Medical OET · Test 06

Test 06 - Part C - Extract 1

My guest today is Dr Nick Pettis, Associate Dean of Medical Education at the University of Durham Medical School.

Level: C1 · 66 sentences

Transcript

  1. My guest today is Dr Nick Pettis, Associate Dean of Medical Education at the University of Durham Medical School.
  2. In light of a new report that's recently been published on the subject, we're talking today about saturated fat.
  3. So, Dr Pettis, can you tell us what the difference is in how many experts view fat now versus 30 years ago?
  4. The low-fat era is finally starting to come to an end.
  5. The 2015 UK Dietary Guidelines did, for the most part, exonerate fat and cholesterol with no restrictions on total fat or cholesterol in the diet.
  6. After 30 years of previous guidelines advising a low-fat and low-cholesterol diet,
  7. I think there is still a lot of misinformation floating around about saturated fat.
  8. Not all saturated fats are bad,
  9. and they've somehow been grouped together and labelled as harmful.
  10. So we still have some work to do there.
  11. Can you talk a little more about the relationship between saturated fat and cholesterol levels?
  12. We spent most of the last generation looking at total cholesterol and LDL
  13. as if to suggest that those two values give you an accurate reflection of what we know to be a much more complex and nuanced issue with lipids.
  14. But when you give people fat from a quality source and lower their carbohydrates,
  15. generally you see their triglycerides come down.
  16. That's a good thing.
  17. You see their good cholesterol, the HDL, go up.
  18. That's a really good thing.
  19. What you see in the majority of people when you give them more saturated fat...
  20. is a shift from the small dense LDL particles.
  21. These are the more risky inflammatory atherogenic types of LDL to larger more buoyant LDL particles which are less inflammatory.
  22. Many physicians still aren't aware of this.
  23. What are your views on saturated fat and its place in the diet?
  24. Quality becomes paramount here.
  25. The saturated fat in a fast food bacon cheeseburger will have an entirely different effect than saturated fat in coconut oil.
  26. I absolutely love healthy saturated fats like coconut oil and grass-fed butter,
  27. and I think they have a place in our diets.
  28. Healthy saturated fats can actually help you burn fat.
  29. They make your brain work better and faster.
  30. They make your skin glow,
  31. and they can help optimise your cholesterol profiles.
  32. It is very important that you only include saturated fat in the context of a diet
  33. that is very low in refined carbs and sugar
  34. and includes omega-3 fats.
  35. The entire LDL lowering hypothesis is being questioned by recent studies
  36. that have found that those who had the LDL lowered the most by vegetable oil had the greatest risk of heart attack or death.
  37. Are you saying we should embrace saturated fat and stop worrying about cholesterol?
  38. No, I'm actually not suggesting that.
  39. The saturated fat in your diet has very little correlation to the saturated fat in your blood.
  40. But we do know that higher saturated fats in your blood are linked to heart disease.
  41. The question is, how do you get high saturated fat in your blood?
  42. Logic would dictate that it is by eating butter.
  43. But biology is not so straightforward.
  44. It is by eating sugar and refined carbs.
  45. Low-fat, high-carb diets trigger synthesis of the type of blood-saturated fats that are linked to heart disease.
  46. Why is nutritional science often so contradictory and confusing?
  47. There is contradictory information because the research is hard to read.
  48. And, of course, if a study is being performed or funded by someone who has a strong opinion,
  49. the outcome is more likely to favour that opinion.
  50. A lot of experts are also looking at outdated research.
  51. These are studies in which people who are eating fat are eating bad fats, inflammatory fats, and junk food.
  52. Well, of course, you would think that the fat is bad for you if you are looking at a study like that.
  53. So it often comes back to an individual's understanding of the research.
  54. Why do a lot of organizations and experts still push a no-fat or low-fat message?
  55. I think that is such an important question.
  56. I've been in practice almost 30 years
  57. and I've had very academic roots all along
  58. and there is this incredible delay.
  59. The structures and organizations and associations that we look to for guidance and advice are not nimble at all.
  60. They bring inherent bias.
  61. These are good people but there's an inherent bias that these structures tend to embrace.
  62. We all know that there are researchers who will lose grant support overnight if they suddenly change from saying fat is bad.
  63. They'll struggle to maintain their academic integrity based on the culture they are in.
  64. In all of this debate over fat and saturated fat in particular,
  65. I still recommend filling your plate with at least 75% phytonutrient rich, colourful, non-starchy veggies.
  66. Plant foods by volume should take up the majority of your plate.