HEALTH WATCH: Bad news on saturated fats

by Michael Greger MD

THE REASON those eating plant-based diets have less fat buildup in their muscle cells and less insulin resistance may be because saturated fats appear to impair blood sugar control the most.

The association between fat and insulin resistance is now widely accepted.

Insulin resistance is due to so-called ectopic fat accumulation, the buildup of fat in places it’s not supposed to be, like within our muscle cells.

But not all fats affect the muscles the same. The type of fat, saturated vs. unsaturated, is critical. Saturated fats like palmitate, found mostly in meat, dairy, and eggs, cause insulin resistance.

But oleate, found mostly in nuts, olives, and avocados may actually improve insulin sensitivity.

What makes saturated fat bad?

Saturated fat causes more toxic breakdown products and mitochondrial dysfunction, and increases oxidative stress, free radicals, and inflammation, establishing a vicious cycle of events in which saturated fat induces free radicals, causes dysfunction in the little power plants within our muscle cells (mitochondria)—which then causes an increase in free radical production, and an impairment of insulin signaling. Fat cells filled with saturated fat activate an inflammatory response to a far greater extent.

This increased inflammation from saturated fat has been demonstrated to raise insulin resistance through free radical production. Saturated fat also has been shown to have a direct effect on skeletal muscle insulin resistance. Accumulation of saturated fat increases the amount of diacylglycerol in the muscles, which has been demonstrated to have a potent effect on muscle insulin resistance.

You can take muscle biopsies from people and correlate the saturated fat buildup in their muscles with insulin resistance, the cause of type 2 diabetes.

While monounsaturated fats are more likely to be detoxified or safely stored away, saturated fats create toxic breakdown products like ceramide that causes lipotoxicity.

Lipo– meaning fat, as in liposuction. This fat toxicity in our muscles is a well-known concept in the explanation of trigger for insulin resistance.

I’ve talked about the role saturated and trans fats contribute to the progression of other diseases, like autoimmune diseases, cancer and heart disease.

But, they can also cause insulin resistance, the underlying cause of prediabetes and type 2 diabetes.

In the human diet, saturated fats are derived from animal sources, while trans fats originate in meat and milk, in addition to partially hydrogenated and refined vegetable oils.

That’s why experimentally shifting people from animal fats to plant fats can improve insulin sensitivity.

In a study done by Swedish researchers, insulin sensitivity was impaired on the diet with added butterfat, but not on the diet with added olive fat.

We know prolonged exposure of our muscles to high levels of fat leads to severe insulin resistance, with saturated fats demonstrated to be the worst.

But, they don’t just lead to inhibition of insulin signaling, the activation of inflammatory pathways, and the increase in free radicals; they also cause an alteration in gene expression. This can lead to a suppression of key mitochondrial enzymes, like carnitine palmitoyltransferase, which finally solves the mystery of why those eating vegetarian have a 60% higher expression of that fat-burning enzyme. They’re eating less saturated fat.

So, do those eating plant-based diets have less fat clogging their muscles, and less insulin resistance too?

There hasn’t been any data available regarding the insulin sensitivity, or inside-the-muscle-cell fat of those eating vegan or vegetarian—until now.

Researchers at Imperial College London compared the insulin resistance and muscle fat of vegans versus omnivores.

Those eating plant-based diets have the unfair advantage of being much slimmer, so they found omnivores who were as skinny as vegans, to see if plant-based diets had a direct benefit—as opposed to indirectly pulling fat out of the muscles by helping people lose weight in general.

They found significantly less fat trapped in the muscle cells of vegans compared to omnivores at the same body weight, better insulin sensitivity, better blood sugar levels, better insulin levels, and, excitingly, significantly improved beta cell function (the cells in the pancreas that make the insulin). They conclude that eating plant-based is not only expected to be cardioprotective, helping prevent our #1 killer, heart disease, but that plant-based diets are beta cell-protective as well, helping also to prevent our seventh leading cause of death, diabetes.

Even if saturated fat weren’t associated with heart disease, its effects on pancreatic function and insulin resistance in the muscles would be enough to warrant avoiding it.

Despite popular press accounts, saturated fat intake remains the primary modifiable determinant of LDL cholesterol, a leading risk factor for our leading killer–heart disease..