Good fat, bad fat, no carbs, low carbs? It’s not that simple

By Jamie Libera, RD, LD, cardiac dietitian, Providence Nutrition Services

"Eat Butter," shouted the June 23, 2014 cover of TIME Magazine. "Scientists labeled fat the enemy. Why they were wrong."

But were they wrong? Are butter, cheese and bacon now the new health foods?

Sorry to burst your toasted-cheese bubble, but I would argue that the scientists got it mostly right – and much of the article actually backs that up. Headlines like this may sell magazines as fast as the words "fat free" sell snack cakes, but neither tells the whole story.

A little history

I doubt that any scientist ever declared that all fat is bad, or that eliminating all fat from your diet would be a good thing. We’ve long known that the body needs some fat to help us form cell membranes, to absorb fat-soluble vitamins, and to help us feel full and satisfied after we eat.

But scientists did discover an association between one kind of fat – saturated fat – and the harmful LDL cholesterol that is linked to heart disease. Based on these findings, the American Heart Association, or AHA, advised Americans in 1961 to trim the saturated fat in their diets – not to eliminate it entirely, but to reduce it – to protect their hearts.

When the U.S. Department of Agriculture released its first Dietary Guidelines for Americans in 1980, it, too, recommended not wholesale fat elimination, but “avoiding too much” saturated fat, along with too much fat and cholesterol in general.

Over the next few decades, Americans complied, reducing their calories from meat, butter, whole milk and the like. But instead of getting healthier, the country got fatter and sicker. Today, almost half of Americans have either Type 2 diabetes or prediabetes, and more than a third of the country is obese. Where did we go wrong?

Lost in translation

The hope was that Americans would replace some of the saturated fat in their diets with better fats and other, healthier choices such as fruits, vegetables, beans and legumes. Unfortunately, that message got derailed, in part, by a food industry that was eager to feed us a simplified message: All fat is bad. Translation: Any product labeled “fat free” is good. Soon, Americans were filling their grocery carts with products loudly exclaiming their fat-free virtue, but quietly loading us with highly processed, refined carbohydrates. That jump in refined carbohydrates and sugars in our diets has played a leading role in the rise in obesity and Type 2 diabetes, and hasn’t done any favors for our hearts, either.

Where to from here?

Today, as the media proclaim the failure of the low-fat movement, the "trendulum" is swinging back in the other direction, with plenty of momentum that could send it swinging too far the other way: "Fat is back!" "The cavemen were right!” “Carbs are the new bad!"

But of course, it’s never as simple as that. Carbohydrates, or “carbs,” aren’t all bad any more than all fats are. As with fats, it’s the kinds and amounts of carbs you eat that make the difference. Complex carbohydrates such as oats, quinoa, beans and lentils help keep you feeling full and energized, and whole fruits and vegetables are vital sources of fiber and nutrients. These are important parts of a healthy diet.

Demonizing an entire food group makes things easy to remember, but it’s not a healthy or balanced way to eat. I encourage my patients to focus less on the trends and more on making healthy choices most of the time. Here are a few guidelines:

  • Choose healthier fats. Most experts still agree that foods high in saturated fat are not the best thing for your heart, and should be limited. The AHA recommends limiting saturated fats to about 7 percent of your total daily calories, but that doesn’t mean you have to count everything, and it doesn’t mean that you can’t have a little butter, beef or cheese every once in a while. But most of the time, try to choose fewer animal-based fats and more of the healthier fats from plant-based oils, olives, nuts, seeds, avocados and fish.
  • Be more choosey. When choosing meats, go for quality: Choose fresh over processed meats, and opt for grass-fed beef and/or game meats when possible – they typically contribute less saturated fat and more heart-friendly fats than conventionally raised beef. Keep your meat selections lean, and try to prepare them without too much added fat. And remember that a proper portion of meat is about 3 ounces, or the size of a deck of cards.
  • Choose healthier carbs. Limit white flour, white rice and other refined carbohydrates that have had the bran and dietary fibers removed. With no fiber to slow them down, they hit the bloodstream hard and fast. Instead, choose whole grains that include all parts of the grain, including the good-for-you fatty acids and fiber.
  • Don’t drink your carbs. Choose whole fruits over fruit juices to get more fiber. Trade most of your sugar-sweetened beverages for all-natural, calorie-free water.
  • Eat outside of the box – or at least know what’s inside it. When you buy packaged food, read beyond the front of the package. The ingredients list and the Nutrition Facts label will tell you more than the front of the package about the fats, sugars, fiber and other components of what’s inside. Better yet, forget the box; cook your own fresh foods and maintain total control of what goes in.
  • Eat more plants. I always recommend that my patients try to eat real food that’s closer to nature. Fruits, veggies, whole grains, beans and legumes are naturally high in nutrients and fiber and have no saturated fat. Try to make half of every meal colorful produce.

New studies will come and go, but the message to be moderate with saturated fat is still a good one, as long as you don’t replace that fat with something equally harmful. It’s a position that the AHA maintains to this day, after more than 50 years of continuing research.

In fact, moderation is a good message to end on. Choosing a colorful variety of wholesome foods, with everything in moderation, is a great way to keep your diet balanced, interesting and satisfying – and that’s a diet you can maintain for a lifetime of health.