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New study confirms the Big Fat Surprise

Nina Teicholz's book The Big Fat Surprise (2014) challenged the conventional view that you should reduce your intake of fat, and especially saturated fat, to reduce your risk of a heart attack or stroke. A similar conclusion was reached by Gary Taubes a few years earlier in The Diet Delusion. Both these writers are science journalists, not clinicians, but their books were based on an impressive amount of literature research and, in Teicholz's case, interviews with leading experts in the field.

In spite of these and other heretics, the conventional doctrine that Fat is Bad continues to be widely taught and believed. But the result of the new PURE observational study seems to show pretty convincingly that the heretics are right.

This intercontinental study examined the role of diet in relation to cardiovascular disease in nearly 150,000 people in five regions. The report appears in The Lancet and is reviewed by Richard Lehman in his blog, an extract from which appears in the current BMJ (9 September 2017) in its From the Journals column.

Lehman thinks that observational studies are generally "bunk", but that PURE is an exception and probably takes us "the closest we are likely to get to the 'truth' about diet and cardiovascular disease." He quotes the conclusion of the paper as follows.


High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke.


So "we can abandon the saturated fat-cardiovascular disease hypothesis with some certainty."


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