Malhotra, interventional cardiology specialist registrar at Croydon University Hospital in London, said that too much focus on saturated fat and government obsession with cholesterol had meant other dietary components – like sugar – had been overlooked, and statins had been over-prescribed.
“Recent prospective cohort studies have not supported any significant association between saturated fat intake and cardiovascular risk,” he wrote. “Instead, saturated fat has been found to be protective.”
“…It is time to bust the myth of the role of saturated fat in heart disease and wind back the harms of dietary advice that has contributed to obesity.”
However, the British Heart Foundation (BHF) disagrees, and said in a statement that there was conflicting evidence on the dietary risk factors for heart disease.
“Studies on the link between diet and disease frequently produce conflicting results because, unlike drug trials, it’s very difficult to undertake a properly controlled, randomised study,” said BHF medical director professor Peter Weissberg.
“However, people with highest cholesterol levels are at highest risk of a heart attack and it’s also clear that lowering cholesterol, by whatever means, lowers risk.”
Advice to reduce saturated fat is based on its role in raising levels of LDL (low density lipoprotein) cholesterol in the blood. But Malhotra points to several population studies in healthy adults that suggest high total cholesterol is not a risk factor for heart disease for the general population. However, he does acknowledge that there is strong evidence that trans fats increase heart disease risk.
Food industry reformulation
He also said the food industry was at least partly to blame for increasing rates of heart disease, as it had compensated for saturated fat reduction by adding sugar to many products.
“The scientific evidence is mounting that sugar is a possible independent risk factor for the metabolic syndrome,” he wrote.
The paper is not the first to suggest that sugar consumption tends to rise when fat consumption is reduced. A recent study published in Critical Reviews in Food Science and Nutrition identified a ‘sugar-fat seesaw’, possibly explaining why dieters find it hard to reduce both sugar and fat consumption at the same time.
Access Malhotra’s full column in the BMJ here.