July 09, 2024

Eat rich and grow rich in health. 

Baton Diet

Nutrition Principle 3

 

We truly can 

Eat rich and grow rich in health.

Higher fat intake, up to 45% of energy (calorie) intake, reduced mortality. (1160) 

Total fat and types of fat in foods were not associated with cardiovascular disease, heart attacks, or death from cardiovascular disease. In addition higher saturated fat in the diet lowered risk of stroke. (1160) 

Higher fat nutrition saved lives.

 

PURE Shakes Up Nutrition Field:  Finds Higher Fat Intake Beneficial (1160) 

PURE is set to shake up the nutrition field, with results showing higher fat intake—including saturated fat—was associated with a reduced risk of mortality. (1160, 1162, 1163, 1217) “PURE” is a large international study on effects of food intake on cardiovascular disease and overall mortality. “PURE” is the acronym for Prospective Urban Rural Epidemiology study. The analysis included 135,000 people, ages 35 to 70, on 5 continents. At the start of the study people without heart disease (cardiovascular disease) were included from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. This is the only prospective randomized study with information on diet, cardiovascular disease, and mortality in 18 countries on 5 continents. 

“High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. (1160) 

Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas higher saturated fat in the diet lowered risk of stroke. (1160) 

Global dietary guidelines should be reconsidered in light of these findings.” PURE study, Dehghan M et al, Lancet 2017 (1160) 

 

PURE global evidence findings challenge conventional diet. 

The PURE study found those with higher fat intake had a lower risk of death. The lower risk of mortality was seen for all the major types of fat found in whole foods. Comparing people who ate the most fat (highest quintile) to those who ate the least(lowest quintile), people who ate the most fat had the lowest risk of mortality (HR 0.77 p0.0001).

This equates to a 23% reduced risk of death in the people who ate the most fat. The individual types of fat found in whole foods were not linked to higher risk of heart attacks or death from cardiovascular disease. PURE study, Dehghan M et al, Lancet 2017 (1160) 

 

PURE is not alone, other large studies agree with PURE. 

Large randomized controlled trials (1173) and meta-analysis of observational studies from North America and Europe in the last few decades agree with PURE. (1169, 1178, 1209) 

Eat rich and grow rich in health. Higher fat intake, up to 45% of energy (calorie) intake, reduces mortality. (1160) 

Total fat and types of fat in foods were not associated with cardiovascular disease, heart attacks, or death from cardiovascular disease. Higher saturated fat in the diet lowered risk of stroke. (1160) 

 

Low-Fat Diets Don’t Work. (805, 1160, 1162) 

Large meta-analysis studies and the global prospective PURE study confirm low-fat diets, and low-saturated-fat diets don’t work. (805, 1160, 1162) A tsunami of evidence is calling US, European, and global dietary guidelines into question. 

The PURE data provides evidence that moderation, as opposed to very low or very high intake of both fats and carbohydrates (carbs), is preferred. (1160) 

 

PURE is at odds with current US, European, and global diet recommendations. 

The US has been advised to eat low-fat, and especially a low-saturated-fat diet, and a high-carbohydrate (60-65%) diet for decades (40 plus years). Recently we have been told to emphasize whole grains in our 60-65% carbohydrate intake. (1163) The US federal school breakfast and lunch “MY PLATE” program is 60-65% carbohydrate and low in saturated fat 10%. The American Diabetes Association Diet (ADA Diet) is low-saturated-fat (10%). The AHA American Heart Association recommends a super-low-saturated-fat-diet of 6%. The PURE study indicates that low saturated fat intake is harmful. (1160) These US diet recommendations were based on the presumption that replacing saturated fats with carbohydrates and unsaturated fats will lower LDL cholesterol “bad cholesterol” and should therefore reduce the risk of heart disease. These guidelines were based on selective emphasis ignoring several randomized trials and observational data that do not support the guidelines. (1166-1167, 1173, 1176) These global diet recommendations are “so much speculating masquerading as concrete truth”. 

 

How much fat intake according to the PURE study? (Please also see the graphs below.) 

Total Fat 

The PURE study showed continual reduction in mortality as total fat intake increased from 11% to 45% of total calories, with 45% fat intake associated with the lowest risk of mortality and lowest risk of stroke. Fat intake between 30-45% of energy (calories) was considered “moderate fat intake” in the PURE study. (1160) There were not enough people in the study who ate more than 45% fat intake to make conclusions about fat intake greater that 45%. (1160) The lower risk of mortality was seen for all the major types of fat in whole foods. The individual types of fat found in whole foods were not linked to higher risk of heart attacks or death from cardiovascular disease. “Our findings do not support the current recommendation to limit total fat intake to less that 30% of energy (calories) and saturated fat intake to less than 10% of energy (calories)” (1160) The PURE study found similar results true for the individual types of fat, continual benefit enhancement occurred as intake of types of fat increased. (1160) 

 

Saturated Fat (the butter, meat, eggs, and coconut oil family of fats)

As saturated fat intake increased, mortality reduced significantly, and risk of stroke reduced. (1160) Low intake of saturated fat below 10% was harmful and intake

below 7% increased mortality. (1160) Comparing those in the top quintile who ate the most saturated fat to people in the quintile that ate the least saturated fat, the people who ate the most saturated fat had reduced risk of total morality (hazard ratio (HR) 0.86) p 0.0088 equivalent to 14% reduced risk of death. (1160)

People who ate the highest quintile intake of saturated fat in the PURE study (about 18% of total calories) had the lowest risk of stroke. Comparing top saturated fat intake quintile 5 to the low intake quintile 1, the (hazard ratio (HR) 0.79 p0.0498) equated to 21% reduced risk of stroke. Continual enhancing of benefit was seen as saturated fat intake increased from 11% to 18% intake, with the most benefit seen at 18% intake. (1160) Examples of foods rich in saturated fats include butter, cream, eggs, meat, coconut oil. 

 

MUFA (monounsaturated fat) is omega-9 fats or the olive oil family of fats.

The PURE study revealed higher monounsaturated fat intake lowered mortality. People with the highest intake, about 18% of total calories, had the lowest mortality. (1160) Comparing those in the top quintile who at the most MUFA to those in the bottom quintile who ate the least MUFA, those in the top quintile had a reduced hazard ratio (HR) of 0.81 (p0.0001) which equated to 19% reduced risk of

death. Consistent with large studies, the Health Professionals Follow up and the Nurse’s Health Study (1210), the PURE study (1160), showed lower total mortality with higher omega-9 monounsaturated fat intake. These three studies are also consistent with randomized trials of the Mediterranean diet that show reduced risk of total mortality and cardiovascular disease among those eating higher amounts of olive oil and nuts. (1165) Additionally, the Dietary Fat Intake and the Risk of Coronary Heart Disease in Women study showed lower risk of heart disease with increased monounsaturated fat intake. (806) 

Monounsaturated fats include olives, olive oil, avocados, chicken fat from grass fed chickens, almonds, pecans, macadamia nuts, hazelnuts, acorns, pistachio nuts, sunflower seeds, and sesame seeds. 

 

PUFA (polyunsaturated fatty acids) (omega-6 and omega-3 fats) of the essential fat families.

A similar result comparing top quintile intake to lowest quintile intake (HR 0.80 p0.0001) or 20% reduced risk of death. Only polyunsaturated fatty acids (PUFA) found in foods, not oils, were counted in the PURE study. The PURE study did not measure polyunsaturated fat intake from oils including vegetable oils. PURE also did not measure trans fat intake, but was conducted mostly in countries where

trans fat intake was limited by legislation and in many countries where convenience foods are not affordable.

When looking at the PURE results keep in mind the sources of polyunsaturated fats (PUFA) counted and shown on the graphs came from foods like vegetables, nuts, fish, and meats and not industrial refined vegetable oils which may have a different effect on health. (1160) Polyunsaturated fatty acids (PUFA) intake included both omega-6 essential fats and omega-3 essential fats in the PURE study. PURE found increased intake of polyunsaturated fats (PUFA) from whole foods reduced mortality

as intake increased up to 14% of calorie intake. The 14% represents the total PUFA intake from whole foods and includes both omega-6 and omega-3 essential fats. 

Foods that contain omega-6 PUFA polyunsaturated fats include vegetables and certain nuts (especially Brazil nuts, pine nuts, pumpkin seeds, and sunflower seeds). Foods that contain omega-3 PUFA polyunsaturated fats include fatty fish that are wild caught, fish oils made from wild caught fish (triglyceride forms of fish oils), meat from grass fed animals fed on green pastures, pasture eggs, butter and cream produced from animals fed green pastures. 

  

 

 

Good Fats Characteristics 

Fat adds flavor and makes food satisfying and fun to eat. Higher fat intake, up to 45% of energy (calorie) intake, reduces mortality. Dehghan M et al, Lancet 2017 (1160) 

 

Omega-9 olive oil family fats are also known as monounsaturated fats (non-essential fat). 

Olive oil and omega-9 fats are heart protective. (806, 1160, 1161) 

Olive oil helps to lower LDL levels, the “bad cholesterol”. 

Olive oil and omega-9 fats raise HDL levels, the “good cholesterol”. 

Olive oil helps us control blood sugars. (1244-1248) 

Omega-9 fats may be eaten in abundance (2 to 10 tablespoons per day or more for adults). Sources: olive oil, avocado, almond, pistachio, pecan, hazelnut, chicken, duck, and turkey fat if the birds are fed on green pastures. 

Omega-9 fats are a preferred energy source (fuel) for muscles compared to carbohydrates. 

Replacing 5% of calories with omega-9 fat (monounsaturated fats like olive oil) reduced risk of heart disease by 20%. (806) 

 

Saturated fats examples include meat, butter, and eggs from grass fed animals. Coconut oil contains saturated fat. Saturated fats are non-essential fats. 

Saturated fats with long chain fatty acids are “satisfaction fats” that help us quit eating naturally so we do not overeat. Saturated fats curb appetite for the meal we are eating, and for the next meal we eat too. (807) 

Intake of saturated animal fats is not linked with heart disease. (806, 681, 1160, 1178) 

More importantly, low saturated fat intake is harmful. Dehghan M et al, Lancet 2017

(1160) 

Saturated fats may be eaten in generous quantity (2 to 10 tablespoons per day for an adult) or more. Mortality reduced continually as saturated fat intake increased up to 18%. (1160) 

Saturated fats do not always remain saturated fats in the body. The human body

can convert saturated fats into omega-9 fats (the olive oil family) and into omega-7 fats, based on body needs. (681) Grass fed animals provide natural saturated fats and generous omega-3 EPA/DHA fats. 

Risk of stroke was reduced with higher saturated fat intake up to 18% of energy (calories). (1160) 

Dr. William P. Castelli, the director of the famed Framingham Study, “… in Framingham, for example, we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least, and were the most physically active.” [Castelli W et al, 1992 (2151)] 

 

Omega-3 ALA and EPA/DHA fats (fish oil family fats) are essential fats, one type of PUFA polyunsaturated fatty acid. 

Fish oil and omega-3 EPA/DHA fats are heart protective (805, 819-23) and are pro-resolving of inflammation. (911) 

Omega-3 EPA/DHA intake raises our HDL levels of “good cholesterol”. (880) 

Omega-3 EPA/DHA essential fat levels are very deficient in most Americans. 

Omega-3 EPA/DHA fats intake should be balanced with omega-6 fats intake in a 1:1 ratio (equal but small servings) to provide 4 to 7% of energy intake (calories). (808, 862) and Dehghan M et al, Lancet 2017 (1160) 

If we are not deficient, the serving size is 1-2 teaspoons per day for an adult. 

If we are deficient, we may supplement with wild caught sources of liquid fish oil. 

Sources come from wild caught cold water fish and 100% grass fed meats, butter, cream, eggs. 

Omega-3 EPA/DHA levels are low in farm raised fish because they are fed corn. 

Omega-3 EPA/DHA fats are addressed further in the PART II of this book which is about the True Mediterranean Diet that is rich in fish and leafy greens. Fish are a source of bioactive long chain omega-3 fats. Leafy greens are a source of short chain omega-3 fats that serve as precursors of long chain bioactive omega-3 fats provided we do not have excess omega-6 fat stores in the body. (1473) 

 

Omega-6 vegetable fats are essential fats, one type of PUFA polyunsaturated fats. 

Vegetable fats are healthy if eaten in fresh whole vegetables and whole nuts like pine nuts, Brazil nuts, sunflower seeds, and pumpkin seeds. RAW vegetables are most beneficial. Cooked vegetables have modest benefit. PURE study, Miller, V et al, Lancet 2017 (1161) 

Vegetable oils are unstable, become rancid quickly, and are not safe to bottle as oils. (806, 862, 864) Vegetable oils like corn oil, soy oil, and safflower oil should not

be eaten or cooked with. 

Vegetable fats (omega-6 fats) average 20 times the healthy level in the US. (808,

862) 

Levels that are greater than 10 times normal are linked to heart disease and cancer. 

Vegetable oils raise blood sugar levels. (1244-1248) 

Omega-6 fats should be eaten in small quantity (1 teaspoon per day) in fresh veggies / fresh nuts. 

Vegetable fats (omega-6 fats) are essential fats, but we can get too much of a good thing. We should not include vegetable oils in our diet. 

 

“Our data provide evidence that moderation, as opposed to very low or very high intake of both fats and carbohydrate, is preferred.” PURE study, Dehghan M et al, Lancet 2017 (1160) The authors refer to “moderation” in diet intake as being: 

Total fat intake 30 to 45% of total energy (calorie) intake 

Saturated fat intake 11 to 18% of total energy (calorie) intake 

Monounsaturated fat intake 5 to 18% of total energy (calorie) intake 

Polyunsaturated fat (PUFA)* intake 8 to 14% of total energy (calorie) intake 

*PUFA from food sources only, and not from oil sources. (1160) 

The PURE study provides unbiased information. The PURE study was funded from more than 50 sources worldwide including the Population Health Research Institute at McMaster University; The Heart and Stroke Foundation of Ontario, Canada; and the Canadian Institutes of Health Research. The researchers report no relevant financial relationships. The funders had no role in the design or conduct of the study. They did not participate in the collection, analysis, or interpretation of the data, in the preparation, review, or approval of the manuscript or the decision to submit the paper for publication. (1160) 

 

PURE study results 

 

 

 

 We truly can eat rich and grow rich in health. 

 

Saturated fats, unsaturated fats, and total fat were not significantly associated with risk of heart attacks or cardiovascular disease mortality in the PURE study. PURE study, Dehghan M et al, Lancet 2017 (1160) 

 

 

Early American settlers ate moderate fat nutrition (30 to 45% fat intake). 

This is the same amount of fat intake the PURE study found to be the most beneficial amount. (1160) 

Paul Bunyan and the early American lumberjacks (lumbermen) ate moderate-fat nutrition (43.6% of calories from fat intake). They ate about 3,000 calories per day. In 1911, American lumbermen ate 43.6% fat in their food. Lumberjacks were known for their strength, agility, and endurance. They used hand saws to fell huge trees that they hauled to the rivers and floated the logs down the rivers. Lumberjacks had to be agile and quick when they walked on the logs while the logs rolled in the ice-cold rivers. To fall in the water could mean death. They worked from sunup to sundown. (Encyclopedia Britannica). 

Early American settlers and lumberjacks ate what the PURE study considers “moderate-fat nutrition”. 

Their primary fat source was saturated fats (about 15 to 30% of their energy intake) and monounsaturated fats were in close second place (about 15 to 30% of their energy intake). Essential fat intake was equally divided between omega-3 fats from fish and grass fed meats, chicken, eggs, and cream (4 to 7% of total energy intake) and omega-6 fats from fresh leaves, vegetables, and pine nuts, Brazil nuts and sunflower seeds (4 to 7% of total energy intake). This mirrors the PURE study. 

The average early American in the 1890’s ate 3,000 calories per day and 32.4 to 36.5% of calories from fat. (681) You might say they ate “PURE” nutrition meeting the PURE study recommendations. 

 

Cultures with high fat intake 

Native Greenland Inuit Eskimos eat about 50-60% of their calories as fat. Their diet

is rich in saturated fats from marine mammals. Greenland Eskimos have the lowest rates of heart attacks and heart disease of any population in the world. (848-851) 

Some elite athletes have eaten 60% of calories as fat (emphasizing olive oil). Fat is the preferred energy source for muscles in athletic endeavors. The studies in athletes are small observational controlled trials. 

James Donaldson was the NBA Starting Center for the Utah Jazz at age 39. He was an early adopter of nutrition rich in fats plus controlled adequate servings of protein and carbohydrate. He said he could still outrun his teammates 10 years younger than himself and gave much of the credit to his nutrition program. 

For now we suggest sticking to the tried and true principles of the PURE study that suggest moderate intake of both fats and carbs. PURE results closely mimic the nutrition early settlers ate in the US and the True Mediterranean Diet presented in Part II of the book. 

 

 

 

 

Glossary of the types of cholesterol measured in blood level tests 

Cholesterol and other fats (lipids) circulate in the bloodstream in several different forms. Of these, the one that gets the most attention is LDL — also known as “bad cholesterol”, or low-density lipoprotein. Lipoproteins come in a range of shapes and sizes, and each type has its own jobs. They also morph from one form into another. The main types are: 

 

TC is Total Cholesterol. 

 

Chylomicrons 

These are very large particles that mainly carry triglycerides (fatty acids from your food). They are made in the digestive system and so are influenced by what you eat. 

 

VLDL 

Very-low-density lipoprotein particles also carry triglycerides to tissues. But they are made by the liver. As the body’s cells extract fatty acids from VLDLs, the particles turn into IDL (intermediate density lipoproteins), and, with further extraction, into LDL (low density lipoprotein) particles. 

 

IDL 

Intermediate-density lipoprotein particles form as VLDLs give up their fatty acids (triglycerides). Some are removed rapidly by the liver, and some are changed into low-density lipoproteins. 

 

LDL 

Low-density lipoprotein particles are even richer in pure cholesterol since most of the triglycerides they carried are gone. LDL is known as “bad cholesterol” because it delivers cholesterol to tissues and is associated with the buildup of artery-clogging plaque. 

 

HDL 

High-density lipoprotein particles are called “good cholesterol” because they remove cholesterol from circulation and from artery walls and return it to the liver for excretion. 

 

The ratio of apolipoprotein B (ApoB) to ApoA1 

A newer test that is used in to predict risk of cardiovascular disease events. Cardiovascular risk reduction with lipid treatment is more closely related to levels of apolipoprotein B (apoB) rather than LDL cholesterol. (1159) 

 

The ratio of total cholesterol to HDL cholesterol (“good cholesterol”) 

Is twice as predictive as total-cholesterol levels alone for predicting heart disease (1168). Lewington S et al, Lancet. 2007 (1168) 

 

 

Moderate fat nutrition (30 to 45% fat) is optimal nutrition. 

Moderate fat intake satifies hunger. It fuels sport activities. It helps prevent weight gain that can otherwise increase risk of conditions like diabetes, high cholesterol, depression, and allergies that are often treated with drugs that further foster weight gain. 

Our companion book is Seven Ways to Avoid WEIGHT GAIN Due to DRUGS. 

 

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