From the Back Cover of "EFAs in Health and Disease":

Myths about Saturated And Essential Fats

Myth	Eating foods without fat is healthy, because humans do not need fat. A "zero fat" diet is what we should strive for.
Fact	People require Essential Fatty Acids (EFAs). EFAs are a critical component of good nutrition because we cannot make them ourselves.
Myth	There is no kind of fat which is good for you.
Fact	EFAs are good for you. They help to prevent and treat high cholesterol, high blood pressure and cardiovascular disease.
Myth	Eating carbohydrates burns fat and helps in weight loss. We should eat carbohydrates instead of saturated fat.
Fact	All excess calories from carbohydrates are converted by the body into saturated and monounsaturated fat. Thus, a diet with excess calories from carbohydrates is just as harmful as a diet high in saturated fat. It may be healthier to eat pizza made with oils high in EFAs than low fat foods such as breads, cereals, and pasta.
Myth	Very low fat diets can be used safely to lose weight.
Fact	Very low fat diets can cause EFA depletion and EFA deficiency.
Myth	The USDA-recommended diet prevents heart disease.
Fact	Most processed foods such as pasta, bread, and cereals, placed by the USDA at the base of their pyramid (to be eaten in the largest amounts), have virtually no EFAs. The USDA claims that fats and oils "provide calories and little else nutritionally". Most adult Americans have insufficient levels of EFAs in their bodies and should eat more EFAs. By failing to emphasize the role of EFAs in good health, the USDA diet causes more heart disease than it prevents.
Myth	Eating low-cholesterol foods lowers your cholesterol.
Fact	The cholesterol content of food has little impact on cholesterol levels. Rather, it is excess saturated fat and calories which cause your body to make more cholesterol.

From the Inside Flap:

Boston University Medical Center Press Release

Characterizing their study as the critical "missing link" in understanding the role of fat in heart disease, a team of Boston University Medical Center (BUMC) researchers has reported in the August issue of the journal Metabolism that insufficient levels of EFAs are a key risk factor for coronary artery disease (CAD).

This finding, researchers say, indicates that the current clinical emphasis on restricting saturated fat and cholesterol in the diet to reduce the risk of CAD is misplaced. The researchers propose that EFAs, which regulate the balance of saturated fats in cells and blood cholesterol, are the most important for reducing the risk of CAD.

"The amounts of dietary saturated and monounsaturated fats and cholesterol are not as important as achieving optimal levels of EFAs," says Edward Siguel, MD, PhD, co-principal investigator of the study, and a senior scientist at BUMC. "Sufficient levels of EFAs," he says, "will help to regulate the correct balance of saturated fats and cholesterol in cells."

In the 1960s, researchers suspected that a deficiency of EFAs was the most important risk factor for CAD, but they were unable to identify biochemical evidence of EFA deficiency in CAD patients. With millions of people in the U.S. having heart disease, the thinking went, EFA abnormalities should have been found easily when they existed. But for more than 20 years, researchers did not detect the biochemical evidence.

Reflecting this state of science, the 1988 Surgeon General's report stated that EFA deficiency is practically non-existent in the United States. As a result, US nutritional policy has focused on diets low in saturated fat and cholesterol and on drugs to lower cholesterol.

Now, however, using a new and highly sensitive biochemical test, Siguel and co-principal investigator Robert Lerman, MD, PhD, have found evidence of EFA deficiency in patients with CAD, what they call the "missing link in the nutrition-heart disease hypothesis." Identifying this deficiency should lead to fundamental changes in clinical care and nutrition policy, the researchers say.

EFAs, along with saturated and monounsaturated fatty acids, are the principal components of fats. The balance of these three types of fatty acids plays a key role in determining the consistency of the cells lining the arteries supplying blood to the heart.

Experts agree that maintaining the proper consistency of the cell walls is a crucial factor for avoiding hardening of the arteries, or atherosclerosis, which causes CAD. However, they have disagreed about the role each type of fatty acid plays in the body and how imbalances should be corrected.

Given their findings, the BUMC researchers say, it's imperative that essential fatty acid levels be taken into account in the diagnosis and treatment of patients with CAD. Moreover, they call for an overhaul of the US Public Health Service and USDA guidelines for a healthy diet, in order to emphasize the importance of eating foods with substantial amounts of EFAs in them.

EFAs are the only fatty acids that the body does not manufacture on its own and that must therefore be consumed in foods. The body can synthesize the other major types of fatty acids- monounsaturated and saturated fatty acids- from proteins and carbohydrates, what people eat.

The USDA guidelines currently advocate a low-fat diet, as represented by the "food pyramid" The guidelines are to obtain the bulk of calories from pasta and grains, which contain few, if any, EFAs, and to use fats and oils sparingly.

"Unfortunately," explains Siguel, "EFAs are difficult to obtain from processed foods, as food manufacturers generally remove EFAs from plant products because they shorten their shelf life."

"When viewed in light of our findings, the USDA recommendations are misleading," says Siguel. "A low fat diet is counterproductive if it is low in EFAs. Foods containing saturated fat and EFAs, such as tofu and some types of pizza, are to be preferred to foods high in carbohydrates and low in saturated fat and EFAs, such as processed breads, cereals, and pasta."

Instead of eating foods low in fat and cholesterol, people should strive to reach their ideal weight and to achieve an optimal balance of EFAs, says Siguel. He points out that excess calories-from any source-are stored as saturated fat. Thus, it is calories, rather than dietary intake of fat and cholesterol, that controls levels of saturated fat in the body.

"Avoiding cholesterol and saturated fats in the diet and replacing those calories with carbohydrates will not decrease blood levels of saturated fat and cholesterol," Siguel says. "The body simply makes more cholesterol and saturated fat from carbohydrates. Eating more EFAs increases the body levels of EFAs, because EFAs are an essential nutrient that the body cannot make."

Ideally, says Siguel, people should eat natural, unprocessed foods that are low in fat, low in cholesterol, and high in EFAs. The foods should also provide fiber, vitamins, and minerals.

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© 1998 Edward Siguel. All rights reserved	modified 9/14/98