How Are Carbs a Bigger Health Foe Than Fats in Real Life? The Fact Test

Many people think of fat as being enemy No. 1 in our battle to eat and stay healthy. Just look at all the low-fat and fat-free products that crowd grocery store shelves. But could fat have been unfairly maligned all these years? Is the true dietary foe standing in the way of our health and wellbeing actually carbs?
A recent large international study suggests that may be the case. The study, published in the Lancet, looked at the self-reported diet, cardiovascular disease and mortality of adults ranging in age from 35 to 70 in 18 countries across five continents, following participants for, on average, just over seven years.
The researchers concluded that it was higher carbohydrate intake that was associated with a higher risk for mortality, while fat intake was related to lower mortality.
Those who were in the top 20 percent of carb consumption were at 28 percent higher risk of dying earlier than those in the lowest 20 percent of carb consumption, although higher carb consumption was not associated with a higher risk of cardiovascular disease or cardiovascular-disease mortality.
Meanwhile, those we were in the top tier of fat consumption – taking in just over 35 percent of their calories from fat – were about 23 percent less likely to die earlier than those in the lowest tier, the 20 percent who took in, on average, only just under 11 percent of their calories from fat.
“Total fat and types of fat [saturated fatty acids and unsaturated fats] were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke,” the study concluded. The researchers further suggested that, in light of their findings, dietary guidelines, which in the U.S. recommend no more than 35 percent of calories from fat, be reconsidered.
Kaleigh McMordie, MCN, RDN, LD, a registered dietitian who blogs about food and nutrition at Lively Table, however, doesn’t think we should all rush to change our diets based on a single study – especially one that relies on self-reported dietary data, which are vulnerable to inaccuracies due to unreliable recall.
McMordie also notes that “not all carbs are created equal.” Carb sources such as fruits, vegetables, milk and whole grains have beneficial nutrients such as fiber and antioxidants, whereas carbs from sugary drinks and refined white bread or white rice do not. “It is important to distinguish where carbohydrates are coming from,” she says.
Ultimately, McMordie says moderate intake of both carbs and fats are important to maintain health — and balance is key, an assertion she says the study’s findings on mid-range fat and carb consumption seems to support.
“We already know that dietary fat is important and too many refined carbs that have little nutrition is not optimal,” she says, adding that trans fats are obviously to be avoided.
The advice McMordie gives her clients, she says, remains unchanged.
“Eat a variety of foods from all food groups and don’t cut out food groups unless it is absolutely necessary. Aim for a moderate amount of fat, protein and carbohydrates from nutrient-rich sources, and listen to your body’s cues to tell you what it needs,” she counsels. “The key is not to go to extremes when it comes to any nutrient.”

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