The story on fat in the diet

In the beginning God declared a wide variety of fruits, grains, nuts, seeds, and vegetables good for food (Gen. 1:29; 3:18). Later flesh from "clean" animals was permitted if it was free from fat and blood (Gen. 9:3, 4; Acts 15:28, 29; Lev. 3:17; cf. Lev. 11; Gen. 7-9).

"God is working in behalf of His people," wrote Ellen G. White. "He does not desire them to be without resources. He is bringing them back to the diet originally given to man. Their diet is to consist of the foods made from the materials He has provided. The materials principally used in these foods will be fruits and grains and nuts, but various roots will also be used."¹

Some have misinterpreted this passage to advocate a diet without any refined foods or free fats such as oils, shortenings, or margarines. Although the original diet was vegetarian and contained no animal fat, it was not necessarily low in fat.

To avoid confusion on the matter, Ellen White explains what she means: "Again and again I have been shown that God is bringing His people back to His original design, that is, not to subsist upon the flesh of dead animals."² The term "original design" refers only to a meat-free diet.

God multiplied oil for bread for a widow and her son and their guest. He multiplied the oil on another occasion undoubtedly for food as well as other purposes (1 Kings 17; 2 Kings 4). He gave Israel oil out of the rock (Deut. 32:13). Manna tasted like cakes baked with oil (Num. 11:8). The Bible even commands the use of oil to be mixed into flour batters, to spread on top of flour products, or to fry with (Ex. 29:2; Lev. 2).

Though Ellen White herself used oil, she spoke out against the use of grease. Webster's Dictionary of 1877 defines this term clearly as the fat of animals, especially land animals. An editorial note in Counsels on Diet and Foods refers to Webster's definition of grease as animal fat.³

Obviously Ellen White did not include butter in the term grease as she used it. She speaks of fried potatoes as being unhealthful because of the use of "grease" or "butter" in their preparation. Why mention butter separately if it is included in the term grease'! Further more, she used butter in cooking her vegetables 4 after these strong statements against grease.

It is a misconception that refined oils increase the risk of heart attack. Coronary heart disease may result from a lack of linoleic acid, which is found in large amounts in many vegetable oils. Increased linoleic acid in the diet lowers the risk of heart attack.

Some oil in the diet actually lowers blood cholesterol further than no oil at all. It also helps to lower blood pressure and even to increase cardiac muscle contractility. Linoleic acid, a fatty acid that is present in large quantities in olive oil, helps to decrease the danger of clotting in the bloodstream. Atherosclerosis can be reversed in monkeys by removing the cholesterol from the diet even when corn oil makes up 40 percent of the diet. When monkeys with 65 percent occlusion of the coronary arteries are placed on a 40-percent corn oil diet, the occlusion rapidly decreases to only 25 percent.

Corn oil, with its great content of linoleic acid, the most important essential fatty acid, reduces serum cholesterol lower than will a no-oil or extreme low-fat diet. Rats given all/2 percent salt solution for drinking water developed hypertension within two weeks on a 2 percent linoleic acid diet, but did not on a diet that included 22 percent linoleic acid. 7

Differences in oils

There is a great deal of difference in oils. They may contain from 1 g. to 11 g. of saturated fat per tablespoon. Those containing high amounts of polyunsaturated fatty acids (safflower, sunflower, corn) help to lower blood cholesterol. Those (such as coconut oil) that contain high amounts of saturated fat tend to elevate the blood cholesterol, especially in people who consume considerable cholesterol in their diet.

A diet high in olive oil results in extremely low coronary heart disease mortality. 8 Olive oil is 76 percent oleic acid, a monounsaturated fatty acid. Some have attributed the coronary heart disease preventive effect to the high level of oleic acid, but it is more likely that the low level of saturated fat is what makes olive oil beneficial.

Because of the beneficial effects of high oleic acid content in olive oil, other foods, such as avocados, have been assumed to be good if they are also high in oleic acid. This may be an erroneous conclusion. Safflower oil that has had its oleic acid content increased to the level of that found in olive oil produces only half as much prostacyclin as olive oil does. Prostacyclin reduces the risk of thrombosis.

There may be an action on the blood vessel wall from the olive oil that is beneficial because of unknown factors. It is the only oil that has been shown to pre serve the elasticity of the arteries in aging rats.

Both low-fat and high-monounsaturated- fat diets lower total cholesterol and low-density lipoprotein (LDL) cholesterol. 9 Oleic acid does not lower, and at times even elevates, the high-density lipoprotein (HDL) cholesterol, as com pared to the low-fat diet.

Many studies in the United States demonstrate that HDL cholesterol has a protective effect against heart attacks. There is some question, however, as to whether the HDL cholesterol is as beneficial as thought. Scientists in the Soviet Union have recently reported an in crease in the rate of death from noncoronary causes as HDL increased. ¹⁰

Peanut oil, when it is consumed with extremely high amounts of cholesterol, produces atherosclerosis in rabbits and monkeys. A recent review article states: "This work would appear to establish rather firmly that in the rabbit fed large amounts of cholesterol, the inclusion of peanut oil produces an unusual degree of atherosclerosis which would not be expected on the basis of its overall degree of unsaturation."

The writers go on to state: "Diets containing excessive amounts of cholesterol cannot be assumed to provide a model which will be applicable when much lesser amounts of cholesterol are consumed in the rabbit and certainly not in man."¹¹

Furthermore, plaque formed in the arterial wall from peanut oil may even be protective. It is fibrous and tends to cap over the cholesterol plaque that might otherwise break off and occlude the vessel.

Peanut oil contains saturated fatty ac ids known as arachidic acid and behenic acid, some of which are suspected of causing atherosclerosis in monkeys. These are present at less than 6 percent of the fatty acids. The colostrum of human milk has 4.9 percent of these acids.

Peanut butter is high in protein, has no cholesterol, is low in saturated fats, and neither raises nor lowers a person's level of serum cholesterol. In view of these facts, peanut butter can still be recommended as a good food.

Cottonseed oil is high in palmitic acid, the major saturated fatty acid that elevates serum cholesterol. Therefore, it is not the preferred oil for routine use.

Rapeseed, or canola, oil has been used in Canada for many years. It was not permitted in the United States until recently when toxic factors in the oil were successfully removed. It is an oil that is also high in polyunsaturated fatty acids and low in saturated fatty acids. It contains considerable alpha linolenic acid, some of which the body converts to eicosapentaenoic acid (EPA), a substance that helps reduce the risk of thrombosis.

Sunflower seed oil, corn oil, and safflower oil would be of value in routine daily use. Others, such as almond oil, are useful but may be quite expensive.

Coconut oil is high in lauric acid, a saturated fatty acid. This tends to elevate serum cholesterol, at least when used with cholesterol in the diet. So it is not a recommended oil for routine use.

Animal fat and cholesterol

While some vegetable oils may help minimize the risk of heart attack, animal fat increases risk of heart disease. Total vegetarian Seventh-day Adventist men had only 14 percent of the expected heart attack death rate of the general population, while lacto-ovo vegetarians had 39 percent, and those eating meat four or more times a week had 56 percent of the expected mortality. Because of the small numbers in the total vegetarian group, however, no conclusion can be drawn from this part of the study. 12

Total vegetarian Adventists in New England were reported to have statistically lower total and LDL cholesterols than the lacto-ovovegetarians. 13 Lacto-ovovegetarians had 24 percent higher LDL cholesterol than did total vegetarians. 14 A daily reduction of 100 mg. of dietary cholesterol reduces serum cholesterol by about 5 mg./dl. and heart attack risk by 10 percent. Since cholesterol is present only in animal products, a vegetarian diet is ideal for reducing dietary cholesterol.

Small amounts of cholesterol fed to animals over long periods result in atherosclerosis even though blood tests re veal little or no rise in serum cholesterol.

Persons eating 2,000 calories daily in crease their heart attack risk by about 30 percent when they increase dietary cholesterol from 200 to 600 mg. a day. Lowering daily intake from 600 to 200 mg results in a 37 percent decrease in risk of dying from all causes—combined the equivalent of living 3.4 years longer.

Adventist men who ate meat four or more times a week had four times the risk of dying from a heart attack in their 40s and twice the risk in their 60s as lacto-ovovegetarian men. Women past 55 had 1.5 times greater risk. Adventist men who ate meat six or more days a week had a 3.8 times greater risk of having diabetes mentioned on the death certificate when compared to lacto-ovovegetarians. 15

Japanese women who ate meat daily had a 3.8 times greater risk of breast cancer as those who ate it less than once a week. Consumption of eggs, butter, and cheese also increased the risk two-to threefold. ¹⁶ Animal fat correlates with breast cancer in international comparisons, but vegetable fat shows no such correlation.¹⁷ Ovarian cancer in Adventists increases as more meat is consumed.¹⁸ Meat like any high-caloric-density food increases risk of obesity. This in turn increases risk of heart attack and many cancers.

When cholesterol in food is exposed to air, it may oxidize and form toxic substances that can damage artery walls. Studies of monkeys revealed that drymix custards and pancake mixes containing eggs caused considerable damage.

Free versus natural fat

Some think natural fat in food is more beneficial and is handled differently by the body than oil added to food in free form. This is not, however, the case. Early stages of fat digestion preclude a different physiological handling of these two kinds of oils.

The time it takes for the stomach to empty its contents varies, depending on many factors, including caloric load. ¹⁹ It takes about an hour for a stomach to empty itself of 10 grams of fat the same amount of time required for dealing with carbohydrates containing the same number of calories.

Processed oils may be actually safer than unprocessed oils because processing removes some of the aflatoxins, pesticides, and other harmful chemicals. Crude oils contain substances that impart undesirable flavor. Chlorophyll or other impurities absorb light and cause deterioration. For this reason proper re fining is necessary.

Hydrogenating oil to make margarines and shortenings produces considerable quantities of trans fatty acids. In nature trans fatty acids do not occur in any great quantity. Milk contains about 5 percent trans fatty acids. 20

A study of 46 generations of rats fed hydrogenated margarines as the sole source of fat showed no apparent deleterious effect. There is little evidence to suggest that trans fatty acids increase the risk of either cancer or heart disease. 21 Apparently these fatty acids do not adversely affect cell function, either, when incorporated into the cells. They are metabolized like saturated fatty acids normally found in food, but they do not elevate serum cholesterol.

Scientific groups recommend that at least one third of our fat be from polyun saturated fatty acids. The plant sterols found in these oils attenuate the effect of cholesterol in the diet by reducing its absorption.

Alpha linoleic acid, one of the essential fatty acids, is a major precursor for the omega-3 fatty acids, such as eicosapentaenoic acid (EPA), that reduce the risk of heart attack by reducing platelet aggregation and clumping of the red cells. English walnuts, soybeans, soy oil, butternuts, rapeseed oil, and flaxseed or linseed oil are high in alpha linoleic acid. This fatty acid may be converted into EPA in the bloodstream.

Optimal amounts of these omega-3 fatty acids have not yet been determined, but Eskimos, who consume considerable amounts offish, which is high in Omega- 3, show an increased risk of cerebral hemorrhage. For this reason, plus the possibility that excessive consumption of fish may elevate one's risk of cancer, re searchers do not recommend eating fish to reduce heart attack risk. Fish oils also decrease insulin production, making them inappropriate for diabetics, and in crease LDL cholesterol, which may actually increase heart attack risk.

Infant and child needs

The American Academy of Pediatrics recommends that infants receive a mini mum of 30 percent of their calories from fat to assure that they get all of the essential fatty acid (EFA) they need for growth, maintenance of cell membranes, regulation of cholesterol metabolism, and synthesis of prostaglandins.

A low-fat diet for infants cannot be justified. Forty to 50 percent of the calories in milk from a well-nourished mother come from fat.

The nutrient and energy needs of in fants and small children are relatively large for the capacity of their stomachs and size of their bodies. Consequently, they need nutrient-dense foods to supply those needs. This is why fat must make up a larger proportion of their energy needs than that for adults. The Food and Agriculture Organization recommends that in underdeveloped nations, where small children often have an energy deficit of 20 to 30 percent, half of this be made up with oils and the other half with foods the children are accustomed to.

Studies have shown that children on restrictive vegan diets are generally small for their age. After age 2, however, mean weight velocity accelerates, suggesting a catch-up in growth. ^{22, 23} Recent reports have documented growth failure in children less than 2 years of age who were fed low-fat diets.²⁴

Infants on low-fat diets have less sub cutaneous fat. Some develop significant but reversible behavioral abnormalities. Children between 6 months and 2 years of age could well have 30 to 35 percent of their calories from fat. However, the National Cholesterol Consensus Conference recommends that all over 2 years of age should attempt to reduce fat intake to 30 percent of calories.

Present recommendations

Based on population studies and heart attack rates, many scientific bodies have recommended that less than 30 percent of calories consumed be from fat. Aver age intake in the United States is 37 per cent, for Adventists 35 to 38 percent. These recommendations are based on animal and population studies comparing fat intake with cancer and heart at tack rates. The World Health Organization's expert committee on coronary heart disease prevention has stated that the relationship between death, blood cholesterol, and coronary heart disease is causal.

The American Medical Association recommends that all persons go on the Phase I American Heart Association diet, which contains no more than 30 to 35 percent of the calories as fat, with 10 percent or less from saturated fat. This diet would have no more than 300 mg. cholesterol per day. The average American eats 400-500 mg. of cholesterol each day. Vegetarian Adventists probably consume 25 to 50 percent less than that.

Those with a serum cholesterol above the median 210 mg./dl. are to go to the Phase II diet if the first one does not reduce their serum cholesterol to desirable levels. On this diet fat should make up no greater than 30 percent of calories, and saturated fat should be equal to or less than 8 percent. In Phase II the cholesterol intake should be no more than 250 mg. per day.

If this does not get the desired effect, one should go to the Phase III diet no more than 7 percent of calories from saturated fat, and cholesterol intake 100 mg. per day or less. All family members of those with elevated serum cholesterol are advised to go to at least Phase I of this diet. This represents two thirds of the U.S. population.

Median serum cholesterol levels in the U.S. stand at 210 mg./dl. The National Cholesterol Education Program recommends that those whose levels are above 200 mg. reduce saturated fat to 10 per cent of calories and cholesterol to 300 mg. per day. If this is not effective, they should proceed to step 2 of the program with less than 8 percent saturated fat and cholesterol under 200 mg. per day. Any one under age 65 whose LDL cholesterol is 160 mg./dl. or higher and who has two other heart attack risk factors (being a man is considered a risk factor in itself), or 190 mg./dl. with no other risk factors, is a candidate for drug therapy if diet modification is not effective. LDL cholesterol should be 130 mg./dl. or less.

Controlling dietary fat

To meet the national recommendations of fat intake somewhere between 20 and 30 percent of calories with only 7 to 10 percent from saturated fat, and to at tempt to get closer to the ideal diet to prevent disease and promote health, the North American Nutrition Council makes the following recommendations:

1. Increase consumption of fruits, whole grains, and vegetables for those who have not already done so, and adopt the vegetarian diet without meat, fish, or fowl. This, the Adventist health study has shown, will reduce heart attack risk further than any other diet promoted for this purpose today. This is likely to also reduce cancer risk.

2. Cook and plan meals without the use of eggs. This would eliminate the single greatest source of cholesterol in the American diet. It may also reduce the risk of certain cancers that appear to be epidemiologically related to egg consumption.

3. Avoid high-fat dairy products such as cream, butter, high-fat cheese, and whole milk. This further decreases cholesterol, saturated fat, and animal fat and is likely to reduce the risk of both coronary heart disease and cancer.

4. Use polyunsaturated oils in limited amounts in place of hard fats such as shortenings. This will decrease both saturated fat and total fat, and perhaps reduce cancer risk further.

The Bible not only does not condemn the use of oil, but even commands its use. The Spirit of Prophecy does not condemn its use either. Scientific evidence is strong against the use of animal fat. There is good evidence against the use of too much vegetable fat. But there is little evidence to support the total elimination of fat from the diet. In fact, a little oil may actually decrease the risk of disease and promote good health. Clearly, those who select their diet from among the foods God called good for food (Gen. 1:29; 3:18) reap important health benefits.

Consumption of nutritious food is necessary to sustain life. The more whole some the diet, the better the health. The better the health, the more complete the mental and spiritual life.