Malaysian study suggests fats not major heart disease culprit

Dr Kalyana Sundram says the study evaluated the lifestyles and long term impact of different ratios of carbohydrate and fat among Malaysians.

KUALA LUMPUR: A newly published Malaysian diet and population study holds vital clues to resolve the global carbohydrate-fat health debate.

The study’s senior author Dr Kalyana Sundram said data from this study supported the hypothesis that restricting carbohydrate consumption might have a greater benefit to heart health than restricting total fat consumption.

He said the study showed the combinations of carbohydrate and fat that could be safely consumed with fat surprisingly being the more benign partner in such dietary combinations.

“A Cross-Sectional Study on the Dietary Pattern Impact on Cardiovascular Disease Biomarkers in Malaysia,” was published in the journal, Scientific Reports, part of the prestigious NATURE publication group. It can be read in full here.

The study comes in the wake of a series of studies addressing the way health professionals are looking at how specific combinations of macronutrients in the daily diet impact cardiovascular disease (CVD) risk biomarkers.

Sundram said: “While most previous studies concentrated on traditional blood lipids, cholesterol and lipoproteins (LDL, HDL), the Malaysian population study incorporated more advanced measures of sub-fractions of these lipoproteins, which are emerging as state of the art measures to assess cardiovascular risk.

“It evaluated the lifestyle and long term impact of different ratios of carbohydrate and fat consumption in this target population.”

Sundram pointed out that oversimplification of macronutrients (fat, carbohydrates, protein) as good or bad had set the tone for the clinicians and public to adopt diets that could often do more harm than good.

The study suggests that a pattern of specific combinations of macronutrients in specific proportions are associated with markers of cardiovascular disease.

“The dietary patterns consist of varying proportions of protein, fat and carbohydrates. The population responses to these patterns vary based upon lifestyle, genetics, age and stage of life, and socioeconomic factors. The Malaysian study addresses all of these variables such that the conclusions have real validity,” added Dr Sundram.

The cross-sectional population study involved 577 healthy, physically active adult Malaysians between ages 20 and 65 from urban centres. None of the participants smoked or consumed alcohol. Almost 60% were white-collar professionals. All participants were free of diabetes, hypertension, coronary heart disease, stroke, cancer, renal failure and hypothyroidism.

The overwhelming majority of the study participants (484 people or 83.9%) consumed meals prepared with palm oil/palm olein. The remainder reported regular consumption of other more unsaturated vegetable oils such as sunflower, canola, corn or olive oil.

Sundram said the results indicated that a re-think about carbohydrates and fats was necessary.

“Our study found that higher proportions of carbohydrates in the diet tend to be associated with elevated levels of multiple CVD risk factors including dyslipidemia, hypertension and atherogenic small LDL particles. Higher proportions of dietary fat intake were not adversely associated with most of these cardio-biomarkers.

“For example, in keeping with current perceptions, our two low-fat diet groups did not result in the anticipated improvement in plasma lipid profiles compared with high fat diets.”

He however cautioned that even in Asia when populations began to adopt a typical Western-styled high-carbohydrate, high fat diet, overall risk for CVD, diabetes and metabolic syndrome were clearly manifested as seen from the Malaysian study outcomes.

He added: “This raises the bar for studies that lead to meaningful dietary guidelines by health authorities. Our traditional understanding of dietary factors and accompanying dietary recommendations for CVD management may require reassessment in light of this and other emerging evidence.”