|Ebbeling, Cara - Harvard University|
|Young, Ian - Queen'S University - Ireland|
|Lichtenstein, Alice - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Ludwig, David - Harvard University|
|Mckinley, Michelle - Queen'S University - Ireland|
|Perez-escamilla, Rafael - Yale University|
|Rimm, Eric - Harvard University|
Submitted to: Clinical Chemistry
Publication Type: Other
Publication Acceptance Date: 10/23/2017
Publication Date: 1/1/2018
Citation: Ebbeling, C.B., Young, I.S., Lichtenstein, A.H., Ludwig, D.S., McKinley, M., Perez-Escamilla, R., Rimm, E.B. 2018. Dietary fat: friend or foe? Clinical Chemistry. 64(1):34-41.
Technical Abstract: The Dietary Guidelines for Americans 2015-2020 focus on eating patterns, and associated food and nutrient profiles, rather than nutrient intakes. While there is no explicit limit on total fat intake, the Guidelines advocate less than 10% of calories from saturated fat and emphasize replacing saturated fat with unsaturated fat rather than carbohydrate, consistent with recommendations in other developed countries internationally. During the era of low-fat diets, the food industry replaced fat with refined carbohydrate in many products, and some public health messages had unintended consequences. Over the last two decades, the prudence of low-fat diets has come under intense scrutiny, and some have suggested that such diets have contributed to adverse health outcomes. However, it is important to keep in mind that one single factor is not responsible for the explosion in obesity, metabolic syndrome, and type 2 diabetes mellitus. The current rates of these disorders are more likely due to many dietary and lifestyle factors that came together and resulted in the perfect storm. These include: ubiquitous availability of supersized portions of foods and beverages, remote controls obviating the need to get up off the couch, microwave ovens providing instant gratification for food cravings, e-mail and text messages eliminating the need to stroll over to someone's desk for conversation, and the plethora of fat-free foods that masqueraded as low-calorie. So many times in the field of nutrition, we have looked for a simple answer and each time we have come up short. It's important to remember that all of the guidelines changed from low-fat to moderate-fat around 2000. These included guidelines issued by the American Heart Association and NCEP, and the 2000 Dietary Guidelines for Americans. Although there was inconsistency in how the revised message was first expressed, the intent in all cases was to recognize unanticipated consequences of the low-fat message including: reduced consumption of all types of fat (including healthful unsaturated fats) and increased consumption of refined carbohydrate. The pervasive nature of the low fat message is unfortunate given the absence of data to support it.