Drawing the Right Conclusions About

Monounsaturated Fat
The popular press has recently been busy interpreting the
results of a major review study on heart disease and dietary
fat. This review was conducted by a team of researchers
spanning the globe--including Denmark, Finland, Israel, and
Boston, Massachusetts where the Harvard School of Public
Health is located--and was supported by a grant from the U.S.
National Institutes of Health.
Information covering 4-10 years of health history on 344,696
individuals was reviewed. Among this group of individuals,
5,249 had experienced serious heart problems and 2,155 had
died from heart-related problems during this time period.
When the researchers analyzed dietary fat content, they
determined that excess saturated fat in the diet clearly
increased the risk of unwanted heart problems. They also
found that high intake of polyunsaturated fatty acids (PUFAs)
was associated with more risk reduction than high intake of
monounsaturated fat. In fact, they found that lowering
saturated fat by 5% and replacing it with either
monounsaturated fatty acids (MUFAs) or carbohydrates
actually raised the risk of heart-related problems.
Some Internet sites and popular press commentators have
interpreted this major review study as a major blow against
monounsaturated fat. Others have treated the results as just
another indication that nobody really knows whether
monounsaturated fat or polyunsaturated fat is best for
improving heart health since there are studies not analyzed by
these researchers that document the benefits of
monounsaturated fat.

But one of the study's own authors has cautioned us against

these kinds of interpretations, and we believe he is correct in
taking a different approach to the results of this high-quality
review study. Martijn Katan, one of the study's authors and
Chair at the Division of Human Nutrition of Wageningen
University, Wageningen, the Netherlands, has wondered
whether individuals consuming high-MUFA or high-carb diets
in this research review were simply eating diets of lower
quality. He has pointed out that MUFAs can be obtained from
meats, dairy foods, and hydrogenated oils, and that carbs can
be obtained from processed foods and aren't necessarily
nutrient-rich. If the high-MUFA diets and high-carb diets in
this review study were otherwise unhealthy diets, the findings
wouldn't be pointing to MUFAs or carbs as the problem, but
rather to the unhealthy underlying diets they represented.
At the World's Healthiest Foods, we always try to focus on the
complete diet, and its unique way of weaving together the
nutrient richness and health benefits of whole, natural foods.
From our perspective, the idea of simply replacing one type of
fat with another does not make sense. Types of fat are
important, but they are only one aspect of our food. Most
whole, natural foods contain all types of fat-saturated,
monounsaturated, and polyunsaturated. And most whole,
natural foods contain these fats in different proportions, giving
us the flexibility to combine foods in different ways to meet
our diet goals. If most of the monounsaturated fats in a diet are
obtained from foods like butter (26% monounsaturated), or top
sirloin (21% monounsaturated), or partially hydrogenated
soybean oil (44% monounsaturated), we would not expect
heart benefits since these foods are not well-balanced in their
fat composition and, in the case of the hydrogenated oil, can
contain trans fats that actually increase heart risk. Similarly, if
the carbohydrates in a diet are obtained from non-whole grain

breads and pastas or large amounts of fruits juices rather than

whole, fresh fruits, they cannot be expected to lower disease
risks since they provide too many simple sugars, too little
fiber, and too few overall nutrients.
In this review study, we suspect that very few of the 5,249
individuals who experienced serious heart problems during the
study period and very few of the 2,155 individuals who died
from heart-related problems were eating higher-MUFA or
higher-carb diets based on whole, natural plant foods. Instead,
we suspect that they were getting their higher-MUFA intake
from too high a percentage of processed foods and/or animal
foods. We also suspect that they were getting their higher-carb
intake from too high a percentage of nutrient-depleted, heavily
processed grains or processed fruit juices. Under these
circumstances, their higher-MUFA and higher-carb intakes
would not reflect a healthy underlying diet based on nutrientrich, whole foods, or a diet focused primarily on plant foods.
Similarly, we also suspect that more protective high-PUFA
diets in this review study were not only high in PUFA, but
also higher overall in diet quality. We suspect that these diets
reflected better food choices and choices more consistent with
a nutrient-rich, whole plant food-based approach.
While the debate of types of dietary fat will no doubt continue,
we believe that the results of this major review study
underscore the dangers of excess saturated fat and remind us
of the importance of high-quality food sources for unsaturated
fat. Both monounsaturated and polyunsaturated fat are needed
in the diet, and what matters most is the underlying plant food
quality that provides us with these essential fats.
WHFoods Recommendations

Don't fall into the trap of thinking that any nutrient is a "magic
bullet." It's not monounsaturated fat or polyunsaturated fat that
is going to single-handedly lower your risk of heart disease.
Keep your sights set on a nutrient-rich, plant food-based diet
that provides you with a variety of minimally processed foods.
References

Jakobsen MU, O'Reilly EJ, Heitmann BL et al.

Major types of dietary fat and risk of coronary
heart disease: a pooled analysis of 11 cohort
studies. Am J Clin Nutr. 2009 May;89(5):142532. 2009.