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Fats are a hot topic of debate in the health-conscious community, and recent reports have made it hard to separate facts from fear-mongering. Canola and coconut oils are two popular fats that have received a lot of attention over the years, and thankfully recent studies are showing us more clearly which fats to embrace, and which to avoid.

Understanding fats

To understand which fats are healthy, it’s helpful to understand “good” HDL and “bad” LDL cholesterol, small fat and protein packages that transport cholesterol throughout the body.

High-density lipoprotein (HDL) or “good” cholesterol helps protect your arteries from cholesterol and removes excess arterial plaque.

Low-density lipoprotein (LDL) or “bad” cholesterol can accumulate in the arteries to form plaque that narrows them and makes them less flexible (atherosclerosis).

Triglycerides. Elevated levels are linked to heart disease and diabetes. Risk factors include smoking, physical inactivity, excessive drinking, overweight, and a diet high in sugars and grains.

Particle size matters

HDL, LDL, and triglycerides come in small and large particles. While the large particles are practically harmless, the small, dense particles are more dangerous. They can lodge in arterial walls, leading to inflammation, plaque buildup, and damage that eventually leads to heart disease.

When considering test results, your doctor will note:

• HDL levels versus LDL levels
• Triglyceride levels
• The ratio between triglycerides to HDL
• The ratio between total cholesterol and HDL
• The size of the particles

Here’s where the former warnings about fats and cholesterol have been misleading: We now understand that more important than knowing your total cholesterol is knowing the ratio between your HDL and your LDL, and especially the size of the particles.

In addition, the Mayo Clinic says many doctors now believe that for predicting heart disease risk, total non-HDL may be more useful than calculating your cholesterol ratio. Non-HDL cholesterol is figured by subtracting your HDL cholesterol number from your total cholesterol number.

Finally, either option appears to be a better risk predictor than your total cholesterol level or simply your LDL level.

Note: In some cases, people have a genetic tendency toward extremely high cholesterol. In those situations, it may take more than diet to manage cholesterol levels.

Should I consume saturated fats?

Sourced from tropical oils and animal products, saturated fats are typically solid or semi-solid at room temperature. Common dietary sources include beef, pork, lamb, poultry skin, high-fat dairy, palm oil, and coconut oil.

Saturated fat sits at the forefront of the debate about dietary oils. Why? For years, we’ve been warned that it increases the risk for cardiovascular disease because it raises LDL, the “bad” type of cholesterol.

This recommendation was based on four hand-picked studies done nearly 40 years ago and doesn’t reflect recent studies that shine a different light on fat intake. What the studies didn’t do is take into consideration other things saturated fats do to help balance the equation:

• Raise HDL (“good”) cholesterol.
• Change LDL (“bad”) cholesterol from small, dense particles — dangerous for heart health — to large particle LDL, which does not increase heart disease risk.
• Support brain health.
• Possibly reduce stroke risk.

In fact, a recent meta-analysis of studies showed there is no significant evidence that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease.

For some people there are legitimate reasons to moderate saturated fat intake:

• Saturated fat intake can be associated with lighter, less restorative, more disruptive sleep (yet increased fiber can help increase sleep quality).
• ApoE4 carriers (increased Alzheimer’s risk) see a much higher spike in LDL cholesterol from high saturated fat in the diet, without a matching rise in HDL. They may benefit from lower intake of saturated fat which can lower LDL cholesterol and improve HDL/LDL ratio.
• A small percent of the population does experience a skyrocketing increase in LDL concentrations along with increased inflammation levels measured by C-reactive protein.

Ask my office about a diet that is sufficient in healthy fats, void of bad fats, and customized to your dietary needs.