancer can result due to such disturbances in the natural processes that occur in each cell in your body.
You will now realise the seriousness of the problem, and the damage such artificial fats can cause in the normal metabolic processes.
It is estimated that for every two per cent increase in consumption of foods in-cooperating trans fat the risk of heart disease increases by 23 per cent.
It is said that animal saturated fat we consume do not produce such high risks of heart disease, being natural fats.
Bad publicity for saturated fats as a cause for heart disease, all started with Dr Ancel Keys publishing his research papers in 1950, comparing saturated fat intake and heart disease mortality.
Keys selected six of his 22 countries, he studied the link between saturated fats and heart disease. He said, “There is a new disease called heart disease caused as a result of consuming saturated fats”.
He ignored the finding of the rest of the countries that showed no increase of heart disease as a result of consuming saturated fat.
If Ancel Keys compared the saturated fat consumption in all the countries in his study, you would find that those who consume the high percentage of saturated fat have the lowest risk of heart disease.
Since his conclusions, unfortunately, the idea that saturated fat, including coconut oil is bad for your heart has become so ingrained in the medical health communities, and the general educated public, it is still difficult to break through that misinformation barrier.
First of all, let us find out in our Asian traditional staple foods how much animal saturated fat is consumed.
In most Sri Lankan homes breakfast would be boiled ‘mung ata’ (green gram) with ‘lunumiris’, and scraped coconut. Or maybe, a slice or two of bread with lentil curry or thin layer of butter with jam or ‘lunumiris’.
Children would be eating breakfast cereals whose parents could afford it. A glass of milk and an egg would be added to the growing children’s breakfast, in most affluent homes.
Rice and curry being the popular food during mid-day, there may be some fried ingredients like dry fish, cooked in polyunsaturated oil or coconut oil.
If the vegetables are stir-fried, very little fatty oils are used. The main component and the bulk of the food is rice.
Dinner time, in most homes people eat rice and curry. Variety wise other starchy foods like Thosai, pittus, hoppers and indiappams, among other foods, are consumed on most nights.
A vegetable curry would accompany such foods, or may be fish or meat curry in richer homes.
Today, in Sri Lanka the average working family finds eating out in cheap food outlets or takeaways are cheaper than home cooking due to the high prices of raw food items, gas and electricity.
This would be not a healthy situation in long terms.
When you analyse these daily foods people consume, more starchy carbohydrates than saturated fats, though the emphasis is eat less fat.
Whether saturated fats causes heart disease or not, when do our people eat so much of saturated fats to cause heart disease? Unfortunately, the idea that saturated fat is bad for your heart has become so ingrained in our society, it might take a few more decades to educate our people that the cause is elsewhere and not in consuming saturated fat.
It is observed that with the introduction of having low fat foods, heart disease rates have progressively climbed, as is observed from the waiting lists in private and public hospitals for heart interventional surgery. Today, people are most health conscious for fear of this deadly heart disease.
Precautionary measures are taken by visiting the general practitioners and checking for risk factors and taking remedial measures, even though one could not afford the medication.
People are dosed daily with expensive statin tablets whether indicated or otherwise, but still the incidence of heart disease is not diminishing.
The reason may be that we are treating the wrong cause for the right disease.

Cholesterol Myth
You ask any person in Sri Lanka, how his health is? Most worriedly, the individual would say, “My doctor said, I have too much of cholesterol and I should be on medication to control it.” Statins that control blood cholesterol levels do not come cheap.
Most poor people cannot afford to pay exorbitant prices for these medications when it could be controlled with lesser and cheaper methods.
These people seem to consume low saturated fat diets though instead they seem to eat plenty of starchy food mentioned earlier. How nutritious eggs are – and people deprived themselves of one of the most nutritious foods on the planet, for decades.
However, most ingested cholesterol is esterified and esterified cholesterol is poorly absorbed. The body also compensates for any absorption of additional cholesterol by reducing cholesterol synthesis.
For these reasons, cholesterol intake in food has little, if any, effect on total body cholesterol content or concentrations of cholesterol in the blood. Your body needs saturated fat.
Most of the saturated fat we consume comes from meat, dairy products and tropical oils like coconut and palm oils. 10% of your energy should come from your fats.
These saturated fats provide a concentrated source of energy in your diet, and they provide building blocks for cell membranes and a variety of hormones and vitamins like A, D, E, and K (fat soluble).

Sugar could be the culprit for heart disease
Sri Lankans consume a diet mainly the bulk composed of carbohydrates, and starches and less proteins and fats. Rice and curry is still the poor man’s diet, and the bulk of the energy is derived from rice.
The average worker will not be able to perform a day’s work without a plate full of rice, and fortunately for him, he could afford a ‘bath parcel’ for Rs.100.
Most affluent class individuals, very health conscious would serve two table spoonful of rice on the side of the plate and fill with curries, salads, in the rest of the vacant areas of the plate.   A rich affluent person’s meal is much more balanced than the poor working class man’s meal. This is the unfortunate plight in our paradise. It is believed that a primary ingredient in processed food that plays a role in heart disease is sugar.  Eating too much of carbohydrates causes insulin resistance, leading to diabetes. The incidence of diabetes and obesity, even among the school children are soaring. Both diabetes and obesity leads to heart disease and stroke.
Eating raw fruits, such as papaw, avocados, and taking omega-3 fish oils, cooking with coconut oil are other healthy habits to prevent heart disease and most other illnesses.
Fruits in the market are too expensive for the average worker to buy, and he would miss most of the antioxidants required to eradicate free radicals that cause chronic diseases.
A few years back the minister in charge of foods imposed a tax on all imported fruits, resulting in further deterioration in poor man’s nutrition. In conclusion, the culprit for heart disease is more likely starchy foods and trans fats consumed in excess rather than the amounts of saturated fat consumed.
People must resume home cooking, avoid processed foods and too much of boiled polished rice and other addictive tasty foods like, paratas, godhas, pittus, hoppers, among others, made of rice and wheat flour and keep them to a minimum. It is a great pity that school going children in Sri Lankan today eat more convenient foods like pastries, including Chinese rolls, cutlets, patties from food outlets  daily as their main meal and the incidence of obesity is so high among them.  They seem to spend more time having private tuition and less or no time playing with a ball, and the importance of exercise is not encouraged by parents or in some government schools. Starchy foods such as potatoes, bread, cereals, rice, and pasta should make up about a third of the food most of us eat, preferably choose wholegrain varieties.
Unfortunately, in Sri Lanka people seem to enjoy more processed foods forming over 75 percent of the food consumed per meal.
Starch is the most common form of carbohydrate in our diet. We should eat some starchy foods every day as part of a healthy balanced diet. Starchy foods are a good source of energy and the main source of a range of nutrients in our diet.
As well as starch, they contain fibre, calcium, iron and B vitamins. Wholegrain varieties of starchy foods are good sources of fibre.  Fibre can help to keep our bowels healthy, and can help us to feel full, which means we are less likely to eat too much.
This makes wholegrain starchy foods a particularly good choice if you are trying to lose weight. Fibre is only found in foods that come from plants. In Sri Lanka today, mostly in towns people eat from mushrooming food outlets. They are mostly processed foods cooked in hydrogenated oils.  They are instantly made hot convenient addictive foods, not forming balanced nutritional meals. We being in a developing country, people find it difficult to cook at home being too expensive, and enjoy a healthy meal with the family.
Both parents need to work to make ends meet, and the children seem to suffer nutritionally.
A healthy diet is a balanced diet of protein (lean meat, fish, dairy products and vegetarian alternatives), unsaturated fat, carbohydrates (starchy foods such as bread and pasta), fruit and vegetables containing high fibre. It should be low in saturated fat, salt and sugar, when planning food for your growing children.
Eating regular meals is important for heart health. Processed foods made of flour should be eaten less frequently.  Eating five portions of fruits and vegetables a day is out of the reach of the average income earners.  Salt must be reduced and alcohol drinking limited to moderate levels. Keep away from sugary drinks and sugary foods.
The solution is in the hands of the law makers to consider and solve poor man’s needs and give him also a fair go and a decent lifestyle, and most of all health education through the media and brochures is a sensible idea.