← The Dr. Gabrielle Lyon Show
The Dr. Gabrielle Lyon Show
The Truth about Saturated Fat, Omega-3 Fatty Acids and Total Mortality | Dr. Tom Brenna
01:31:33
Loading summary
Transcript295 lines
- [00:00]
A
If you start substituting high Omega 6 oils for your dairy fat, that's when things really go off the rails. When you feed those oils to pregnant animals, you can look in the brains of the offspring and they are screwed up.
- [00:16]
B
I mean, I've never heard that as a technical term. So is it a mistake for pregnant women to avoid fish?
- [00:26]
A
Absolutely a mistake. No doubt. 100%. People that eat the most fish in the world do not have kids who are mentally challenged. They just don't. I always invoke iodine deficiency, so you see nothing like that. The kids just get smarter.
- [00:42]
B
Is pregnancy that one time to build the brain versus post pregnancy into childhood
- [00:48]
A
breastfeeding is so important. Kids are getting omega 3, they're getting DHA in breast milk. We are not just the heart, we have lots of other organs. The most important of which in my opinion, is the brain.
- [01:03]
B
Omega 3 fatty acids, DHA are necessary. Amazing. For brain development. Important for pregnant women. Is there something else also on the horizon? You're thinking this hasn't been developed enough and it's going to come out.
- [01:18]
A
The story of precision nutrition is an undertold story. It is one that.
- [01:35]
B
Most people assume nutrition advice is cautious for a reason. That if something is warned against, it must be dangerous. But what if the opposite was true? What if one of the biggest nutrition warnings of the last few decades didn't protect people at all, but quietly removed something the developing brain depends on? For years, pregnant women were told to be careful with fish. Many, including myself, stopped eating it altogether. And almost no one asked what was being taken away. My guest today is Dr. Tom Brenna, a scientist who has spent decades studying brain fats, pregnancy, nutrition and the real population data behind national dietary guidelines. His work forces an uncomfortable conversation. How do well intentioned warnings turn into long term nutritional gaps? What happens when fear drives policy instead of evidence? And how many people are living with the downstream effects without ever knowing why? This conversation isn't about food trends. It's about how guidance meant to keep people safe can quietly shape brain development, attention and cognitive health for, you guessed it, an entire generation. Welcome to the show.
- [02:56]
A
Well, thank you, Gabrielle. Thanks for having me.
- [02:59]
B
Like I said before, I'm a huge fan, which makes me a little nerdy, but I am a huge fan. And you and I met in D.C. at the HHS building where they were about to announce the new dietary guidelines, right? And there you were. And what was so interesting is each one of you, there's nine of you on this committee, each one of you had your own specialty Should I say.
- [03:26]
A
Yeah, that's right. We each worked on a rather narrow section of the. Well, the concepts that were being considered.
- [03:35]
B
And you worked on the 2015. So your 2015 and the these last 2020, I guess it would be considered 2026.
- [03:44]
A
This is as well. Yeah, it's 2025. 2030. I was also an advisor to 2010.
- [03:48]
B
Okay, so you've got a lot of.
- [03:51]
A
I'm kind of a rut.
- [03:53]
B
So you've been doing this for a long time. And as one of the nine people there, I just want to get a sense of there's a lot of noise on the Internet about all of what transpired. And frankly, I just want to say one thing. I think you guys did a great job. I think that. And when I say you guys did a great job, I know that there is a different interpretation of the outcome of what you guys provided. But the questions that you asked and the answers provided I think were exceptional. And it is also available for people to read where you guys got your science and how that was all developed. Is that fair to say?
- [04:32]
A
That's right. Everything we did really is posted and publicly available. So if you really want to dig into it, it's all there.
- [04:42]
B
Now I want to read something that I was quite surprised to see. One of the things that I've learned from you and others on the committee is that there is not necessarily a rhyme or reason in that every five years there's no unifying process behind how the questions are asked and what is answered. When we are at the hhs, it's very exciting. I got a hold of sign of a stake. They did pick that for me. The American Society for Nutrition, which is one of the most well respected societies and it really focuses on excellence in nutrition research, published a commentary. The title is this is news from the American Society for Nutrition which anyone can look up which will link RJ we can link to the bottom of this is American Society for Nutrition calls for strong science in national nutrition guidance. I want to read one more thing. Again. I was surprised at that statement. Then reading this says the following. The American Society for Nutrition supports ASN supports the broad eating pattern in the newly released Dietary Guidelines for Americans which are the DGAs that emphasizes minimally processed nutrient dense foods and limits added sugar, sodium and saturated fat which are linked to an improved long term health outcomes. Dietary approaches that focus on whole foods and reduce reliance on highly processed foods and sugar sweetened beverages have demonstrated health benefits. That was a very nice statement. At the same time, ASN is Concerned that departing from the established scientific review process undermines confidence in the DGAs and nutrition science, contributes to confusion and distrust, and obscures the opportunity for meaningful scientific discourse.
- [06:39]
A
Well, I was a little bit surprised by that, too. There were several specifics that were leveled in terms of criticisms. One was questions about how folks were chosen. Well, there were nine of us and two of us had been on previous dietary guidelines, so we were chosen by normal methods, whatever normal really means. And as you've already alluded to, normal is different every five years. There is also a behind the scenes period for every one of these dietary guidelines. So when the report comes out from the Dietary Guidelines advisory committee, the 15 or 20 scientists that get together and issue a report, that report goes to either FDA or usda, depending on who's the lead agency that year, and they seek input, but ultimately draft the Dietary Guidelines for Americans. Behind the scenes, I did not see the process this time as deviating as much as perhaps other people did. We did not draft the Dietary Guidelines for Americans. We did a very limited, circumscribed job. And what we did is sitting online. And so I didn't dream up the upside down pyramid. For instance, I have to say that I only learned of what was going to be in the Dietary Guidelines for Americans just a couple of weeks before they were released. And I didn't even learn 100%. We only saw a draft. And we were quite happy with the draft, to be perfectly honest, but we weren't asked to modify it. I mean, people make comments. So I just don't think that it's that different than it ever was.
- [08:39]
B
And again, there was a lot of noise around it. And the outcome, which I think is really moving in a positive direction, which is, again, changing the protein guidelines. That's major. It's first time, I mean, that that's ever happened. And they brought you on. So your background is you're a professor emeritus from Cornell. You did nutritional sciences, then you went into basic science and chemistry. You were lead scientist at IBM.
- [09:10]
A
I was a scientist at IBM before I went to Cornell.
- [09:13]
B
Pretty extraordinary. And you've published quite a bit and really have made some great contributions beyond the Dietary Guidelines, but in meaningful ways, through infant nutrition, childhood nutrition, pregnancy. We're going to come back to that. But that is perhaps one reason why you were chosen to answer the question or address saturated fat. Can you highlight potentially maybe frame up the difference between and you've been involved. Is it fair to say three dietary guidelines?
- [09:47]
A
Yeah, I think that's fair, yeah. Three is good. Three of the last four.
- [09:50]
B
That's pretty great. What is that? Three? That's three fourths. Three out of four. 75%.
- [09:56]
A
Yeah.
- [09:57]
B
I'm really not very good. Not very good at math. But anyway, besides the point. So as we just frame this up, so there's the outcome, which I want to know how you guys, how the questions were asked and the literature that was examined. But just briefly, how did that transition from the first time that you did it to the second time to the third time in terms of questions and just your task at hand?
- [10:22]
A
Well, in 2010, I advised the committee on fatty acids, and specifically omega 3 fatty acids. That's what they asked me to talk about in 2015, the theme Transition to what is known as dietary patterns. And so Nutrans took kind of a backseat and sort of overall, I mean, is it a diet? Is it a dietary pattern? There is a technical definition that's relevant, but the point is the overall diet was what people were looking at this time. The DGAC looked at a variety of things. Dietary patterns was part of it. There was equity involved and food equity and that kind of stuff. But in this particular case, we were very specifically asked to advise on very circumscribed things. So saturated fat is what I worked on. I didn't work on protein. I didn't work on sugar. I just worked on saturated fat. And we were given a task, and we accomplished a task, and we handed things in, and then we found out what they did with it, to be perfectly honest. Now, how are we chosen? You're about to ask me that. And the answer is each one of us had published on these things, but it sort of makes sense to bring people in, have been working on a topic rather than folks that have not been working on a topic. And so my work, I think, in this area was pretty well known or pretty well knowable. And I think that's how I ended up being asked.
- [12:09]
B
And the primary. Can you frame up a little bit about the history of the dietary guidelines from the saturated fat perspective?
- [12:16]
A
Oh, my. So saturated fat is. Let's see. I feel a lecture coming on.
- [12:23]
B
Oh, I'm so excited.
- [12:24]
A
I've been waiting for two days for this saturated. Oh, boy. You encourage me. The saturated fat story, best I can tell, may date into the 1800s. 1870 is where I would start. And so the story of saturated fat versus vegetable oils really reaches back into the period before 1900, I would say. And it's always been this competition for what we're going to spread on Our bread. And it's going to be butter or it's going to be what was called oleomargarine. And it was. I'll Skip forward to 1902, when a technique for making oils into solids was developed. And that's partial hydrogenation. So that's where the trans fats come from.
- [13:24]
B
Is that like Crisco?
- [13:26]
A
Indeed. Do you know where the name Crisco comes from?
- [13:31]
B
No, but I will say my mom used to make blonde brownies with Crisco every. Probably every month.
- [13:36]
A
Crisco made the most beautiful baked stuff. The best bakers in the 20th century used Crisco. Crisco was introduced around 1914, and it got its name from the material it was derived from in the process. So there was a lot of cottonseed oil around at the time. And when that cottonseed oil is partially hydrogenated, it assumes some crystalline properties. And so they picked out crystalline cottonseed oil. Crisco. That's where the name came from.
- [14:17]
B
You would be great on trivia or Jeopardy.
- [14:20]
A
If the category is edible oils. I'll be great. Yep.
- [14:25]
B
Just. Hey, just throwing that out there, guys.
- [14:27]
A
Okay. Yes, Terrific. I don't know what I'm going to do with the other ones.
- [14:31]
B
Fine.
- [14:31]
A
All right.
- [14:32]
B
No one said you had to win
- [14:34]
A
mass spectrometry for the double jeopardy.
- [14:36]
B
Yeah, definitely no one.
- [14:36]
A
You're definitely so and so. Crisco was really a tasty, nice product, and no one really understood the concept that it's going to maybe cause heart disease in a whole bunch of years.
- [14:51]
B
Was it utilized to limit, say, if something was very perishable, like butter or something like that?
- [14:59]
A
Well, what you have is what. It's an old story in the food industry, and not a bad story, that when you extract something from an edible food, butter is one thing. There's butter and there's buttermilk. So you have butter and so there's things that are left over. Well, do you throw it in the river or do you try to make something out of it? So this is oil, cottonseed oil. And the question you might ask is, can we make something edible out it? Can we use something. And I also want to. It also makes. It's a point I make a lot. Having inexpensive food is not a bad thing. It's a good thing. And we don't want to sort of price food out of the reach of folks that don't have a big budget. So now that's what was going on in the United States. What was going on in Europe is actually much more Remarkable, which is that they were partially hydrogenating whale oil from about the 1930s, probably from before that to the 1960s. Much of the whaling that was done depleting and basically wiping out the whales from the southern oceans was to generate whale oil that went into margarine and as partially hydrogenated whale oil. When we cleaned out the whales from the Southern Ocean, we then transitioned over to fish oils. Those are various kinds of fish from various fisheries around the world. Partially hydrogenated fish oil became what the Europeans and others were using in their margarines. There is a nice video on the web, on YouTube from about 1942, which is kind of like almost an archaeologist. How's it made? And it's the making of margarine. And they show the various oils that go in. And one of them has a big sign on it that says hardened whale oil.
- [17:06]
B
Wow.
- [17:06]
A
Right. So people don't talk about that now. Why is that important for us here in 2026? The reason it's important is because the studies that have been invoked that are said to be studies of saturated fat come from that era. When people say that they're about saturated fat, the answer is. Well, not exactly. Some of the most prominent studies were done in Europe in the 1960s and 70s. One of my favorites actually says it estimates 40 to 50 grams per day of hardened marine oils were in the diet of the control group. So you take out this partially hydrogenated. I say partially hydrogenated. I really should say. That's what we call trans. We say trans fat. Now, if you think trans fat from vegetable oil is bad, wait till you see trans fat from fish oil. I've analyzed it years ago. You can't get your hands on it anymore. But I analyzed it years ago. You can't imagine it looks like. When you look at the chemical analysis, it looks like the Alps instead of had nice peaks that tell you what each fatty acid is. There just is a mess in these things. And so that is what people are calling saturated fat. And all the studies do it. Every one of them.
- [18:37]
B
Wait, so that seems like a major mistake.
- [18:41]
A
Yes.
- [18:42]
B
Thank you to Manicora for sponsoring today's episode. Winter means more time indoors, more travel, and if you have kids, a new bug cough or sneeze every other day. I like keeping my routine simple. And manicura has become something I reach for almost every morning. And why do I love it? It is rich and creamy. It tastes delicious. I either take it right from the spoon or I use these little packs. It coats my throat. Tastes amazing. Now, what makes Manicora special is where it comes from. Their beekeepers work in this remote forest of New Zealand where the bees collect nectar from the Manuka tea tree. Yeah. So cool. And this plant is naturally rich in bioactive ingredients. So basically the honey that you have ends up with three times more antioxidants and prebiotics than regular honey. And because it contains mgo, which is a rare antibacterial compound, Manuka honey has benefits that you don't get from other honeys. And all you need is one teaspoon to get the most out of these amazing bioactive ingredients in Manuka honey. And now it's easier than ever to try Manicura honey. Head to manicora.com doctorlion to save up to 31% plus $25 worth of this free starter kit, which is amazing. I have one. It comes with this massive J power of manuka honey that is go to m a n U-K-O-R-A.com drlion and save 31% plus $25 worth of free gifts. Basically, we are hearing an exponential amount of noise and concern regarding seed oils, vegetable oils, quote, animal fat, saturated fat. So there's the animal fats again. People have been very concerned about this for a long time and they group that into saturated fat. And then there's the hydrogenated fat, seed oils, which are also within the fair to say saturated fat.
- [20:54]
A
I'm going to call them trans. They're hydrogenated. They're trans. Partially hydrogenated is trans.
- [20:59]
B
Partially hydrogenated. Trans. But that does not fall under the category of saturated fat. Right.
- [21:04]
A
Some of it's saturated, more of it saturated than was in the original product. But mostly what you're concerned about is these weird isomers that are made.
- [21:14]
B
And the reason I frame this up is because again, the conversation talks about saturated fat and then insinuates that all of these things are saturated fat. Is that.
- [21:23]
A
That is correct. They say it's saturated fat and it's not.
- [21:26]
B
And it's not saturated fat. So in the 60s they started hydrogenating trans.
- [21:34]
A
Oh, they were doing it in the 30s.
- [21:36]
B
Okay. And this fat was way more dangerous.
- [21:39]
A
We know that now. And the other thing is that we spend most of our time talking about cardiovascular disease, but we're more than just the heart, there's a lot more stuff. So for instance, what we learned later is that those weird looking fatty acids that do not appear in nature to any degree when we eat those things, they go into the brain, they go into the retina, and that's terrible. Yes, it is. And that was what was going on back then. Now, if you.
- [22:12]
B
Are they illegal now?
- [22:14]
A
Yes. And they've been illegal for a long time, but. A long time. Decades. So I don't like to do this as a good guy, bad guy thing because in the war years, I wasn't there. But in the war, great firms.
- [22:32]
B
How old would that make you?
- [22:37]
A
One of the nice things I like about the omega 3 field is that the scientists live into their 90s. That's how I really think it works. But anyway, stuff started in the war years. There was not a lot of food around, and you had fish oil, whale oil, and if you could hydrogenate it, you could feed the population. And this is what they were doing in the uk. In Europe, they had two world wars to worry about. So the question that you could ask yourself even today is, do I want to risk a heart attack in 30 years or starve in three months?
- [23:15]
B
That's really good. I've never actually thought about it that way, and I don't think that people have. So sorry to interrupt you. I love the old rationing videos. Have you ever seen that? You. You sure? I mean, we are like, we're real nerds now. Like, we've just exposed ourselves. There are a ton of videos on World War II rationing. And the reason I was very interested in is the protein recommendations were actually higher. They were. It was. The soldiers were getting a pound of meat. It was. It wasn't necessarily calorie restricted, even on the home front at the same time as these victory gardens. And sorry to interrupt you, but from what I understand is that they had to make this food. There had to be food.
- [24:05]
A
I'm told in the UK during World War II that everybody got fish. And that kind of stopped after the war ended. So they were probably better nourished during the war than after the war.
- [24:18]
B
And your statement that. Which again, I have never heard anyone say that, See, I knew I was excited for a reason, is that we didn't think about the idea that there would be a starvation problem and then making foods less perishable because obviously canning and all that stuff happened. But it wasn't about the next 30 years. It was about how to survive.
- [24:41]
A
Indeed, that's the case. It's war.
- [24:43]
B
Okay?
- [24:44]
A
So. And the ships were being blown up in the Atlantic, and you can't get food in, but you have this thing that you might be able to eat. If you can treat it somehow, then you can feed the population.
- [24:53]
B
And somehow that they didn't know it was dangerous. At the time, that's fair to say. And then that trans fat made it into the general American diet. Is that kind of what happened?
- [25:06]
A
That's kind of what happened, yeah. Because you start out saying in Europe it was whale oil and fish oil, but in the US it would have been partially hydrogenated vegetable oil. Call it trans. That's what we call it these days, trans. So it would have been trans fat. And so the trans fats, that would have been less expensive. And so if you say, well, if we don't know if there's anything wrong with it, it's not toxic, it tastes good, it makes wonderful pie crust.
- [25:41]
B
Here I am telling, from a friend,
- [25:43]
A
I am extolling the culinary virtues of Crisco, the original stuff with trans fat hair. But do you know that it really is not a great thing for your health? I'll make one other point. We talk about these things like the world is a static place, like there's no other background. Those of us of a certain age remember when people were smoking two to four packs a day. Almost everybody in the 60s and 70s knew somebody who was a chain smoker, lights one cigarette with the last one. And so think about what smoking is now known to do. And I scratch my head and I think, well, if I smoke four packs a day, maybe hydrogenated fat, who cares? Just making the point that it's a different world now and the risks are different. So getting rid of smoking probably unmasked some risks because smoking was certain. It was not that unusual for people to have, particularly men to have heart attacks in their 40s and 50s.
- [26:56]
B
So what you're saying is we, if I'm understanding you correctly, is that we created these dietary guidelines of again, 10% saturated fat. Hasn't that. That's been maintained since what, 1980?
- [27:07]
A
Probably, but that's probably 90 at least. But, but the number is basically picked out of a hat. There isn't, there isn't some curve that somebody has made said, ah, there's a threshold. So, so the, the last I looked at, which are not terrific numbers, it's ask people what they eat and see what they say.
- [27:25]
B
What'd you eat yesterday? I don't remember. Remember exactly.
- [27:29]
A
Something. Yeah.
- [27:31]
B
Anyway, this is the problem with food frequency questionnaires is that I don't know. Rj, What'd you eat? Rj you probably don't even know that you had protein waffle pancakes.
- [27:40]
A
Well, a food frequency questionnaire asks you how many times you ate it in the last month. And a large fraction of people claim that they've eaten under 600 calories, which means they would be dead. So, yeah, anyway, so the rationale of
- [28:00]
B
the 10%, the rationale from the 10% based on cardiovascular disease risk reduction from
- [28:06]
A
partially hydrogenated whale oil.
- [28:09]
B
That seems like a problem.
- [28:10]
A
I think it's a problem too. And I really wish the ASN would look very carefully at the studies, as some of us have, and would really look carefully at what's saturated fat and what isn't. I actually don't think there is a lot of data on saturated fat. I don't think there is a lot of clean data on it. There is data on dairy. And over the years the word saturated fat have been a code word for dairy. So you say, well, saturated fat. And then people say, oh, what's saturated fat in, ah, butter. Well, okay, yes, that's true. You've just figured that out, but that's where they were leading you when they said saturated fat. So. But what are the original data? People have looked at dairy and you don't see a great deal of. You just don't see risk here.
- [29:02]
B
So as we frame up this new dietary guidelines, again, the 10% saturated fat has not changed since.
- [29:10]
A
Actually, I have something else for you.
- [29:11]
B
Oh, great.
- [29:12]
A
Yes, Layout. Okay, terrific. Let's see. It's an act that was passed unanimously in Congress and signed into law in January of this year. Of this year. It's something like the Whole Milk School Lunch Act, Something like that. That act authorizes the use of full fat dairy in the schools. And it has a wonderful little line at the end. It says, saturated fat in whole fat milk shall not be counted towards the 10%. In other words, Washington has taken saturated fat off budget. They do that sometimes with the budget over the years. And what they basically said is the school lunch won't count that well, all of a sudden there is no cap in school lunch, is there?
- [30:18]
B
Wait, so explain this to me differently so I understand. So saturated fat is at 10% for the dietary guideline.
- [30:29]
A
Yes, that's right.
- [30:30]
B
Okay. And then when it comes to clusters or groups or schools, then the whole milk, saturated fat doesn't count in the school lunch program. In the school lunch.
- [30:41]
A
So that's saturated fat that comes in as whole milk could be flavored, but it comes in at whole milk. It doesn't count towards the 10%. So you can have 10% in everything else. And then as long as you're drinking milk, you can go any number you want.
- [30:56]
B
Explain to me how that works. Like, is that.
- [31:00]
A
So I have a hamburger, but I
- [31:02]
B
mean, like, is that a good thing that it doesn't count? Is it sending confusing messages?
- [31:07]
A
I'm making the point that the 10%
- [31:11]
B
is a made up number.
- [31:12]
A
May have. Well, it is a made up number, but it may have been maintained. But it hasn't really been maintained everywhere. They've gotten around it in school lunch.
- [31:20]
B
I see.
- [31:21]
A
That's the point I'm making. I am pretty sure they didn't want to keep it. But the act that was signed by the President in January, I think it was around January 14th. The act that was signed by the President passed the Congress by unanimous consent. Everybody voted for it, Nobody voted against it, Not a single person. So when is saturated fat not saturated fat? When it comes in as whole milk in the school lunch program.
- [31:53]
B
So if you're thinking about. And here's the definition of saturated fat. Saturated fat is a fat found in animal products. Now this is. Let's just go here for a second. Like fatty meats, beef, lamb, pork and full fat dairy, as well as tropical oils and many processed baked goods, pastries, fried foods. I'm going to pause there. It also says it is typically solid at room temperature and should be limited in the diet. Okay, let's just pause. Saturated fat is a type of fat found in animal products like fatty meats. But from my understanding and from looking at the data, almost 50% of the fat in say, fatty meat like beef is monounsaturated.
- [32:31]
A
There's a lot of monounsaturated in there. Yes, that's right.
- [32:34]
B
So now if we're thinking about science, and this is the whole idea, is that we're trying to make the best decisions we can. This is information that I am reading. And then it's saying that it increases the risk of heart disease and that we should recommend replacing saturated fat with unsaturated fat from olive oil, nuts and avocados. Then quickly underneath that, there's the American Heart association that says limit saturated fat to less than 6% of total calories. This is 2024. How do we reconcile all this? Wow.
- [33:11]
A
How much time you have?
- [33:13]
B
At least two hours.
- [33:16]
A
Well, may I ask who said that?
- [33:19]
B
Which one?
- [33:20]
A
All of it.
- [33:20]
B
Okay, well, the first one comes up with a Google. And this is. I did this actually on purpose. So this is what a person who is looking on the Internet. So this is, put it in Google, use AI Mode. AI Mode says and gives this information. And this comes from. This is a university. I don't know if I'm going to say it.
- [33:45]
A
And then also the American Yeah, that's all fine. I just.
- [33:48]
B
And also I want to say one more thing which I forgot to say in the beginning. All of your comments and opinions, they are all your own. They are not associated with any university, they're not associated with any government agency or hhs. So I'm going to.
- [34:00]
A
Everything I say is my opinion. That's right. Thank you very much for that anyway. Yes, that's correct. So I see what you did there. What you said is, well, I'm going to Google it and see what comes up. And here are all this stuff that's really confusing. I would agree it's confusing and it is contradictory. If it's contradictory, I can't really explain it. I can only tell you what I think is right, which is where we're going. So I think the 10% limit is not justified. I've said that before. I think the 10% limit chases us away from highly nutrient dense foods and actually causes nutrients of concern.
- [34:41]
B
Give me an example of what this would be. Would that be zinc, selenium, B12?
- [34:45]
A
Bingo. All that stuff. And we, we know that we can recover much of that by dairy, for instance. But if you're scared of cheese and milk and things like that, then you're going to stay away from it because you think it's going to give you heart disease. One of the things that really bugs me about this, and I would query more in that Google inquiry, is to get away from the cardiovascular story. Because when we look carefully at whether saturated fat defined. However you like, I was going to
- [35:25]
B
ask you to define. Okay.
- [35:28]
A
When we look at that in terms of total mortality, you don't see effects. If you don't see effects, why are we focusing on cardiovascular?
- [35:36]
B
Thank you to Timeline for sponsoring this episode. If you're a frequent listener to the show, you know I believe that muscle is the organ of longevity. It regulates metabolism, protects independence and supports long term health. But muscle health, surprisingly, isn't just about protein and resistance training. It also depends on mitochondrial health, the energy producing engines inside your muscle cells. And as we age, mitochondrial function declines, which affects strength recovery and of course, metabolic health. One of the ways the body maintains mitochondrial health is through mitophagy, the process of clearing out damaged mitochondria and renewing healthier ones. Timeline's Mitopure contains Urlithin A, backed by over 18 years of research and multiple placebo controlled human trials. Supporting, get this, mitochondrial health. This isn't a stimulant or a quick energy boost. It works at the cellular level. Supporting mitochondrial Renewal which over time may help improve muscle function and recovery. If muscle is the organ of longevity supporting the engine inside that muscle matters. Go to timeline.comdrlion to get 35% off off a mitopure subscription. Let's go a little bit deeper because you've set a statement. I don't want to gloss over it. Everything. Most statements out there regarding saturated fat are related to heart disease, correct? The American Heart association again I am on now. I've switched to a search engine that I use called open Evidence. I have no relationship with them, but this is. You have to have a medical license to be able to look at this. This scours for you can put in criteria but it's typically journals. It's the New England Journal of Medicine. It's all academic journal of the American College of Cardiology, British Journal of Sports Medicine. So there are all these journals which will then provide you with synthesized information. Every single thing here points to the connection between saturated fat and heart disease. The concerning component is we are making broad generalizations that affect our children, affect prisons, affect nursing homes, affect anyone that receives federal funding, and even more importantly, affect day to day decisions of moms like me. What is the truth? No small task. What is the truth on saturated fat? So the American diet right now, to the best of our knowledge, is 11% saturated fat. What? In the 80s it was 15% saturated fat.
- [38:35]
A
Well, once again, if you count trans fat, which you shouldn't, but if you do, then maybe those numbers are right from the, from the early days. The point I am really making is that the evidence for saturated fat being related to heart disease is actually so messed up and conflated with trans fat that it's impossible to separate. But if you look carefully at foods that are high in saturated fat, you find out that those relationships are just not there. So I don't think the 10% makes any sense at all. I don't think it's justified. And when folks talk about this, they gloss over that there's trans fat all over the place in these studies that they're citing. Okay, so let's see. I also want to bring it back to the idea that we are not just the heart. We have lots of other organs. The most important of which in my opinion is the brain.
- [39:52]
B
Mine is muscle and my husband who's in urology is something else.
- [39:59]
A
I can probably find common ground with your husband. I'm sure I can find common ground with muscle too. But the thing about. Well, think about reproductive organs and the brain. They have a lot in Common actually, Omega 3 is a big deal.
- [40:17]
B
Before I move on, I just want to read something to you, okay? Because you're going to find this very exciting. So this is open evidence. And now this is from the Cochrane Database of systematic reviews 2020. And I asked, open evidence, what is the evidence of saturated fat and heart disease?
- [40:34]
A
Okay.
- [40:34]
B
And it said reducing saturated fat and replacing it with polyunsaturated fat reduces Cardiovascular events by 17 to 30% with effects comparable to statin therapy. Why am I hammering this one? I'm annoying and I'm sorry. And number two, this is the information that providers clinicians are being given to then go out and put, quote, best practices in place. So I just, I want to say that, and to be fair, I'll read the next statement. So the first statement. 17 to 30% reduction comparable to statin therapy by reducing your saturated fat intake. However, this blows my mind. However, the evidence shows little to no effect on all cause, mortality or cardiovascular mortality. And the benefit vary, varies substantially based on baseline cardiovascular risk. What are they? Like what? What?
- [41:38]
A
Well, well, you just got. You just said it's related to cardiovascular events but not to mortality. Is that what I get? Did I get that right?
- [41:49]
B
Yeah.
- [41:49]
A
Okay, so one of the things folks
- [41:53]
B
notice comparable to statin therapy.
- [41:55]
A
Okay, fine. One of the things that folks notice is that when you talk about mortality, you have a very clean outcome because almost everybody can count bodies. However, when you assign events, you have to do a diagnosis. So is it a heart attack or is indigestion a really bad case? And so it doesn't make a lot of sense that there are more events than there is death.
- [42:26]
B
I'm with you.
- [42:27]
A
And that is almost a smoking gun for there being biased. Now I have another point that's very, very important and that relates to what we just did on dietary guidelines. We talked about randomized trials as giving us the chance of identifying causal effects, as opposed to prospective cohort trials which ask people what they eat at one time and then see how many people get sick later. That's just a natural observational thing. But a randomized trial is only a truth teller if it is double blinded, or as I prefer the way the ophthalmologists call it, double masked. None of these trials are the least bit blinded from the 20th century. They're not blinded. Everybody knows what group they're in. Everybody knows whether they are consuming the control or they're consuming vegetable oil or whatever it happens to be. You can design trials like that. And I have recently published a trial that's designed in such a way so that people didn't know what they were eating. But it is not easy and it is not cheap. And so people, most of those studies, they left people on their normal diets. They said, okay, you just eat whatever you're normally eating, which happens to be 50 grams of hydrogenated marine oil. And then we have these other people over here and we're going to feed them all kinds of other things. We're going to feed them polyunsaturated fats and then vegetable oils or whatever it happens to be. And then we're going to blame all of the differences on saturated fat, which it sounds like they're all eating milk or something. And that's just not the case.
- [44:23]
B
So as this translates to. So the question that you were designated to answer on these guidelines, what was that question?
- [44:31]
A
Well, it was about the relationship between saturated fat and cardiovascular mortality and the things that one usually looks at. And so one of the things that I, well, let's say reverified for myself, is that the studies that are out there often lead with a statement that saturated fat causes more cardiovascular events. But then as you go through the paper, you find out, just kind of as a throwaway at the end, that there wasn't any difference in total mortality. Okay, well, if there's no difference in total mortality, isn't that what people care about? Total mortality? Yeah, I think that's what people care about. And so we turned it around and we said, we're going to talk about total mortality first and then we will talk about the various kinds of mortality, coronary heart disease, cardiovascular disease, mortality and events. And look at those. And we found with a very high level of confidence that total mortality is not affected. And in the observational trials, which is really what there was in the other
- [45:49]
B
guidelines or this one?
- [45:51]
A
No, this is this one because we did a randomized trial and we did prospective cohort trials. We looked at both, and in the prospective cohort trials, there was stroke as an outcome. And does it surprise people when saturated fat, what we call saturated fat, is protective against stroke? That's what it looks like. That's what the data say, protective.
- [46:19]
B
So
- [46:22]
A
is this whole thing, what do you want to die of? I hope not. If total mortality is not affected, and even if you say heart disease is worse, but if total mortality isn't effective, then that means something else must be benefit. Most benefit.
- [46:38]
B
I've also seen, as we kind of wrap this piece up, it's fair to say that we don't know the number or percentage of saturated fat that would be detrimental, then I want to take this one step further by talking about potentially the LDL conversation. So. But if we are just gonna look at total mortality from cardiovascular disease, which is really the outcomes that people care about, there isn't, again, there isn't a strong relationship between the two.
- [47:12]
A
There's not a strong relationship. But I would even ask you, do people really care about total mortality due to cardiovascular disease? Or they care about total mortality.
- [47:22]
B
Care about total mortality.
- [47:23]
A
I think they care about total mortality. And. And the data say there's no effect on total mortality. Even if you accept what is called saturated fat, which I've just got finished explaining, is not all saturated fat.
- [47:38]
B
So it's challenging because there are these guidelines, the Dietary Guidelines now make this recommendation, which now essentially weaponizes animal based products because of the 10% number or less.
- [47:54]
A
There's also another thing, and I'm not that well versed in this, but I will raise the point that much of the work that's been done on red meat is not just red meat. It's red and processed meat. Well, it's fresh red meat, the same as processed meat. And if you throw in everything that's processed is a nice roast or steak or hamburger, do we really think that that's exactly the same as a very processed. And I want to pick on anything in general specifically, but the cheapest, very processed kind of meat you can think of, do we really want to put those things in the same category? I don't know why one would want to put those in the same category. I mean, they may well both be fine. But the red meat part, fresh red meat, I don't see a problem.
- [48:47]
B
Does this lead us to this moment where what we can all agree is that we need more science behind what potentially we're defining saturated fat, what the actual implications are?
- [48:58]
A
We have to first have the folks who are saying that saturated fat is bad actually recognize that that is not what they've been talking about all these years. They've been talking about saturated fat plus partially hydrogenated oils. In other words, they've been talking about saturated fat plus trans. And the trans has been some of the worst trans that there is when
- [49:24]
B
this data is, say, presented to these groups. Again, this is not about a person or any of those entities. But what you're saying and looking at, if someone were to pull this up and to look at the science of the supplemental material. So it's hard to not acknowledge that
- [49:45]
A
people don't seem to have any trouble not acknowledging it.
- [49:47]
B
So what do you. And this is again, just a personal question. I don't want to spend so much time on that. Why do you think that there is again, is it, is the science questionable is what you're telling me? Perhaps. Maybe it's questionable or some other reason.
- [50:08]
A
Well, as scientists, we have to describe what we've done and we have to describe it with specificity. And when someone is calling something saturated fat and it's not saturated fat, I'm not sure how much further I have to go with that.
- [50:23]
B
I agree.
- [50:24]
A
I could go back and say, well, you're just trying to raise money or you're selling something or something like that. But I would prefer to just sort of say, look, you have to recognize that people are mischaracterizing what their data look like. They're mischaracterizing it. We need to look more carefully. There are data out there that address this. I just mentioned it.
- [50:46]
B
That's really important. I think that you imagine that that's the next step. I think a lot of what the new administration is going to do or the current administration is. It seems as if they're going to allocate funding to try to explore that more.
- [51:02]
A
So they say.
- [51:03]
B
Correct. They do say. Can we just touch on the LDL story?
- [51:09]
A
Okay, so
- [51:15]
B
reading again, what is available, and from my understanding, it's complicated. And for some people, let's say 20% of the population has an LDL cholesterol over 160. Again, I'm just framing this up as to how one could intellectualize the statement that if you reduce saturated fat, then you will lower your LDL cholesterol. So you will. Okay. And so this says replacing 5% of energy from saturated fat with polyunsaturated fat again reduces mortality by 27%.
- [51:54]
A
Where?
- [51:55]
B
Not sure.
- [51:57]
A
Not in Japan.
- [51:58]
B
Not sure. But there is this relationship between saturated fat and lowering LDL cholesterol. My question is at what percent of the population is that meaningful? And is that reduction, is it a linear reduction of LDL cholesterol with saturated fat to then have some kind of meaningful outcome for a mom like myself that wants to make sure my husband lives longer than me?
- [52:25]
A
Well, we understand a lot about the LDL story. For the extreme cases, these are folks with the genetic
- [52:38]
B
mutation.
- [52:39]
A
Yes. Mutation that causes their cholesterol levels to be sky high? We have a pretty good idea how that works. The question I think that's really relevant is to what degree do reductions in LDL cholesterol at the Moderate level below 160 really help us Out. And I cannot get past looking at the Japanese data. Now, usually people shut you down by saying, well, there's hardly any Japanese who have high levels. Actually, there's 100 million Japanese. And so there are plenty of them that have higher levels. And if you look carefully, the relationship between cholesterol and heart disease is the opposite of what it is in the United States. It doesn't go up. It actually goes down a little bit. And those data are robust.
- [53:28]
B
Okay, so I want to correct myself first. So I just pulled up my notes for this episode. The current average LDL in the US is 111 grams per deciliter. I got to make sure someone can correct me, but this is what I found. Those who have an LDL above 130, that's around 25% above 130. And above 160 is about 5%.
- [53:52]
A
5% above 160. Okay.
- [53:55]
B
Okay, thanks again. As we frame it up, if saturated fat intake is down from 15%, let's say we pick that number from the 80s, then there should be an average drop in LDL to mirror this.
- [54:11]
A
Right. But one of the points that the Astrup paper makes is that decreasing LDL doesn't always have a relationship with decreasing cardiovascular risk. So the question is whether one can make a blanket statement about this kind of reduction and whether it makes any sense at all. And I think the answer is probably not. And what else to say? I can repeat myself by saying that we understand that sky high cholesterol levels are a problem. We're also recognizing these days something we didn't recognize years ago, which is that triglycerides are a big deal also. And this is the other fat in the blood. And this is an independent risk factor as well.
- [55:11]
B
How high? And I have those numbers, by the way.
- [55:13]
A
Well, well, if there are something like, if they're above 500 milligrams per deciliter, then. Then I think they're. They're candidates for. I'm going to call it a pseudo pharmacological intervention. And when I call it pseudo pharmacological, it's kind of a fish oil thing. And so what does that mean?
- [55:31]
B
What do you mean? Here, I got. I have some numbers for you.
- [55:34]
A
Okay, go ahead, give me some numbers. Hit me, Hit me.
- [55:37]
B
People with elevated triglycerides above 200 are closer to 70%. 17%. 17%. So people. The LDL above 160 are greater are like between 5 and 7% of the population, which doesn't seem like that much.
- [55:53]
A
Right.
- [55:53]
B
People with elevated triglycerides above 200.
- [55:56]
A
Yeah.
- [55:56]
B
Are closer to 17% of the population. That's a higher number. And this is, from my perspective, a carbohydrate issue.
- [56:04]
A
Yes, I think it's a carbohydrate issue and it may well be an insulin resistance issue as well.
- [56:10]
B
Okay. So.
- [56:11]
A
And you don't get numbers that high unless you're. You're not eating much for omega 3s. Omega 3s won't go that high. Omega 3s lower. I mean, we've been, we've known this since the 80s that omega 3s lower fish. The fish oil, essentially. Fish oil lower triglycerides. And that's the.
- [56:26]
B
Irrespective of carbohydrate intake.
- [56:29]
A
Pretty much. But they're going to basically lower it because they turn on the, they turn on the genes that, that, that burn. Burn fat is what they do. And so sign me up. Indeed.
- [56:40]
B
This episode is brought to you by Bon Charge. Now, my husband looked at me the other night and said, should I be scared? And honestly, fair. I was sitting in the dark with a glowing red mask strapped to my face. I don't have time for a $5 million step skin routine. I just don't. But I do have 10 minutes while I'm answering emails or pretending to read before I pass out the bond Charge. Red light face mask uses red light and near infrared wavelengths to support skin health, which again, it's a great way to scare your husband. It's lightweight and it's portable. It doesn't feel heavy or uncomfortable. Since I started using it consistently, my skin looks the following smoother and just overall more healthy. I didn't have to add another complicated thing in my life to get the job done. Go to boncharge.com and use the code DRLION to save 15%. And listen, many of us make a ton of various investments, but skin care and something that works is an investment that you will not regret. Go to boncharge.com and use code DRLION to save 15%.
- [57:55]
A
Fish. Fish. Fish. Why don't we get to talk about fish?
- [57:57]
B
We're going to talk about. We're going to move right on to that. And then I want to know, dosing, is that like your normal 4 gram dose? And let. I'll switch that. I want to again, close this out because, you know, there's the hearsay. There's a game of telephone like, oh, did you hear about this? You were literally there.
- [58:12]
A
Yeah, I was there.
- [58:14]
B
You were literally there. I got some great photos of you. Also have been contributing to the Dietary Guidelines for quite some time. 10% saturated fat doesn't necessarily make sense. We don't have evidence from a mortality standpoint. You should hurry up and change that. I'm hoping you'll do that for the next one then. Also. Consequently, the LDL cholesterol discussion. Still, while it might link back to the saturated fat, might not be the primary problem.
- [58:43]
A
I really don't think it is. And I would also reference for you that once upon a time, we were so very sure that it was HDL that protected you and LDL that was the problem. So good cholesterol, bad cholesterol, and the HDL stuff all fell apart with the pharmacological interventions in the 2000s, and everybody was scratching their head. Now people are actually working on subclasses and do we really see reverse cholesterol transfer and those kinds of. Of things? And that's fine. The point, however, is that these gross measures are just that. They're gross measures. There's other things going on.
- [59:24]
B
So should we talk about another mistake? Sure.
- [59:27]
A
What mistake would you like?
- [59:28]
B
Pregnancy and avoiding fish?
- [59:31]
A
Oh, God, yes. Sure. What would you like to know?
- [59:36]
B
Well, this is really fun. I've been pregnant twice. It's not very fun. I'm not a huge fan of that. I just will say being pregnant. Yes, it's very. I. Hyperemesis gravidome.
- [59:44]
A
Oh.
- [59:45]
B
My husband was active duty. I was alone in New York City throwing up, like, all day.
- [59:49]
A
Okay.
- [59:49]
B
It was terrible.
- [59:50]
A
So that wasn't fun.
- [59:51]
B
It wasn't fun. But I actually. It was one of the only periods of time I shifted away from reading about amino acids to reading about epigenetics, pregnancy, nutrition for pregnancy. And there's actually not a ton of. Of data from a protein perspective, which I suppose makes sense for pregnant women. However, looking at some of the data around omega 3 fatty acids, children. Now we're talking about something that could be really meaningful. You know that women are told many women avoid fish while they're pregnant.
- [60:35]
A
Ready?
- [60:35]
B
I'm ready. Hit me. Hit me with your best shot.
- [60:36]
A
There was a song like that. It was in roughly 1999 that an FDA commissioner was asked by a reporter, almost blindsided by a reporter, how come you're allowing women to be poisoned with all this mercury and tuna? And from the perspective, and there's some subtlety here, but we do have a few nerds in the audience. So it was in the 1980s and 90s that analytical chemists perfected ways of analyzing metals. So you could see de minimis Tiny little bits of metals. And so it wasn't very hard to see any kind of a metal in a. In a natural product. And so if you looked in tuna, you could see it because the chemistry was really very highly developed. It took longer to develop it for organic molecules than it does for elements. Anybody could see Mercury in the 80s and 90s if they looked for it. But you wouldn't be able to see other small molecules, not other small, like aluminum.
- [61:54]
B
Like, what are the other.
- [61:55]
A
Well, metals you could always see. In other words, you could.
- [61:59]
B
Microplastics.
- [62:00]
A
The technology. You can't see microplastics. Then the technology for analyzing metals was very well developed because it's actually, in a way, easier to measure metals than it is to measure organic molecules. When you measure metals, you blast the daylights out of everything and make a bunch of atoms, and then you detect the atoms. But if you try to do the same thing with organic molecules, you lose the organic molecules. So you have to be more nuanced and sophisticated and that kind of thing.
- [62:30]
B
Let me ask you this. Is it a mistake for pregnant women to avoid fish?
- [62:33]
A
Absolutely a mistake. No doubt. 100%. Since we'll call it the 21st century, we have been collecting data on the consumption of fish, specifically in pregnant women and the mental development of their kids. And what we find is that compared to women who eat zero fish, women who eat a little fish, their kids almost always do better on almost all the tests that we look at. And it keeps going up, up, up, up, up. And then it plateaus, and it depends on. Then it starts to depend on what fish you're eating. But we have gone up to 100 ounces a week. The recommendation is 12 ounces a week, at least from the. From the government right now. We've looked at 100 ounces a week, 10 times more of whatever they fish out of the sea. In the Indian Ocean and the Seychelles Islands, for example. Even there, you don't even start to see it coming down again because let's say there's mercury. The mercury is entirely below any kind of a detectable harm level. You only get benefit. You don't get harm. Whoa, whoa.
- [63:52]
B
I was expecting you to say only eat fish or tuna once a month. Is there a limit?
- [64:02]
A
So I really don't think there is a limit. I don't think the evidence shows there's any limit. There is a point where you plateau, you don't get any more benefit. But it's not like if you keep going, you're gonna turn around the people that eat the most fish in the
- [64:17]
B
world
- [64:19]
A
do not have kids who are mentally challenged. They just don't. And you will understand that we know what mental defects looks like. I always invoke iodine deficiency as being something that we know what that looks like. You see nothing like that. The kids just get smarter.
- [64:42]
B
So the components. Right, so pregnancy is. Is pregnancy that one time to build the brain? Like is that. That's a critical component versus post pregnancy into childhood.
- [64:56]
A
We are putting DHA into our brain until we're about 20 years old. So pre pregnancy, post pregnancy. One of the reasons why breastfeeding is so important, beyond the immune stuff behind the bonding stuff and all that kind of thing, is that kids are getting omega 3, they're getting DHA in breast milk. In 2001, we got it put into infant formula for the first time in the United States anywhere. Anyway, it was in other places, but not in the U.S. no. The brain is remodeling consistently until at least age 20 and probably out to 25. So we are doing brain development all that time.
- [65:42]
B
Do you think that it is that static? Because, you know, when you think about Alzheimer's and other cognitive problems, if one avenue of science shows that it could be helpful, it would make sense that there might that dha. And again, I want you to explain what that is, might mitigate some cognitive decline.
- [66:04]
A
Well, there's been a lot of hypotheses around that and there has been some work in reduction in or hypotheses looking at reduction in neurodegeneration towards the end of life. And the data are. I'm going to call it mixed. I'm going to eat fish until I'm in the ground. But. And so it isn't going to cure it. But certainly the underlying mechanisms which we still have not identified, I'm working on some of that in other things I'm doing. But the underlying mechanisms, I'm quite convinced are related to fatty acids and the extraordinarily high energy that we produce to run the brain, to run the retina and the interaction between all that energy, which throws off reactive oxygen species which then oxidize these highly oxidizable fats.
- [67:03]
B
So dha, can you frame us up what that is, the spectrum? There's omega 3, omega 6.
- [67:12]
A
DHA is an omega 3 fatty acid. It's actually, again, for the nerds in the audience, docosahexaenoic acid.
- [67:20]
B
You said it, I didn't.
- [67:21]
A
Docosamines 22, hexamines 6. So it's got 22 carbons and six double bonds. And I like to call this the year of DHA because we've got two and I ignore the.026. So that's 22.6. There we go. At any rate, this is what we call an omega 3 fatty acid. The omega 3 part is a part of the structure of the molecule. So if you draw the molecule on a blackboard and then you name it according to organic chemistry, which you took, then you will see that the last double bond is three carbons in from the back end. If you go to omega 6 fatty acids, you'll find that the last double bond is six carbons in from the last carbon. Now, Omega 3 and Omega 6 are special because they are processed by the same enzymes in the body. And so when there is a big imbalance between the two, you start to suppress one against the other. And that's why a balance is actually quite important. What we have in the United States is a high amount of the omega 6 fatty acid and vegetable oils called linoleic acid. If you really want to read some nerdy stuff, you can look at the Dietary Guidelines foundational report, which is posted, and I think it's chapter five, which is a nice discussion of this stuff. There's lots of other stuff and there'll be things on the web that you can see about this. There is no question. None. Zero. Absolutely zero.
- [69:08]
B
So tell me how you really feel. Is it like a. Oh, tell you
- [69:10]
A
how I really feel?
- [69:11]
B
Yeah, go with it, dude.
- [69:13]
A
Let me, for emphasis, start over. There is no question, absolutely zero. None. That omega 6 linoleic acid suppresses all the omega 3s metabolically, everywhere.
- [69:24]
B
Wow. So that's a.
- [69:25]
A
Period, full stop. People say that's not the case. It is the case. It is always the case. No exceptions.
- [69:31]
B
Wow. The outcome. So then a clinical outcome to that would be. Or a metabolic outcome or a biomarker outcome. Outcome would show higher amounts of.
- [69:43]
A
Well, it. It. I'm quite sure that it depends on genetics and we've been working on those genetics and you'll have me back for another one of those.
- [69:52]
B
Can't wait. Anytime.
- [69:53]
A
But in. In vulnerable folks, the omega 6s in vegetable oils are actually enhancing a pro inflammatory state. We're seeing. We're seeing a response to omega 3s pushing down colorectal polyps. We've published this already.
- [70:16]
B
What is the dose?
- [70:19]
A
Two grams a day.
- [70:20]
B
Not very much.
- [70:21]
A
Not very much. And if you're of a certain genotype, it pushes down colorectal polyps at the end of a year by 50%. Is that good?
- [70:31]
B
Wow.
- [70:32]
A
It's published in the American Journal of Clinical Nutrition.
- [70:34]
B
Okay, so we'll pull that up. Rj. Got to make a note of that. Pull that up. And then. So it's based on genetics, obviously. Someone could probably run those SNPs.
- [70:44]
A
And, yes, it's actually more complicated, but it's actually. It's more and less complicated. It's an insertion deletion, which is sitting in the fatty acid desaturated gene cluster. Now I really lost everybody.
- [70:57]
B
Yeah, definitely. I was just thinking, are you popular at parties? Okay, but there's no downside for someone who would be wanting or interested in taking omega 3 fatty acids. But you said it's the balance.
- [71:11]
A
The balance is what you need. The balance is what you need. You have to be balanced. And in the diets that we have now, we have an excess of Omega 6. Now, the Omega 6 folks will say, yes, but if you eat more vegetable oil that has more Omega 6, it pushes down cholesterol. Well, it does, but we just got finished having that conversation about whether that actually benefits, if it's anything or not. And we always go back to the heart, but not the brain.
- [71:38]
B
So going back to the heart, meaning. Meaning individuals are looking at LDL cholesterol or total cholesterol and saying, well, this reduces total cholesterol. But that might be irrelevant to the. If I'm understanding what you're saying.
- [71:55]
A
Yeah. You are actually not in your mission. You have it. You have it correct. In fact, working on the Omega 3, Omega 6 story is what led many of us to start talking about saturated fats and to start looking into that. Because if you say, eat less omega 6, it's got to be replaced with something. And so what should you replace it with? Now, the best thing I think to replace it with is monounsaturated. So olive oil. And. Well, we now have avocado oil, but, you know, we're clear cutting the Amazon to make avocados, avocado trees. And there isn't enough olive oil to supply more than a very small fraction of the demand in the United States. And so what I think we ought to be doing is what we learned how to do 20 years ago, which is to make effectively a kind of an olive oil. But we can do it with sunflowers and safflowers and peanuts because we basically taught them how to make olive oil. From this perspective, they're called hyalic oils. And there is a fundamental disagreement about what will happen with that. But I meaning, will it be the
- [73:09]
B
Same as the trans fats. Is that what the disagreement.
- [73:11]
A
No, no, I don't think it will. I don't think the trans fats will be relevant here because the fatty acid profile in these high oleic oils is almost indistinguishable from olive oil. In fact, olive oil has a range depending on where you grow the olive trees, whether they're in the hot area of North Africa or they're in the cooler area in Tuscany, let's say. And there's more linoleic as you go north and there's less and as you go into the hotter regions. And so there's a range, and so these high oleic seed oils are within that range.
- [73:44]
B
You know, that's fascinating. You're talking about essentially the food matrix, but in a different way, the compounds of the food. And if you were to say in an ideal world, would you say, I want you to have 2 grams of omega 3 fatty acids. I want you to have a component that is DHA, 200 milligrams. And I want you to have olive oil from Tuscany because it's up north. How would you think about getting granular for someone who wants to just say, you know what? I'm going to do a tablespoon of monounsaturated fat from olive oil and then I'm going to do three pills of omegas, because that's going to give me two grams and then dha.
- [74:28]
A
How do I here. So the other thing to recognize is that when as the. I just told you that Omega 6 suppresses Omega 3. If you push down the Omega 6, you don't need as much Omega 3. The Omega 3 is actually more effective. We've never really calculated how effective, but I mean, you can actually.
- [74:47]
B
Meaning if you push down, if you
- [74:50]
A
have high linoleic acid, you're creating a metabolic need for omega 3. In order to balance it, you need more of it. I would rather have a traditional diet. We didn't have these amounts of omega 6 in the diet before roughly the year 1900, before maybe a little earlier than that, but it's about that. There were almost. There's almost nowhere on the planet where we had these amounts of linoleic acid. There's a. There's some that was in northern China with, with rapeseed oil, but. But only a few hundred years ago. So this Omega 3, this Omega 6 business with high levels of linoleic acid is. Has been an uncontrolled experiment that we conducted from the 1950s. And coming back here and saying, well, we don't want to do this new experiment by pushing it down. Well, no, that was. The experiment was putting it so high.
- [75:38]
B
I see. And the Omega 6 would be things like corn, Kepler canola.
- [75:48]
A
I'm glad you asked me that question. So here's the problem. It has not been for 20 years that being able to say the name of the plant that an oil came from tells you what to eat. We can no longer do that. You can't say soybean oil because there's four different soybean oils that have been widely sold in the marketplace. There's at least three sunflower oils, and they've all been intentionally bred to have different fatty acid profiles. So I can't just say for what
- [76:18]
B
reason, for what purpose, for the very
- [76:20]
A
purpose that I'm describing. Whoa. And the other reason is that the traditional oils, what we used to call the commodity oils 20 years ago.
- [76:31]
B
I'm from Chicago. There's commodities and the options exchange.
- [76:35]
A
Yes, indeed. So how many hog bellies do you want anyway?
- [76:42]
B
These are jokes. We are collectively funny together.
- [76:48]
A
If you push down the amount of Omega 66 in the oil, it increases the shelf life and the frying life. And so we've been frying potato chips, we lays up in north of Dallas and everywhere else around has been using these high oleic oils for years because the frying life is longer. There's fewer of these peroxides that get formed during the frying process, and so they like it a lot better. Now, I'm speaking for lays, and they should hit me over the head because, I don't know, I've never been set foot inside lays, but at any rate, I'm pretty sure that's what they've been doing. And that, I think, has made the products healthier. I mean, what I used to like to say is if chips make you fat, that they have to make you sick too. And I had lay potato chips the other day.
- [77:53]
B
Busted.
- [77:54]
A
That's it.
- [77:54]
B
So for the omega 3 fatty acids, when someone. I know you don't see patients, but is there a good ratio if there's a physician out there? Again, we look at omega 3, omega 6 ratios. You know, many of our patients have higher omega 6s, and there's a whole.
- [78:14]
A
Yes, they do. And so. And so you're thinking the. You're thinking of the omega quant kind of. Yeah, I think that. I think that what those folks have been using are pretty good, is a pretty good guide. So below 4 is. Is bad and above 8 is good as the. The is a Kind of the broad guidelines. Yes, I think there is. And I watched that whole story develop since well before it started. I remember the discussions on it and one person running with it. And I'm very, in a manner speaking, proud of him for running with it.
- [78:57]
B
That's very cool.
- [78:58]
A
Making it happen.
- [78:59]
B
So there was one individual.
- [79:00]
A
Yes, that's right. And you look on the website for Bill and, you know, and we had conversations about, you know, well, you know, we're measuring cholesterol. What the heck does that mean? If we could only measure Omega 3 somehow, then we'll give people a little bit of control and we think that'll have more control and be more important.
- [79:20]
B
I pulled this number. It says more than. And I don't know if this is accurate.
- [79:23]
A
Sure.
- [79:24]
B
More than 95% of people fall short of recommended DHA intake.
- [79:28]
A
Yeah, well, that's almost certainly true, but it depends on who's recommending it and what it should be recommended as. Absolutely.
- [79:33]
B
What about kids? How much? So I think about my two little kids. We have little fish oils that we try to give them. It's kind of hit or miss, but is that adequate? I know that you're gonna say something is better than nothing.
- [79:48]
A
It is.
- [79:49]
B
But you talk about the food matrix.
- [79:51]
A
Yes.
- [79:53]
B
How much should they. In an ideal world where you're like,
- [79:56]
A
okay, well, look, my. My grandkids just stuff salmon into their mouths. They absolutely love it.
- [80:08]
B
So maybe we just have that.
- [80:09]
A
Okay, well, I am kind of more of a Whole Foods guy at Little W, Little F. Despite the fact the headquarters are over four blocks from my place.
- [80:21]
B
Oh, I see. I see.
- [80:22]
A
I get it. Okay. But I'm more of a guy who thinks that the nutrient package is important. If you can't have fishing people. We've got allergies and this kind of stuff. Right. So. And we can talk about, you know, what has caused that we ought to be introducing foods. I think pediatricians are getting the idea they should be inducing everything very early on when the immune system is recognizing self and non self. But at any rate, I get my. Well, when she was three, I bring her over to Wegmans in Rochester and she wants the salmon sushi. And then we sit down and she picks the salmon off the top, leaving the rice carcasses behind, and just shoves the rest of it down her throat. And so she's taking in something like two weeks worth of. She had to make it three, maybe more than that in that little thing. And she's giggling the whole time. She's gobbling it up.
- [81:32]
B
I mean, but you guys get a, you guys got ahead of it. And you know, my kids, they love salmon, but you know, the other sardines, also good sardines.
- [81:43]
A
Absolutely.
- [81:44]
B
What about, I'd love for you to just touch on this. People will say, well, I'm getting my Omega 3 from flax and chia walnuts. Would you just speak to that just very quickly?
- [81:55]
A
Sure. So this is a little bit of an example that something is better than nothing. But the data say that these plant based sources of Omega 3 are not the same as the long chain Omega 3s. And I'm hesitant to call them animal sources because there are vegetarian sources.
- [82:21]
B
Naturally.
- [82:21]
A
Naturally, yes. It would be from the single cell organisms from the ocean, so we call them algae, oil. But there's other things like that. And I am well aware that there are vegetarians in the world. I won't say vegans, but I will say vegetarians. And even this is a nuanced thing because if you decide you don't want to eat animals, but it's okay to eat dairy, for instance, that's great. If you start substituting high Omega 6 oils for your dairy fat, that's when things really go off the rails. Because dairy fat is very low in omega 6 naturally. So you're getting the least suppression of the omega 3s if you eat dairy. If you start eating high omega 6 sunflower oil, you're suppressing the omega 3s, you're creating a metabolic demand. And when we do studies in animals and there's lots of them out there, and I would just remind everybody that animal studies can be very well controlled. Human studies are the worst controlled studies that there are. Okay? So forgive me, I'm doing my science here, okay? And so when people don't talk about well controlled studies and they only rely on human studies, you can argue about things for seven decades like this that we're arguing about. But at any rate, when you feed those oils to pregnant animals, you can look at almost anything going on in the brains of the offspring and they are screwed up.
- [84:03]
B
Not, I mean, I've never heard that as a technical term.
- [84:07]
A
Screwed up is a technical term, but
- [84:10]
B
you make a really good point. And to frame this up for people, people have been arguing about omega 3s, omega 6s, should women, pregnant women, eat fish, should kids eat fish? Avoid it because of metals. And what I'm hearing you say is really two things. Number one, we got saturated fat wrong. Yes, like we really got that wrong. And number two, omega 3 fatty acids, DHA are necessary. Amazing. For brain development important for pregnant women. And conversely, Omega 6 is not just safe and neutral.
- [84:51]
A
We're just going overboard with it. That's all. The Omega 6, you have to have some Omega 6. And so when I have these conversations with people say, sometimes they just go too far and they say, Omega 6 is terrible. No, no, it's not terrible. You need. You need this much and you really don't want to go, you know, above this much. It's really not that hard. I mean, a little is absolutely required. I mean, there's actually human studies from the early days from 1961, where kids were put on omega 6 deficient diets, babies were put on omega 6 deficient diets and they knew they were omega 6 deficient and they developed skin lesions which were rapidly reversed when they put them back onto the Omega 6. We can't do that anymore. It probably wasn't a great idea, but it served a purpose to at least answer a question way back then. And so you have to have some Omega 6. It's just not so much, not as much.
- [85:50]
B
Just two final questions. The last one is a bit robust. There is a lot of discussion about ADHD mood, omega 3 fatty acids. Is there real science behind the utilization of omega 3 fatty acids and improving ADHD?
- [86:08]
A
So I am told. Now I know how to read this literature. I must say that I am not as up on the ADHD literature as I would like to be to answer you definitively. People I know who have been working on this say that there is something to it. But I'm not going to tell you that giving fish oil to kids with ADHD is going to solve the problem because I don't know that to be the case. I don't think it'll make it worse.
- [86:42]
B
I agree with you. I'm hopeful that it can help. It seems to help a lot of other things, maybe not adhd. My last question. So beyond fish mercury, saturated fat nutrition policy information seems to really shape our thinking. And it becomes extremely, I don't want to say misinterpreted, but accepted as truth when perhaps it's not. And this is just from my curiosity, which I'm sure that other people are thinking, is there something else also on the horizon that you're thinking, okay, this hasn't been developed enough yet and it's going to come out well,
- [87:31]
A
let me answer it this way. I think the story of precision nutrition, precision medicine, precision nutrition, is an undertold story. It is one that doesn't fit as well with the research paradigms. That we have ask a huge number of people what they eat and then try to make correlations and that stuff. But I think that we are going to have to get towards that. When we have these conversations about one number for everybody, like in dietary guidelines, we need to be getting much more specific about that. We need to be able to say here are life stage issues, pregnancy, lactation, brain development and maintenance of brain health are all going to be going to have demands that are different than that 50 year old man that I was complaining about. They are, as a matter of fact, there's just no question that they are. And then there are, I am quite sure, differences due to genetics. We really should tighten up our genetics when we look at these things. I am more or less one trick pony on my genetics because we identified something we think is actually a causal polymorphism that defines requirements. But I'm still working on that. I think we have not incorporated that into our research the way we should and into our recommendations the way we should. A lot of genetics that is not an amino acid change, so that are really obvious changes. But a lot of the genetics we do is correlative or associated. We've heard of the nerds, have heard of genome wide association studies and the A association is a cleaned up version of the word correlation. We really need to, to move that needle towards things that will be causal insofar as that word is relevant in genetics. So I think we have a long way to go to do personalized nutrition. That's where I would like to see us move the whole thing forward beyond the general recommendations for everybody.
- [90:08]
B
And I'm looking forward to our next visit. I'm sure that you'll have more to share and also with the genetics, but also the metabolomics of the genetics.
- [90:19]
A
Okay, well metabolomics and lipidomics as a subset of that is something that is near and dear to my heart in part because it is fundamentally a chemistry thing. It is also something that has been devilishly difficult from a laboratory point of view. You always get correlations, you always get data, as my advisor used to say. And not everything is an artifact. You hope.
- [90:58]
B
Tom Brenna, I'm a huge fan. I think you do great science, you're a great human and just it is so wonderful to have scientists like you that don't mind teaching, are very personable and just willing to identify the science and also speak to it. Just thank you for all the work that you've done for all the years behind the scenes. Thank you.
- [91:23]
A
It's my pleasure. Thanks.