Abstract

Background: Since 1984 UK citizens have been advised to reduce total dietary fat intake to 30% of total energy and saturated fat intake to 10%. The National Institute of Clinical Excellence [NICE] suggests a further benefit for Coronary Heart Disease [CHD] prevention by reducing saturated fat [SFA] intake to 6% - 7% of total energy and that 30,000 lives could be saved by replacing SFAs with Polyunsaturated fats [PUFAs]. Methods: 20 volumes of the Seven Countries Study, the seminal work behind the 1984 nutritional guidelines, were assessed. The evidence upon which the NICE guidance was based was reviewed. Nutritional facts about fat and the UK intake of fat are presented and the impact of macronutrient confusion on public health dietary advice is discussed. Findings: The Seven Countries study classified processed foods, primarily carbohydrates, as saturated fats. The UK government and NICE do the same, listing biscuits, cakes, pastries and savoury snacks as saturated fats. Processed foods should be the target of public health advice but not natural fats, in which the UK diet is deficient. With reference to the macro and micro nutrient composition of meat, fish, eggs, and dairy foods the article demonstrates that dietary trials cannot change one type of fat for another in a controlled study. Interpretation: The evidence suggests that processed food is strongly associated with the increase in obesity, diabetes, CHD, and other modern illness in our society. The macro and micro nutrients found in meat, fish, eggs and dairy products, are vital for human health and consumption of these nutritious foods should be encouraged.

Highlights

  • History has presented us with a very confused and sometimes misinformed message with reference to healthy eating

  • Since 1984 UK citizens have been advised to reduce total dietary fat intake to 30% of total energy and saturated fat intake to 10%

  • The National Institute of Clinical Excellence [NICE] suggests a further benefit for Coronary Heart Disease [CHD] prevention by reducing saturated fat [SFA] intake to 6% - 7% of total energy and that 30,000 lives could be saved by replacing SFAs with Polyunsaturated fats [PUFAs]

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Summary

Introduction

History has presented us with a very confused and sometimes misinformed message with reference to healthy eating. Following the completion of the Seven Countries Study in 1970, the seminal work of Ancel Keys [1] had a profound influence on the diets of the USA [2] and the UK [3]. Keys’ conclusions were: 1) The incidence rate of CHD [Coronary Heart Disease] tends to be directly related to the distributions of serum cholesterol values. 2) The average serum cholesterol values of the cohorts tended to be directly related to the average proportion of calories provided by saturated fats in the diet. 3) The CHD incidence rates of the cohorts are as closely related to the dietary saturated fatty acids as to the serum cholesterol level

Dietary Advice
Classification Errors
Saturated Fats and Polyunsaturated Fats
Nutrient Classification
Dietary Fat and Coronary Heart Disease
Swapping Dietary Fats—The Limitations and the Consequences
Findings
Conclusion
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