Fat & Cholesterol Pt. 3 – Women are special

[Music] hello dr gary huber glad you could join us for part three we're going through the book the big fat surprise by nina t colts and her book is looking at cholesterol in our country and in our culture and what do we think we know about fats and how much of what we think we know is absolutely false if you missed part one and part two uh go back and look at that we're going to talk today about this topic as it relates to women's health which is really important men metabolize fats different than women there is absolutely a difference we have to appreciate that we have to appreciate the early studies were mostly done on just men so as we take a look at women i want to go back just a short review from part one and part two ansel keys in the 1950s had a theory a theory that fat and in particular a particular saturated fat was a problem that caused heart disease it was a theory but it was never proven and yet here we are 70 years later and we all believe that somehow fat causes heart attacks or that ldl cholesterol is the devil and is going to kill us all so his basic logic from his his theory was that since fat has more calories than carbs eating fat would make you fat simple premise it just isn't true he also surmised that fat was bad for the blood vessels and that's not true either right we're going to talk about whether it's oxidized that's the big difference i want to insert a little bit of logic right here right now what did our forefathers eat when we literally go back and look at the 1800s into the early 1900s our forefathers ate bison an antelope and elk and rabbit and fish and chickens we ate meat think about what you grew up hearing throughout the 1970s 80s and 90s we were told don't eat animal fat vegetable fats healthier corn oil canola oil that's when heart disease started when processed foods enter the mainstream so don't lose track of logic eating animals has been what we've done since the dawn of time and when we go back and look at heart attack rates in the late 1800s and early 1900s there weren't any we talked about that in the in the first video so if you get a chance go look at that the framingham study i'm going to include a few studies in here because i think it's point it's helpful to understand where we came from the framingham study is a very famous study from 1948 into the 1980s 14 000 people in framingham massachusetts were studied for decades three generations in fact were studied and here's some of the findings from that study now i find something in the study i don't necessarily have to report it or i can bury it in a off journal that's not going to be red that happens a lot in this literature on on cholesterol the framingham study and this again going back to the 1950s and 60s showed us that men and women that had cholesterol from 205 to 264 that they could find no correlation with heart disease doesn't make any sense right you grew up hearing that your cholesterol needs to be below 200. yet one of the earliest and most important studies that we looked at didn't show that okay that's not what enzo keys relied on though uh to support his theory 50 of people that had heart attacks had a cholesterol below 220. we know that's true today there have been other studies that have looked at that the majority of people that have a heart attack having normal cholesterol it seems odd doesn't it and if that's the case then why are we checking cholesterol to rule out who's at risk it's not a very good tool it's not very predictive and then lastly men that were in the ages of 48 to 57 and had a cholesterol around 200 180 to 220 had a greater risk of heart attack than men that had a cholesterol above 220. again it doesn't make sense given what you and i have heard in the last few decades what came out of all that you've heard of good cholesterol and bad cholesterol ldl is bad hdl is good you have to remember the basic premise ansel keys believed that fat in general was bad and saturated fat in particular was the evil and back then they weren't doing studies of hdl and ldl separately that came along through the 1960s and 70s when that technology came out but as we looked at that newer technology we still had in our mindset scientifically that that was bad that was kind of the premise it was a bias and we can we can absolutely say that hdl cholesterol is the good cholesterol and it's amazing in fact what the studies have shown it is the most important ldl wasn't that important but as i talked about in the other videos the drug companies couldn't come up with a drug to elevate hdl so they came up with a drug to lower ldl but the study showed that hdl of the two was the more important piece so we look at hdl and ldl understand yes there is some truth there but it's only one tenth of the story now we're going to uncover the rest we're going to go back to ansel keys for just a minute 1950s he has a theory he's a scientist and again he's a bit of a bully bit of a loudmouth and upon his theory he was basing it on a number of studies i'm gonna only use one of those studies that he based his theory on it's this study the anti-coronary club study from 1959. now that study was done by dr jolof dr jolof at that time was the new york city health department director and he engineered the study and from it he came out with what was called the prudent diet if you're above the age of 35 you may remember the book of the prudent diet reduce and stay reduced on the prudent diet the whole idea of the book was lower fat lower fat increased carbohydrates will keep you healthy right that was the basis of the book jolof influenced dr paul dudley white paul dudley white was eisenhower's physician if you remember eisenhower had a heart attack in the white house in 1955. paul dudley white and ansel keys were colleagues and close friends and the two of them went on to create this ideology that cholesterol was the problem in fact paul dudley white went on to become the the president of the national institute of health which was a new organization back then right in this study it was only men and this was common back in that day right they just studied men as a model women weren't often talked about and there were 600 men in the study why am i sharing this with you because i want to show a trend in the literature that's important and it's affected the studies on women as well so the american college of cardiology this was their diet all right and the group that you see on the left that was the the test group the group on the right was a control group so we had two different groups of guys the test group was going to get the following they were going to get a diet that was reduced in red meat they were told not to eat much in the way of beef pork and lamb limit the amount of eggs in dairy they could have unlimited amounts of fish and chicken that was promoted as being more healthy because it has less fat less saturated fat and they had to as part of the diet eat two tablespoons of vegetable oil remember this is the 50s and 60s we're walking into vegetable oils and processed fats as becoming mainstream in our culture prior to this there hadn't they hadn't been at all and their fat intake could only be 30 the control group by contrast ate a typical diet where it was 40 percent fat and they get at unlimited meat unlimited saturated fat there was no restriction placed on them whatsoever so what are the results right i'm very curious what happened to these guys well there's what the media reported but then there's some facts that weren't reported or were buried and i'm going to show you what those details were because they're very important so first of all they said oh this is an amazing success we saw a drop in cholesterol we saw blood pressure go down and weight go down this is awesome this is the cure for heart disease and the summation in the media was that a diet low in saturated fat will protect you against heart disease and that message gets iterated for the next several decades with other studies here's the hidden facts though there were 26 deaths in the prudent diet group the group that was eating low fat 26 deaths okay well there was only six deaths in the control group hmm they seemed to do better how many heart attacks were those deaths well in the prudent diet group there were eight deaths from heart attack how many guys in the control group had a heart attack none hmm smells a little fishy doesn't it in fact joelof himself died of a heart attack in in 1961. so you have to look at that study and the media is promoting one thing yet there's some facts and details that weren't being shared that made a big big difference these vegetable oils are not healthy but that's not what was promoted so now finally ladies let's get to you shall we when we look at the framingham study in women and yes it started off mostly men they started incorporating women as they as the years passed by as we look at the framingham study here's what they found women could have a cholesterol up to 294 294 and there was still no increase in risk and heart disease 294 much different than what we're taught today so what really matters is hdl and that's what's come out of the framingham literature hdl is king ldl it's not that important what have you and i heard our whole lives we're going to totally focus on your total cholesterol and your ldl those aren't the important triggers it is hdl that is the most important in fact from the framingham literature we know this if your hdl is above 64 as opposed to somebody who has an hdl below 35 there is an eight-fold difference in risk so what do you want to be do you want to have an hdl below 35 or do you want to do whatever it takes to get it above 64. you want to do the latter right eightfold reduction risk regardless of what the ldl is in 1992 the nhlbi that's the national heart lung and blood blood institute reviewed all the literature related to cholesterol as it relates to women and heart disease all the literature this is a this is a professional panel that reviewed all the literature and this was their conclusion total mortality death was higher for women with low cholesterol than for women with high cholesterol regardless of age and that's been shown there are studies today that show us that people with really really low cholesterol they're more at risk for alzheimer's they don't live as long they have a greater risk so why are we trying to lower ldl and cholesterol again it doesn't make sense not my opinion i'm reporting what these professional boards have said i want to share one of the most important studies for women this is the the be fit study the the corporation boeing that you may know in seattle uh it's the be fit study because it's the boeing employee fat intake trial right and this was in 2000 it looked at men and women and they had a cafeteria so they could really control what these men and women were eating and here was the diet uh there was 383 men and women they were followed for one year they were put on the the national cholesterol education panel had some guidelines on what they felt a low cholesterol diet should be and they were put on those protocol they were followed for a year their total fat intake had to be below 30 percent if you're an american at that time you were typically eating about forty percent and saturated fat uh had to be limited to just seven percent calories which is very low uh by by modern uh well by american standards so that was the that was the diet they were put on for a year and it was very well controlled so men and women are equal perhaps but we're not the same the way that we metabolize fats is very different so the ldl levels in the women drop 3.7 to 4.7 and that was what was promoted yay was a success we dropped ldl the problem was on a low-fat diet that's low in saturated fat hdl also dropped which one's more important ldl or hdl hdl in the hdl dropped by almost twice as much as the ldl we affected the ratio in an adverse way and because of that because we depleted or reduced hdl they calculated that the risk of heart disease to women actually went up anywhere from seven to fifteen percent that's not good men were not as adversely affected okay so this impact of removing fat and taking away saturated fat affects women dramatically they have a different metabolism than then the key here and all of this the thing i want you to take home whether you remember any of these studies is this for your entire lifetime you've heard that ldl is the king ldl is important what's my ldl number it's not significant what is significant is your hdl that's way more significant and way more predictive right that is the key so here's the question you and i have well if hdl is that important how do i increase it do statins increase hdl they do not how do i increase my valuable hdl well number one exercise far and away every study ever looked at when people exercise their hdl went up all right well maybe i don't want to exercise maybe i got a bad knee maybe i'm not into that what are other things i can do yes the second most powerful thing you can do to elevate your hdl is eat saturated fat now your cardiologist your family doctor somebody might tell you yeah but when you saturated fat your your ldl goes up too it does it does but the hdl comes up more than the ldl actually the ratio improves and actually a higher hdl is more predictive regardless of what your ldl is and the last thing we can do is take in fish oil omega-3 fats now if you live in my beloved city of cincinnati it's practically illegal to eat fish here once a week is the typical so taking a fish oil has been shown to also increase hdl right so that's really key so other studies this is not a one-off so it i'm not just pointing to the b-fit study and seeing saying that's the proof uh other studies stefanik in the new england journal of medicine and other studies have found similar findings in other studies we consistently find that women on low saturated fat diets see their hdl fall 33 more than men do there really isn't a good reason to put a woman on a low fat diet and there's really no reason to limit or saturated fat the second finding that's consistent is triglycerides on low fat diets go up triglycerides are a reflection of your blood sugar what do you eat if you eat a low fat diet more carbs right that's been shown time and time again you ask people to reduce their fat they immediately eat more carbohydrates carbohydrates make your sugar go up sugar makes your triglycerides go up what's more predictive of heart disease triglycerides or ldl triglycerides so once again we continue to see the same risk factors uh be accurate and then reducing saturated fat and replacing it with vegetable oil that started back in the 1920s and into the 1930s with the development of crisco and then it's advanced since then right but when we replace vegetable oils we see really bad things we see an increasing cancer rate we actually see a shorter lifespan so eating vegetable oil which is what was proposed to us back in the 40s and 50s and 60s let us where we are today let me ask you a simple question um you were all there in the 1970s and 80s and 90s right what did we do we took all the fat out of the food didn't we and we increased our carbohydrates and we got away from animal fats and did we see diabetes and obesity and heart disease decline no we saw it go through the roof we've done the social experiment you were a part of that social experiment when we got rid of fat and animal fat and saturated fat and ate more carbs and eat more vegetable fat cancer heart disease diabetes obesity just skyrocketed the reality of what we've lived through a couple more points well you have to remember these big boards like the acc the american college of cardiology the aha they go well we're convinced that you know lowering cholesterol is really valuable for heart disease what else can we tackle what about breast cancer i'll bet you fat's bad for breast cancer too and this study came out in 2015 and it was a review of the literature but they weren't studying humans they were mostly looking at literature studying mice and what they found the the quote was the consumption of dietary fat is probably suggestive of an increased risk of breast cancer and this became what was known as the fat cancer hypothesis the problem was they receded were feeding vegetable oils to mice and seeing an increase in breast cancer so they just assumed fat was bad for humans and remember i said vegetable oil well that was an idea but then walter willett a well-known physician dietitian out of harvard did this very large study the nurses health study 90 000 nurses were studied from 1976 for more than a decade and here's what he found here's the results of the women's health study now he's looking at fat intake and breast cancer number one the more saturated fat a woman ate the lower her breast cancer risk and that held true regardless of what age you were that was the exact opposite of what they thought they might find secondly low fat diets we know they're not good for heart disease low fat diets increase the risk for breast cancer the real problem is in most of these diets they're having people stop healthy fats and take in man-made or man-altered vegetable oils that's one of the biggest problems here that's not the only study although that's a pretty big one right there was a bigger study the women's health initiative this was initiated back in 1993 probably one of the largest studies ever done it was going to answer all the questions we had about women's health and in that study 40 there was different arms to the study they looked at hormones and bone density and all kinds of different things but in one arm of the study 49 000 women were followed for 10 years that is a lot of power to find the truth those women had to eat a diet that was 29 fat so their normal diet of 37 was reduced to 29 and their saturated fat intake was reduced from about 12 and a half down to nine and a half percent okay so they reduce the fat that you're wondering what the results are well there was no reduction in breast cancer or any kind of cancer on that diet there was no reduction in strokes or heart attacks on that reduced fat diet and lastly there was no benefit to weight loss so it had no upside to it whatsoever and we know the downside to heart disease on a low fat diet so bottom line for women this is the take home a low-fat diet does not benefit women on any level heart breast cancer longevity cognition low-fat diets increase the risk of heart disease and breast cancer risk eating more saturated fat i know it goes counter to everything you've ever heard promotes an elevated hdl this thus reducing heart disease and breast cancer risk and for both men and women we don't have any convincing studies to date to show that eating a low fat diet is beneficial for reducing heart disease or mortality and if that's the case then why would i want to take a statin or reduce my my risk of heart attacks so statins 29 billion dollars a year do people benefit a small percentage of people with horribly genetically altered cholesterol metabolism do but the vast majority do not studies bear that out the largest study on the planet four million people for five years showed little to no change in heart attacks or deaths from heart attacks when we increased the use of statins we can talk about that at another time so i hope that was really helpful i have a brief case i want to share with you this is a case of anna who is 62 years old she comes in saying she wants to lose weight and she wants to feel less achy she also had heartburn and was started on a ketogenic diet so she went on a high fat low carbohydrate diet and by the way not everybody needs or wants to do a ketogenic diet but let me show you what happened when she did well first of all these are her labs we're going to look at ldl hdl triglycerides and something called small ldl that's a smaller particle that's very predictive of risk all right 2017 her ldl was 71 and her hdl was 43. this is on a ketogenic diet notice the ratio we would like a two to one ratio or lower of ldl to hdl she was less than two to one her triglycerides were less than a hundred and her small ldl we like that below 500 it was perfect and then she went to her family doctor and proudly announced that she was on a ketogenic diet and losing weight and he was horrified that she was on this high fat diet and he demanded that she stopped the ketogenic diet so this is what happened in 2018 and he put her on the classic low fat diet look what happened when she stopped eating fat her ldl went up to 138 her hdl dropped the ratio got worse the bad stuff got worse and the good stuff got less all right triglycerides went up to 124 that increased which is predictive of risk and then lastly the small dense particles went up to almost 750 that's not the right direction that's increasing your risk so what did we do we put it back on a ketogenic diet and later on that same year in 2018 this is what happened her ldl is now trending down look at her hdl from 40 up to 49 that ratio is now 2 to 1 or better triglycerides are trending down which is classically what you see in a ketogenic diet and their small ldl came back down to 462. that's pretty typical okay so here's the big question if i'm eating fat free why am i fat a lot of people struggle with this because carbohydrates are driving that mechanism and this hasn't been accurately portrayed or conveyed by the american heart association who still recommends a high carb low fat diet go back and see parts one and part two so the world is not flat we have to be able to change our understanding as new evidence evolves that's what science should be as we get new evidence we should take what we thought we knew and adjusted and corrected unfortunately organizations like the american heart association and others have dug their heels in they've been preaching this for over 50 60 years and they can't take it upon themselves to actually look at the literature and pull back on their recommendations okay that doesn't mean you and i have to suffer it doesn't mean you and i have to continue to eat a low-fat diet eat a lot of carbs and become diabetic and overweight it's not required we're going to continue our discussion there's some more things need to be talked about you've heard of the mediterranean diet what is it does it work and if it does why trans fats uh very important topic pufas polyunsaturated fatty acids that's a lot of the corn oil the canola oil and that's mostly what your fast food restaurants are cooking with what happens when you eat those things not good things aldehydes are toxins that happen when you heat these oils and we'll talk about some of the truths of saturated fats so i hope this was helpful bottom line if you're a woman there's really no need to be on a low-fat diet and don't be afraid of saturated fats what you should be afraid of is corn oil and chips and french fries and man-made trans fats that's the problem if you said i'm gonna go eat a cider beef have an avocado coconut oil fish eggs pork you'd be awesome i guarantee your cholesterol levels would actually improve and more importantly not more importantly but as important as your breast cancer risk would go down all right so i cringe when a woman comes in and tells me she's eating a low fat diet because usually that means she's eating a high carb diet and usually she's overweight and diabetic and i don't want that for you i want better so hope this was helpful stay tuned for parts four and five coming up that's right more fun stuff take care bye now you

Channel: Dr. Gary Huber

Views: 169

Rating: 5 out of 5

Keywords: women's health, healthy, women, healthy women

Id: X0v6xIvsfzE

Length: 26min 15sec (1575 seconds)

Published: Mon Aug 03 2020