Tipping the Balance of Fat

Tipping the Balance of Fat

August 3, 2023

Joy Stepinski, MSN, RN-BC

High fat diets are, for the most part, a big part of American meals. At breakfast, eggs, bacon, and sausage are enjoyed. In the nice weather, people grill large steaks and burgers. When eating dessert, ice cream is an undeniable favorite. Although these foods are largely part of life, they are comprised of high amounts of fat. Fat is a requirement of the body, and is needed for fuel and energy storage, cell membranes, and synthesizing other molecules. Yet what happens if it is consumed in excess?

The conventional diet that most Americans enjoy is known as the Standard American Diet (SAD). Looking at a breakdown of foods within this eating pattern, 63% are refined and processed foods, 25% are animal foods, and 12% plant-based foods [1]. Of the plant-based foods, half are typically French fries, which are cooked in oil. One tablespoon of oil contains 14 gm of fat and raises the fat content of plant food significantly. The country has also seen the advent of processed plant-based foods, such as the Impossible™ Burger. Of note, 52.5% of calories within this burger are from fat.

Another popular diet is the high fat-low carb diet, often referred to as the “keto diet.” A true ketogenic diet is a way of eating that causes the body to enter into a chronic state of ketosis [2]. Instead of using glucose for energy, the body utilizes ketones. A diet of low-carbohydrate, moderate protein, and high-fat can transition the body into a different metabolic state (ketosis) than its normal function.

Glucose is the primary source of energy for the body. However, in a ketosis state (normally a survival mechanism for when glucose is depleted), the liver converts fatty acids from fat stores into ketones [3]. The ketogenic diet can have beneficial effects on children and adults with epilepsy or patients diagnosed with specific brain tumors. However, its use for long-term weight loss has not been demonstrated. Long-term studies, such as one that followed 63 patients for 12 months [4], led to no benefits of weight loss after one year over a low-fat diet.

Other studies discuss the negative ramifications that a perpetual state of ketosis may have upon the cardiovascular system [5], such as heart dysfunction. Furthermore, a high fat diet is linked with Alzheimer’s disease, cancer, diabetes, and chronic kidney disease. It also lacks fiber and other important nutrients.

High-fat diets, including SAD, can alter the body’s acid-base balance. This can lead to a condition called metabolic acidosis. When more fat is metabolized, an accumulation of waste products can occur, with an excess of ketones and acids. Metabolic acidosis can progress throughout someone’s lifespan, and especially increases with advanced age [6].

The kidneys work to restore the acid-base balance. One way the organ does this is by increasing the urinary elimination of sulfate. Sulfate is correlated with animal protein content, and is higher in those who consume diets based in animal-protein than in people who primarily eat a plant-based diet. The consequences may be kidney stones, insulin resistance (diabetes type 2), muscle wasting, high blood pressure, and heart disease.

Another effect of high-fat diets is found in the microbiome. An abundance of microbes resides in the body, aids in human development, regulates metabolism, and protects the body from pathogens. Diets low in plant fiber can reduce beneficial microorganisms, in particular Akkermansia muciniphilia [7]. This microbe is normally responsible for regulating the quality and thickness of the mucus layer in the gut. When A. muciniphilia is depleted, the mucosal layer becomes thin and leads to a leaky gut. Microbes crossing the gut lining will consequently cause an immune response. Ultimately, the reduction of A. muciniphilia is thought to play a role in intestinal diseases, such as inflammatory bowel disease; lead to inflammation throughout the body; and is implicated in neurodegenerative diseases, like Alzheimer’s.

Often people who live in impoverished countries suffer from malnourishment and deficiencies because they do not have access to food. However, citizens in the United States tend to have unlimited access. Consuming diets of excessive energy, fat, and cholesterol can also cause malnutrition [8], leading to many chronic disease states, like heart disease, stroke, cancer, and diabetes. Food choices matter. If the balanced is tipped too far either way, disease may ensue.

The good news is that diets rich in whole plant foods include lower risk of obesity, heart disease [9], diabetes type 2, high blood pressure [6], neurodegenerative diseases, gut disease, and inflammation [7]. This food is filled with fiber, minerals, and phytochemicals. Long-term sustained benefits, including longevity, have been demonstrated through the China Study [9], Blue Zones project [10], and many others.

References:

1.       Forks Over Knives. (2016). The Standard American Diet is even sadder than we thought. https://www.forksoverknives.com/wellness/standard-american-diet-sadder-than-we-thought/

2.       Nordli, D. R., & De Vivo, D. C. (1997). The ketogenic diet revisited: Back to the future. Epilepsia, 38(7), 743-749. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1528-1157.1997.tb01460.x

3.       Crosby, L., Davis, B., Joshi, S., Jardine, M., Paul, J., Neola, M., & Barnard, N. D. (2021). Ketogenic diets and chronic disease: Weighing the benefits against the risks. Frontiers in Nutrition, 8, 702802.

4.       Foster, G. D., Wyatt, H. R., Hill, J. O., McGuckin, B. G., Brill, C., Mohammed, B. S., Szapary, P. O., Rader, D. J., Edman, J. S., Klein, S. (2003). A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine, 348, 2082-2090. https://doi.org/10.1056/NEJMoa022207

5.       Brehm, B. J., Seeley, R. J., Daniels, S. R., D’Alessio, D. A. (2003). A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism, 88(4), 1617 – 1623. https://doi.org/10.1210/jc.2002-021480

6.       Adeva, M. M., & Souto, G. (2011). Diet-induced metabolic acidosis. Clinical Nutrition, 30(4), 416-421. https://doi.org/10.1016/j.clnu.2011.03.008

7.       Mayer, E. (2016). Mind-Gut Connection. Harper Collins Publisher.

8.       Nestle, M. Food politics. 2002. University of California Press.

9.       Campbell, T. C., & Campbell, T. M. (2006). The China Study. BenBella Books, Inc.

10.   Buettner, D. (2012). The Blue Zones: 9 lessons for living longer from the people who've lived the longest. National Geographic Books.