Welcome back!
Installment 3 of the Q&A series. As I’ve stated previously, this is by no means an exhaustive list of questions and answers but simply some one’s that I receive, have heard, or felt need to be addressed. Today is on dietary fat. Even above carbohydrates, dietary fat has some real misnomers with how people discuss the intake of and how it affects our bodies.
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On to the questions...
Will eating fat make me fat?
What the research tends to point to (regarding overeating) is that dietary fat will provide more weight gain and increased fat mass when compared to carbohydrates, referencing the study by McDevitt & colleagues. Dietary fat has 9 kcal per gram that’s eaten. This is important to remember because 20g of carbohydrates is NOT the same from a calorie perspective as dietary fat. Fat at 9kcal per gram is different from carbohydrates and protein, which have 4kcal per gram.
What I am saying though, and I believe wholeheartedly that the research backs this, is that it’s easier for the human body to store body fat than even overeating on pure carbohydrates. I thought an interesting review conducted in 2020 highlighted just this. A review simply looking at lowering the dietary fat content in one’s diet without intent on losing weight found that it resulted in a slight but significant amount over the long-term.
What’s the optimal fat intake?
For a lot of people, 0.5 g of fat per kilogram of body weight is a decent estimate of the lowest advisable daily fat intake. To find your weight in kg you can devide your weight by 2.2. Generally speaking, diets with pretty “typical” macronutrient distribution involve consuming 0.7–1.5g of fat per kilogram of body mass (or around 20–35% of energy intake from fat), with the rest of the calories coming from carbohydrates and protein. However, there is plenty of flexibility when it comes to balancing fat and carbohydrates in the diet. People who do a lot of high-intensity exercise may seek to consume over 6g/kg/day of carbohydrates, whereas people who prefer low-carb diets may seek to cap carbs at 10–30% or less of their energy, and some might even prefer a ketogenic approach that limits total carb intake to no more than 50–60 grams per day. Relative intakes of fat and carbohydrates should be determined based on your body composition, goals, exercise habits, dietary preferences, and total energy intake, with care taken to ensure that you have adequate amounts of protein in your diet as well.
What we’re really looking out for regarding dietary fat intake is the intake of saturated fat along with it. A recent systematic review, along with many other pieces of literature, continues to highlight the negative effects of increased saturated fat in the diet leading to an increased LDL cholesterol and insulin resistance. Increasing your intake of mono/poly-unsaturated fat in the diet appears to provide a beneficial effect, largely with an effect on blood pressure and elevated triglyceriedes
Is there any truth in my testosterone being affected by going low fat?
I personally had wondered this for quite a while. To sum this up quickly, the answer is no. A recent systematic review and meta analysis Whittaker & Wu, it looked into this idea. Separately, both a systematic review and meta analysis take large chunks of individual research over the years pertaining to one main idea and boil it down to give a trending consensus on the idea itself; what this research tells us overall. Six different studies ended up making the cut to be reviewed. The researchers set out to find short-term (2–10 week) interventions comparing low-fat diets (~19% of energy intake on average) to higher-fat diets (~39% of energy intake on average) with similar total calories. The analysis revealed that low-fat diets induced statistically significant reductions in total testosterone, free testosterone, dihydrotestosterone (DHT), and urinary testosterone, with non-significant reductions observed for luteinizing hormone and sex hormone binding globulin.
While this may seem like a one-way ticket to high-fat dieting for life, we have to take a closer look.
First and foremost, with any meta-analysis involving so few studies (in this case, well under 10), the findings should be used to generate hypotheses and a very tentative working understanding of the topic rather than firm conclusions. Based on the data available, it does seem that short-term (2–10 week) fat restriction (dropping fat intake from ~39% of energy to ~19% of energy) results in a statistically significant reduction in testosterone levels.
To explain this occurrence a little better, there have been multiple studies showing a reduction of testosterone values when limiting BOTH dietary fat and carbohydrate intake. In the end, it’s a result simply of decreased energy coming into the body. What do we know that helps natural testosterone production? Great sleep, a healthy diet (however you choose to implement that), and a solid exercise regime.
Annual blood work revealed elevated lipids across the board. What diet should I implement to lower these levels?
A piece I plan to publish in the next couple of months is going to be covering all the information regarding your annual blood work so definitely keep an eye out for that. Your annual exam is a very important part of your preventative health that is commonly completely covered by your insurance. Patient advocacy is important now, more than ever. Taking your health into your own hands regarding following up with your primary care provider if certain questions go unanswered or wanting to know the next steps in certain treatment should absolutely be the right of the patient. It’s important to note that these elevations in blood lipids do not happen overnight. Also, these findings could stem from two separate lines of pathology. One could certainly be the combination of diet & lifestyle, while another could be that of hereditary/genetic means which is diagnosed as familial hypercholesterolemia.
So you get your blood work back; Let’s say you’ve been diagnosed with dyslipidemia with elevations in Cholesterol (total), LDL, Triglycerides and a decreased value of HDL. What do you do next? It’s been pretty clear cut by now that reducing your intake of saturated fat lowers the level of serum cholesterol in the body which will in turn, reduce your risk for cardiac events later in life. A systematic review published in 2020 outlines this by saying those who benefit the most from this dietary implementation are those currently at-risk for cardiac events and those individuals would be someone in this scenario of revealing a pattern of dyslipidemia from bloodwork and also those with a family history of cardiac events. So if we’re reducing saturated fats, what does that look like, and what are we replacing it with? If anything…
Polyunsaturated Fat:
Habitual fat intake is closely related to lipid metabolism and cardiometabolic health but the TYPE of fat is what the big difference in outcomes stems from. Considerable research supports a reduction in cardiovascular disease risk with habitual dietary intake and high blood circulation of omega-3 polyunsaturated fatty acids (PUFAs). The primary source of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) is seafood, especially oily fish. Because of a potential hazard with an overconsumption of fish & seafood, risking heavy metal or mercury poisoning, adding in polyunsaturated fats from plants should also be implemented. α-linolenic acid (ALA) is what is derived from plants, another omega 3. Sources of plant based ALA can be found within flax, chia, and canola seeds which serve as a precursor to the synthesis of EPA & DHA in the human body
Fiber:
I’ll stop and get this out of the way. My absolute favorite part of discussing and counseling individuals about altering and improving their diet and nutrition revolves around increasing one’s fiber content. The benefits from fiber and far reaching. Reported benefits have been found in improving someone’s lipid profile, therefore mitigating cardiovascular risk, general weight loss, and even though we have much work to do regarding the full understanding of the digestive system and microbiome, there’s hardly any doubt that fiber can aid in helping out in that realm of health as well.
Introducing some fiber into your morning is one of the best ways to kickstart your new nutrition. There have seriously been a lot of studies looking into the beta-glucan content and mechanism of its lipid lowering effect. While beta glucans, a form of soluble fiber, cannot be digested, they do slow the passage of food through the intestines. Because of the delayed absorption of macronutrients, carbohydrates included, blood sugar levels are maintained longer with more stability. Furthermore, it travels slowly through the digestive system, bringing cholesterol with it. Beta glucans are most commonly found in oats which make for an excellent addition to your breakfast.
Protein:
Studies have shown a little bit of a back and forth regarding the increase in protein intake, and an improvement to lipid profiles. One of the reasons for this is simply because an increase in protein could very likely mean and increase in meat or dairy. Along with that could certainly come an increase in saturated fat, which I’ve discussed previously. An increase in protein absolutely does not have to mean this though. In a 2005 review looking into different studies on meat intake and heart health outcomes, an important note was made. The typical American diet in today’s world consists of frequent processed food and stops out to eat and through the drive-thru. These processed foods have been highly implicated in both increases in cardio-metabolic health and long term adverse events.