Fat. Does the word make you cringe? Fat is bad, bad, bad … isn’t it? Eating fat makes us overweight, gives us heart attacks, causes cancer, wrecks our health … doesn’t it? If it says “fat free,” it must be healthy … isn’t that true?
Yet, if fat is so bad, how is it that in certain Mediterranean regions such as the Greek island of Crete during the 1950s, where heart disease and other chronic disease rates were startlingly low, fat consumption was about equal to fat consumption in America? Cretans during this time in history were among the longest-lived people in the world. Yet their diet was full of fat.
According to researcher Ancel Keys, Cretans consumed 3 to 4 ounces (or about 1⁄2 cup) of olive oil per day, per person. That’s a lot of fat! Keys reported that the people of Crete drenched their salads in it, dunked their bread in it, poured it on their potatoes. Some Cretan farmers even drank a wine-glass full of the stuff for breakfast! Why weren’t the people on this tiny island suffering from the same health problems as Americans during the 1950s and 1960s, those health problems we’ve been told had (and still have) everything to do with too much fat in our diets?
Perhaps Crete is an anomaly? Yet studies from other countries reveal similarly striking results. Heart disease rates in the southern, or rather the Mediterranean, regions of Italy, Spain, and France were also remarkably low, even though percentage of fat calories varied greatly around the region.
Yet not every country could get away with fat consumption to the degree enjoyed in the Mediterranean. Keys’s studies of fat consumption and diet also included Finland, the country with the most coronary heart disease and the shortest life spans in Europe. Keys examined middle-aged men in Finland to determine why coronary heart disease was so common in this country, even among men who were thinner and more physically fit than many of the overweight, less fit American men in Keys’s studies. Blood cholesterol levels of the Finnish men proved to exceed average levels in American men.
Subsequent dietary surveys revealed that the typical diet in Finland was extremely high in saturated fat. According to Keys, meals included “great mounds of butter,” and it was not unusual to see “grown men down a couple of glasses of rich milk.” Keys also relates watching Finnish loggers take “slabs of cheese the size of slices of sandwich bread, smear them a quarter of an inch deep with butter and eat them with a beer as an after-sauna snack.”
Other studies conducted by Keys revealed that among patients with very high blood cholesterol levels, diets very low in fat produced dramatic drops in cholesterol levels within one week, and studies examining the effects of different types of fatty acids—saturated, monounsaturated, and polyunsaturated—on blood cholesterol levels revealed that saturated fatty acids tended to raise blood cholesterol levels the most.
It would seem, then, that the type of dietary fat, not just fat in general, is specifically related to the risk of developing coronary heart disease and other chronic diseases. Does this mean some fat is “good” and some fat is “bad”? That we should eat all of one and none of the other?
Actually, the fat issue is a complex one, and not simply a matter of “bad” and “good,” as the media often imply. For instance, just because the Cretans drowned their food in olive oil doesn’t mean we can do the same and remain slim with unclogged arteries. The residents of rural Crete had far more active lifestyles than most Americans today. Also, scientists now know that fat per se isn’t bad. On the contrary, fat is beneficial and even necessary to a healthy, fully functioning body. However, certain types of fat in differing proportions do apparently tend to be more or less beneficial to health.
Americans eat a lot of saturated fat, mostly from animal sources. The residents of Crete during the days of Ancel Keys’s research were eating almost all their fat from plant sources, namely olive oil. What’s the difference? While oil of any type is 100 percent fat and has the same number of calories as any other oil, each oil or fat type has a different composition—its own ratio of saturated to monounsaturated to polyunsaturated fatty acids. And the fatty acid makeup of an oil appears to make all the difference. The fatty acid composition in, say, a cheeseburger, is far different from the fatty acid composition of a calorie-equivalent portion of olive oil.
Let’s look back at Greece. According to Keys, at the time of his research, the general Greek population received approximately 20 percent of their calories from olive oil alone, with total fat intake ranging around 35 percent. (People living on the island of Crete had total fat intakes exceeding 40 percent of daily calories, again, mostly in the form of olive oil, as reported in the American Journal of Clinical Nutrition.) Keys describes the rural Greeks, who were accustomed to traditional eating habits and who couldn’t afford richer foods, as “remarkably healthy.”
The wealthier population of Athens, on the other hand, tended to eat food more inspired by the French school of cooking (more prevalent in non-Mediterranean, northern France), which is relatively heavy on butter and cream compared to olive oil. Although no study has proven a direct correlation between these varied diets in Greece and heart disease, Keys could not “help but mention” that Athens had no shortage of wealthy coronary heart disease patients. Keys’s observations significantly complicate the simplified message Americans have been accustomed to hearing over the past fifteen years or so: that fat is bad and we should eat less of it. Fat is not “bad.” We need fat to function. The trick is how to consume it in a way that maximizes our health and gives us the best possible protection against chronic diseases like coronary heart disease and cancer.