11. Spain Weighs In on Saturated Fats

In a companion article and video, The Swindle of the Century — How Bad Science Became Nutrition Dogma (https://plantationbay.com/satfat), Plantation Bay discussed how saturated fat was wrongly villainized by the medical community, and how lowering fat consumption became a worldwide obsession that led to much worse health for a large part of humanity. Despite considerable evidence to the contrary, bad science continues to be trotted out by respected institutions in what seems to be a rear-guard mission to avoid admitting they've been wrong for 70 years.

Anti-Saturated Fat diehards (which include the American Heart Association, Mayo Clinic, Cleveland Clinic, and Harvard University) frequently point to one study or another that can be framed as a "proof" that saturated fat is bad, monounsaturated fats (MUFA) and polyunsaturated fats (PUFA) are good.

What the clinical reports fail to mention is that in almost every case, the test was rigged, because the "high sat-fat" diet was also deliberately high in starch and sugar. In other words, it was really an "overeating" diet. Saturated fat was not the cause of elevated mortality; overeating was.

With clever framing and post-study re-framing, many studies can be twisted far from common-sense truth. One of the most frequently-cited studies is PREDIMED, which supposedly shows the benefits of MUFAs and PUFAs over a diet that was merely lower in fats than before. (Yet many responsible people and institutions will cite it as proof that saturated fat is bad, which absolutely was not the point of the study, and if anything, the study proved the opposite.)

PREDIMED (PREvención con DIeta MEDiterránea) involved 7500 cardiac-risky patients in Spain. They were divided into three groups with different dietary instructions: "Mediterranean diet with more fish, vegetables, and olive oil (MUFA)"; "Mediterranean diet with more fish, vegetables, and nuts (PUFA)"; and "lessen your total fat intake".

Spain has the second-highest per capita consumption of olive oil in the world, 7 times the US; and it has practically the highest pork consumption in the world, double the US. If you can convince Spaniards “in the interest of science” to actually cut olive oil and pork intake over a 5-year period, guess what they'll eat more of instead?

The critical conceptual void in PREDIMED was that the supposed control group was not monitored for a likely increase in starch and sugar consumption to make up for the lower fat intake.

As a scientific study PREDIMED also suffered from other issues. Randomization was imperfect (many "random" assignments were not individual, but by whole clinic for convenience). The study was not even single-blind: three different groups were told what to eat and it was crystal-clear which groups were supposed to turn out healthier. The "good" groups were given free groceries and regular counseling; the "lessen-your-total-fat" group was given a leaflet once a year. Guess who the organizers hoped would win?

There was little to no monitoring, so in fact there was no proof of dietary compliance by any of the groups.

And yet, still, the bottom-line findings were basically NO difference in All-Cause Mortality or Cardiac Mortality, though 30% more "cardiac events" (mainly stroke) for the third group.

Since all subsequent references to PREDIMED (up to today) make a big deal out of that 30%, what did it actually mean in real life? Over a 5-year period, 3.3% of the “nuts group” had a “cardiac event”, 3.8% of the “olive oil group”, and 4.4% of the “eat less fat but we don’t care how much starch and sugar group” who had a cardiac event.

4.4% v. 3.3%. A difference of 26 persons in 2500.

Given the way the groups were defined, PREDIMED did not prove anything against saturated fats, but fairly conclusively demonstrated that if you just tell people to lower fat intake (as every government on earth has told its people for the past 70 years), their health will suffer if they obey, because they will then probably eat more starch and sugar to make up. It is easy to imagine that the members of this group indeed decided to consume fewer pork chops but rewarded themselves with more doughnuts and pizza.