Telling people not to eat saturated fat to protect their heart has been a "myth", a senior heart specialist claimed today.
Dr Aseem Malhotra of Croydon University Hospital in London, UK, wants to "bust" the myth, he said.
And, he claims, there is too much emphasis on cutting cholesterol levels.
But his claims were challenged by another senior heart specialist, who said the link between cholesterol and heart disease was "clear."
Dr Malhotra writes in the British Medical Journal that trans fats – found in many fast foods, bakery products and margarines – are widely accepted by scientists to raise the risk of cardiovascular disease through inflammation.
"But saturated fat is another story," he states. "The mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for almost four decades."
But Dr Malhotra argues that this advice has in fact raised the population’s heart risk since the 1970s, and that an "obsession" with total cholesterol levels has led to overuse of statins.
The advice to limit saturated fat may have lowered low density lipoprotein (LDL) cholesterol, he adds, but this appears to be limited to "type A" LDL particles, rather than the dangerous "type B" LDL particles.
In fact, saturated fat has been found to protect the heart, he writes, and the problem with processed meats is not their saturated fat but nitrates and sodium used as preservatives.
Furthermore, a low fat diet seems to lead to a drop in energy expenditure, unhealthy blood lipids, and increased insulin resistance, compared with a low carbohydrate diet, he said.
"This has caused a rise in obesity, driven largely by increased sugar intake, Dr Malhotra writes.
"It is time to bust the myth of the role of saturated fat in heart disease and wind back the harms of dietary advice that has contributed to obesity," he concludes.
But Professor Peter Weissberg, medical director of the British Heart Foundation, hit back
He said: “Studies on the link between diet and disease frequently produce conflicting results because, unlike drug trials, it’s very difficult to undertake a properly controlled, randomised study.
“However, people with highest cholesterol levels are at highest risk of a heart attack and it’s also clear that lowering cholesterol, by whatever means, lowers risk.
“Cholesterol levels can be influenced by many factors including diet, exercise and drugs, in particular statins. There is clear evidence that patients who have had a heart attack, or who are at high risk of having one, can benefit from taking a statin.
"But this needs to be combined with other essential measures, such as eating a balanced diet, not smoking and taking regular exercise.”
Malhotra, A. Observations: Saturated fat is not the major issue. The British Medical Journal 23 October 2013; doi: 10.1136/bmj.f6340 [abstract]
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