Saturated fats used to be really easy to discuss with patients. It was like talking about cigarettes, you could just say, “Avoid them.” But for the last fifteen years, Americans have been drowned in a sea of misinformation created by the food industry. That’s what Dr. Evan Allen is here to talk about.

Dr. Evan Allen, the author of Oversaturated, believes that this distortion of the truth ignores decades of established research and has led millions of people to embrace a diet high in saturated fat. Because of that, he believes that many will suffer the consequences of diabetes, dementia and heart disease.

Evan has been practicing medicine for over twenty-five years and, in that time, he’s opened two practices in Henderson, Nevada. He’s received board certification from the American board of obesity medicine. But more importantly, when he really started to pay attention to nutrition, the health of his patients improved dramatically.

He hopes to give healthcare providers what he never had, which is a guide to talking to your patients about a healthy diet that’s low in saturated fat and ultimately, genuinely improve the health of your patients.

Evan Allen: I was a fairly traditionally trained and traditionally practicing family doctor for most of my career. In 2011, I was going to have my first child and I had to get an insurance physical. Having been a vegetarian my whole life and never having the belief that I could be at risk for any serious diseases, I sort of didn’t care about it much. I had gained some weight and had some minor nagging illnesses, but nothing that was preventing me from working.

I did the blood draw and the EKG and all of the stuff that happens when you get an insurance physical. It came back and reported that I was a level two candidate, because I had a fatty liver, which I was a little miffed at. I’ve been vegetarian my whole life and never voluntarily eaten any meat that I know of.

I thought, “Well, how is this happening.” I really didn’t know exactly where to go from where I was, but I had read the traditional stuff that all of us read in the media about how carbohydrates are really bad for you. It’s transitioned to eating higher fat, eggs, cheese and butter, and trying to avoid loads of crackers and pasta and grains and things like that.

At the time, my wife was pregnant, and we were eating eggs and butter all the time. I was fairly surprised, given everything that was going on in the media at that time about how saturated fat isn’t bad and carbohydrates are the real source of all the problems.

I didn’t really know what to do with that. A few weeks later, actually, after my son was born, I ended up watching the video, Forks Over Knives on Netflix. At the time, it significantly upset me and caused me to become angry about this ridiculous propaganda that this movie was putting forward.

I decided that–I’m a very educated physician, I know lots and lots about medicine and lots and lots about nutrition, and I’m going to show how–and I don’t want to use any excessively pejorative words–but I was going to show how the doctors who had been in this film had feathers and bills, let’s put it that way.

Look to the Data

I researched fairly intensely for a couple of weeks, all the data, one side and the other, and all the information I could find. The data had a fairly clear-cut bias, which was the type of diet they were recommending, which was very high in fiber and very low in saturated fat, which is in line with all the traditional guidelines, was actually significantly better both in laboratory studies and randomized control trials and observational cohort studies–where you look at people over long periods of time.

Most of the recommendations they were making were well grounded and fairly solid science. The only thing that I found that I could use to get around that–to support the narrative that I had been supporting in my mind up until that time and which I was also telling my patients, to avoid all carbohydrates and increase their fat protein to improve blood sugar–the only narrative I could find that supported that practice was to disregard cholesterol. To think that having high cholesterol was good for you. I knew already at that point that was impossible.

My clinical experience was far too strong–treating patients with high cholesterol and watching them improve as the cholesterol got lower and watching them get worse when their cholesterol stayed high–to believe that cholesterol was not a serious risk factor. To this day, there are plenty of people out there who deny this and argue the other direction. I don’t know that there is a way to silence those voices, but the scientific evidence against cholesterol is incredibly strong and it’s only gotten stronger since I did that initial foray into the research.

Having found all this information out there about high fiber diets, low in total fat and low in saturated fat, being really beneficial, I ended up doing the experiment of just adopting that plan myself. I was already vegetarian, so it wasn’t really that hard of a challenge for me to give up meat, but giving up butter, eggs, and cheese was actually somewhat of a challenge.

I’m sure it was much easier than somebody who is eating a traditional diet. However, it was hard for me to give up all the pizza I had been eating. When I did that, I dropped 45 pounds, found out that I no longer wheezed, fixed my urticarial vasculitis that I had been diagnosed with when I was in the Air
Force, and just generally felt substantially better, even in my late 40s, than I had in my late 20s and 30s.

My sleep improved and my energy improved. These are the kinds of stories you hear people tell with any kind of nutritional change from an unhealthy diet to a less unhealthy diet. I don’t try to argue that my personal experience was in any way compelling to anyone else–lots of people tell all kinds of anecdotal tales about what improved with them.

My focus then was, where does the literature really go on this? Having just read a lot of literature, I thought, well, let’s try this with some patients. I started making different recommendations to certain patients about what to cut out and what to emphasize. What I found was that the results were much better across the board in patients who made big changes.

Going on a diet low in saturated fat in the western world is very unusual and very challenging. It takes a lot of effort and a lot of energy to really closely look at all your food, and be very careful in restaurants, and be very careful when you shop. Keeping your total saturated fat under 6% of your calories is really a lot of work.

A New Practice Model

There is a lot that could be made better by changes in society in general, obviously. But, when people did it, I found blood sugars normalizing, blood pressures normalizing, significant improvements in body composition, and reversal of fatty liver, which is very common in the United States. It really made a big change in how I approached things. Then, what I started to get disappointed in was the amount of time that I needed to deliver that message. It was not easy to deliver in our canned office visits that we have under typical insurance models.

I developed a new practice model–I opened a concierge practice. I had more time to spend with patients and more time to emphasize lifestyle. I went ahead and got board certified in obesity, and that has really helped me with patients and helped develop a more overall approach to problems. I still do traditional family practice and I’m quite good at it. I can still prescribe medications for problems when people need them.

However, for people who can and have the energy to make the lifestyle changes that I generally recommend, I find that the amount of medication they need or the amount of interventions that they need are really quite a bit smaller than they would have needed without the changes in lifestyle.

Recommendations for All

Charlie Hoehn: What types of people are you making these recommendations to?

Evan Allen: I make the recommendations across the board, and the reason I do that is because heart disease is the number one killer in the United States. It starts in childhood. The first evidence that someone will have heart disease is sudden death–for men it’s one and four, and in women it’s even higher, it’s one in three.

It’s really not legitimate, in my opinion, to wait until you have symptomatic disease to make the changes required. If some other disease were the number one cause of death, then I might say we should target these recommendations more narrowly. At the moment, that’s not the case. We’ve dropped heart disease deaths–we’ve taken about two thirds from the peak in the 1960s. In the 1960s, 600 people per hundred thousand were dying annually of heart disease and that’s down to about 200.

It’s still the number one cause of death–just a little bit above cancer. From my point of view, that’s a lot of dice to roll to just go ahead and keep doing what you’re going to do, and not worry about it until you develop symptoms–given that at best, you have a 25% chance of suddenly dropping dead.

In the book, there’s an example of a guy, Bob Harper, who was the host on The Biggest Loser. He was quite physically fit, was doing what he thought was best nutritionally, was working out, and had a sudden death event, which was his first evidence that he had heart disease. Luckily, there was somebody there with paddles to shock his heart back to life, but if he had been there by himself or that had happened in another circumstance, he probably wouldn’t have survived it.

There is an example of somebody who didn’t survive, which is Jim Fixx, who was the author of The Runner’s Bible back in the 70s. He had high cholesterol, thought running would solve all his problems, and died at age 52 while running.

Push Against Keto

Charlie Hoehn: What made you decide that you needed to take a stand against this current wave of fat champions?

Evan Allen: ‘Fat-philia’, yeah. The point is that the scientific and historical narrative that has been constructed in support of this keto diet is tissue thin. When you interrogate it at almost any point, you find that it’s built on a set of assumptions about the state of the earth that don’t hold up. I find that the current situation, when it comes to nutrition, is you have a decent amount of people who are in the middle, but generally agree that cholesterol is dangerous, and yet still think that maybe carbohydrates are dangerous. I get where they’re coming from.

Carbohydrates are dangerous when they’re in foods that are not good for you–that’s your refined grains that are associated typically in America with desserts. Those are your sugary desserts that are cream based, those are your carbs that you’re getting from foods like pizza. I think everybody agrees that those foods which are both high in refined carbohydrate and also high in saturated fat are negative for health.

They should not be a primary source of calories for anyone. I think a lot of people get better when they do keto, because they eliminate a lot of discretionary calories. If you’re on keto, or you’re on a healthy plant-based diet, and there’s a jar of M&M’s in the hallway that you have to walk past every day, in either case, you’re not going to eat the M&M’s.

In either case, you’re getting a lot fewer discretionary calories. Whereas, if you’re not doing any kind of modification of your eating, then you’re going to take some M&M’s when you walk past. They taste good, you like them, they’re yummy.

The situation for the moment with keto is that a lot of people with a lot of money have been funding this idea that keto is the solution. The primary funder of it has been the Laura and John Arnold Foundation–this is not in the book, but when you really follow the narrative back far, you usually find somebody who is funded by the Laura and John Arnold Foundation. I don’t know exactly why Laura and John Arnold’s Foundation, which they made with Enron money, has decided to push a low carb narrative, but they certainly have and there’s certainly big money there.

The dairy industry has also funded lots of research that tries to suggest that saturated fat generally, and specifically, the saturated fat found in high fat dairy foods, which are the number one source of saturated fat, are actually beneficial to your health. It’s a tell in the way they’re doing this. They’re doing it all with either observational studies, or studies of studies, or what are called meta-analyses, but not doing basic science research.

Basic science research is really the pillar that allows us to know that something is actually causal or not causal. Basic science research, whether we try it the lab with animals, or drip it on cells and culture, when we add saturated fat to an animal or cell culture, it is harmful–it causes deleterious metabolic effects across the board.

These studies get ignored. Cohort sized epidemiological studies, where we follow people over time–you have Finland, where 20% of their calories were from saturated fat and they had the highest rate of heart disease, versus Japan which ate between 3% and 4% of calories from saturated fat, and they had the lowest rate of heart disease.

The keto arguments, when you interrogate them, just don’t really hold up. Even the biggest proponent of low carb diets, which is Gary Taubes, admits that in general, low carb diets raise your LDL cholesterol.

There’s a chapter in the book about LDL cholesterol and just how dangerous it is. If you believe that, then you have to believe that diets high in saturated fat are dangerous, because they’re going to raise that LDL cholesterol.

The Seven Countries Study

Charlie Hoehn: You have a chapter in your book called ‘When Communities Change How They Eat’. Talk to me about that chapter?

Evan Allen: The Seven Countries Study, which again from the keto point of view is considered this fraudulent study–you know that somebody is giving you a line when they tell you that the seven country study was fraudulent, because it was run by so many different researchers in so many countries. Had it been fraudulent, it would have been the most massive conspiracy ever and would not have gone undetected.

For example, we had a fraudulent study just recently, the PREDIMED Study, which was banded about by people who recommend high fat diets as a wonderful study that showed how high fat diets were not dangerous. Then it was found within a decade to have been completely fraudulent and was retracted.

If the Seven Countries Study had tried to do something like that, that also would have gotten out certainly between 1970 and 2019. It hasn’t because it wasn’t fraudulent. In the Seven Country Study, Finland had the highest rates of heart disease. The Finnish government took this as a sign that Finland should change and do something different. An amazing researcher named Pekka Puska put together a program for the region of North Karelia in Finland, which had the highest death rate from heart disease, and what he recommended was a transition from diets high in saturated fat to much more plant-based diets.

He recommended to take much of the pork and meat out of their stews and replace them with potatoes and vegetables. They tried to help farmers, instead of producing so many dairy products, to grow the natural berries that grow very well in Finland. Then freeze them and use those as a source of calories over the year, rather than as many dairy products. They generally changed the fat content in almost all the products that were available, and asked people to be educated in this way. In the North Karelia Project, over the period of a decade, they dropped heart disease death rates by 80%, that is an 8-0.

A much higher drop in a much shorter period of time has happened in the United States over the last fifty years. We have largely maintained that. If the narrative that keto people put forward, which is that saturated fat is really quite good for you and that you should try to eat as much as possible, were true, then the Fin’s health and death rates from heart disease should have worsened in that period of time when they were being specifically told to eat a low saturated fat diet.

Well, that’s exactly the opposite of what we see. For me, this is compelling evidence that the world does not work the way that this prevailing, and what I think of as industry sponsored counter narrative, has suggested is the case.

If putting butter and coconut oil in your coffee were good for you, then the Fin’s should have gotten less healthy over time. The Japanese should have, over the last fifteen to thirty years as they increased their consumption of fat and decreased their consumption of rice, seen actual significant drops in the rate of heart disease.

What’s really happened is, in Japan, things have been pretty flat, because heart disease treatment has gotten better. Whereas in Finland, rates dropped dramatically.

Plant-Based, Low Fat

Charlie Hoehn: When did we really start measuring heart disease?

Evan Allen: There is a great graph that the CDC puts out that shows causes of death over the 20thcentury. What you see is that there was heart disease as a significant cause of death in the 1900s–it was number two behind pneumonia. If you go back earlier or even to 1870, heart disease was actually really quite rare at that time. It’s really the last half of the 19thcentury, and then the early part of the 20thcentury, that we see a big bump.

A whole lot of things are happening with industrialization at that time. When you get industrialization, you start to get electricity, refrigeration, you get industrialized transport of foods, and you get much better storage of foods. Rather than having those people get their calories from a dry goods store, people start to get their calories more from markets that are selling meats and dairy products and eggs and other things like that.

Those things become a bigger part of the diet. And, in general, heart disease is first reported in the 18thcentury when we can be clear from autopsies that it was actually heart disease. It was quite rare. It was really quite limited to the wealthy and upper class.

I think there is good reason to think Henry the 8thalso suffered from heart disease. He was also wealthy, and we know exactly what he ate. We don’t see a really high carb diet. We see a lot of wild game– pheasant, grouse, duck, beef, and loin–all the sorts of the things that rich people would have liked to eat.

So, in general, heart disease was considered sort of a product of wealth, and if somebody who was wealthy had heart disease, the general advice was to adopt a more peasant-style diet, which was lower in saturated fat and lower in animal products. This would improve the symptoms and that was widely understood.

As it became more common in the late 19thand early 20thcentury, a bunch of different nutritional approaches were tried and many of them were quite successful at treating the symptoms. But it was only in the early part of the 20thcentury that researchers started testing laboratory animals with various diets to see what would instigate the process of heart disease in those animals.

What became quite clear early on–we’re talking about 1917 to 1920–is that a diet high in saturated fat and cholesterol promoted the hardening of the arteries. You could feed rabbits cholesterol and they would get hardening of the arteries that look just like human beings. Then you could also feed the same rabbit saturated fat without cholesterol, and the liver would turn the saturated fat into cholesterol, and the rabbits would get the same hardening of the arteries.

Over the course of the 20thcentury, it became clear that the primary driver of high cholesterol in the blood was saturated fat, and not cholesterol. There is a mathematical equation that has been developed on the basis of feeding studies where you put people on a metabolic ward and limit everything that comes in and out. You can calculate, if you know someone’s baseline cholesterol, what will happen to their cholesterol level, if you feed them a certain number of their calories from additional saturated fat versus unsaturated fat versus cholesterol. The saturated fat is the single most important variable.

If industry and people who pushed the keto narrative really wanted to change the minds of people who know the science in depth, what they would do is they would fund basic science research where they put people in metabolic ward, feed them additional saturated fat, and watch their cholesterol drop.

But they don’t fund that kind of research and the reason why they don’t fund that kind of research is it has already been done, and we already know the results. The results don’t support eating diets high in saturated fat, if you want to have a reasonably low cholesterol level.

Is it Sugar?

Charlie Hoehn: What about the narrative right now that it is sugar and inflammation that is the problem?

Evan Allen: That is absolutely correct, and I really hope that there is nobody out there in the nutrition space who is recommending a high sugar diet. If there is someone out there recommending a high sugar diet, I will find them and tell them to stop doing that.

The reason to avoid high sugar diets is because sugar does have some significant negative health effects, but it is pretty hard to tease those negative health effects out, once you control for the primary sources that people get their sugar from.

People generally don’t get their sugar from hard candy. They generally don’t get their sugar from tablespoons of sugar that they put in their mouths from a Domino’s bag. They generally get their sugar from foods high in sugar. What are those foods? Those are foods like donuts, pop tarts, cookies, cakes, pies, brownies–delicious foods and foods that are easy to overeat, but also foods that are very high in saturated fat.

If you are eating lots of donuts and lots of ice cream, you will get lots of sugar and it will be bad for you. I don’t stand behind anybody that tells people they should eat lots of sugar. Neither did Ancel Keys, who wrote extensively about how Americans should be replacing their sugar calories and should not get significant amounts of energy from sugar.

Look at nations like Cuba. Cuba in 1995 underwent what was called The Special Period, when after the collapse of the Soviet Union, the money coming from the eastern block to Cuba dropped dramatically.

Cuba was in a tough situation and they needed to adopt to a “whatever calories we can get” approach, because total caloric intake dropped to famine levels. The average Cuban lost 11 pounds, and death from starvation went up. I’ve talked to people who were living at Cuba at that time, and they were eating rats. Nobody had pets anymore because they would kill them and eat them. It was a very, very dangerous time.

But Cuba grows a lot of sugar cane, and because they grew sugar cane and this was a source of calories that they could easily get to the populous without needing to generate currency, sugar consumption actually increased dramatically during The Special Period–up to a total of 27% of calories. I would find that kind of disgusting. That would be a very sweet diet if you are getting 27% of your calories from sugar. I think even a child might get tired of that.

However, obesity rates dropped, diabetes rates dropped, and heart disease rates dropped. The theory that sugar causes all these horrible metabolic problems seems to fly poorly in the face of that data and, we can’t do experiments. I don’t think it would be ethical to do an experiment where you fed someone 27% of their calories from sugar. I think that is harmful and the Cuban experience doesn’t make me want to go drink a lot of Coca-Cola and eat hard candy.

It does suggest that the narrative that sugar is unique and the only problem, and that you can completely ignore saturated fat, and put coffee with coconut oil in your stomach every morning, isn’t particularly accurate.

Ceramide

Charlie Hoehn: There is a chapter in your book that I haven’t come across before or this condition–ceramide.

Evan Allen: Yes, that is something that is relatively new, and I hope is instructive and informative to people who read the book. Ceramide, when I was in medical school, wasn’t really capable of being studied at the time, except as a major component of things like skin cells and ear wax, because in regular tissues it is present in such small amounts that’s very, very hard to get accurate assessments. Techniques in analytic chemistry improved so dramatically, that by the first part of the 21stcentury, we were able to do much more analysis on what are called sphingolipids, which is just a fancy word for a very specific kind of fat.

What we found over the last twenty years is that diets high in saturated fat tend to raise the levels of certain of these ceramides that are metabolically harmful. These are ceramides that are based on palmitic acid, which is the most common saturated fat found in foods, and steric acid, which is the second most common saturated fat founded in food. These ceramides seem to predict risk of things like heart attack and other significant metabolic disruptions like fatty liver and diabetes, independent of what we call the traditional markers–things like LDL cholesterol, blood sugar, and insulin levels.

Studies have been done feeding people diets high in saturated fat versus diets high in unsaturated fat, and what we have shown is ceramide levels, both in the liver and in the serum, go up dramatically. There is interesting research that I don’t have in the book implicating ceramide also in the development of asthma. We know that people with higher circulating levels of saturated fats have higher levels of asthma.

Ceramide is really a new and novel bio marker that does help us predict metabolic disturbance and is uniquely linked to diets high in saturated fat. Interestingly, since the book has been published, there is actually an editorial that just got published last week out of the University of Utah that suggests that we should begin screening patients. Certainly, at least screening patients who have had a heart attack or stroke for their ceramide levels to take steps to reduce their ceramide levels, because those patients are at such high risk. The benefit of ceramide is it acts independently, and it is a mechanism that is different from cholesterol.

Unfortunately, there is a subset of patients who have bought into this low carb narrative and have been convinced that cholesterol is not a bio marker of concern. For these patients, it is difficult as medical providers for us to treat them or talk to them about the risks, because when we bring up cholesterol they glaze over.

The ceramide data is independent of the cholesterol data. In a study that was published since I published the book, ceramide levels were better predictors in patients who had heart attacks already, and who mostly get statins to drop their cholesterol levels. They were better predictors of the risk of a reoccurrence of heart attack than even LDL cholesterol was.

I think this is an avenue where there hasn’t been much misinformation propagated to the public yet, and as a physician, if we can start measuring ceramide levels and decreasing saturated fat intake to drop the ceramide level, it will also hopefully drop cholesterol levels and drop overall risk in the population in general. The reason I wanted to put that in the book is because the data and science on ceramides is really quite strong.

There’s basically been complete radio silence on the part of media about this emerging risk factor and I wanted to bring it to more health professionals and the general public’s attention.

Talking to Patients

Charlie Hoehn: At the end of your book, you have a chapter specifically for health care professionals about how to talk to their patients.

Evan Allen: Whenever you are dealing with patients, what you have to try to explain is how the science relates to their specific situation, and yet individual cases you can’t use as a general rule.

I deal with this all the time when it comes to cigarettes. People tell me, “My grandpa smoked a pack a day every day and he lived to be 98, so I am not worried.” Well, I can easily imagine someone who drives without their seatbelt who never got in a wreck.

It is easy to imagine somebody who has never had fire insurance, and never had the house burn down, and feels perfectly comfortable not having the insurance. Any cursory examination of those cases suggests that you can’t count on someone who is lucky and who has adopted a risky behavior necessarily applying to you. Sad to say, red meat is a class 1B carcinogen. Processed red meats, which are common enough–bacon and burgers and things like that–are class 1A carcinogens, along with asbestos and cigarettes.

The idea that a diet composed entirely of these foods is going to be beneficial for health, is way too big of a hill to climb. It requires a much, much larger evidence base than one guy who does it who seems to be doing well.

In general, what you want is an eating plan that’s been tested in hundreds of thousands or millions of people and been found to be associated with low rates overall of disease. For example, you have Ireland in 1835. In Ireland in 1835, the average person ate 4,000 calories a day of white potatoes. Everybody knows this, and they know what happened after 1835 when the potatoes started dying–the Irish started dying, because they had no calories, and they started starving to death.

When they were eating 4,000 calories of white potatoes a day, their death rate from diabetes was two per million. I know that eating a diet relatively low in fat and high in unprocessed plant-based carbohydrate is probably pretty safe in terms of somebody who is diabetic. This is not going to significantly increase their risk and there is plenty of scientific research to back that up.

In fact, the studies show the other direction. One of the big proponents of a carnivore diet, Shawn Baker, has pre-diabetes blood sugar levels on his own blood test. How is he getting pre-diabetes if he never eats any carbohydrates, unless blood sugar is not entirely based on what carbohydrates you eat, but more on your overall insulin resistance? A diet high in saturated fat causes that insulin resistance, which I think we show pretty clearly in the book.

You can’t go on individual anecdotes. Individual anecdotes are useful to generate hypotheses, but they are not the way you find out facts. We have data going back millennia that suggests that disease rates of non-communicable disease, things like diabetes, heart disease and cancer, are quite a bit lower for people eating traditional, plant-based diets. Death rates in Chicago in 1850 from cancer were one in 400, and that is being generous, because the published death rate was one in a thousand. I will say one in 400, because they missed a bunch of cases. Death rates in Chicago now from cancer are one in four. It is hard to imagine that’s only genetic.

Although I find my story very compelling for me and I am happy about my story, I try not to base my case on what happened to me personally. Other people have made other big changes in their diets that are different from mine and still gotten big health improvements. That in and of itself isn’t how we find out the truth.

Charlie Hoehn: What is the best way for our listeners to follow you in your journey or even connect with you?

Evan Allen: I interact the most on Twitter and my handle is @Evan Allenllen0417. That is probably the easiest way for people to get my latest info. I also have office hours, and if anybody wants to come and see me in my concierge practice in Henderson, they are certainly welcome to. I’ve had patients travel from as far as Paris, France to come see me in my office. That always sort of shocks me that anybody is that interested in my point of view, but it is certainly a nice compliment.

In addition, if people really wanted to get a hold of me, they can certainly contact me by direct message on Twitter. Unfortunately, I am not able to give any individualized medical advice, because of the laws against practicing medicine without an examination. In general, they are going to get general information from me, but on the other hand, I think that the general principles of healthy living are pretty nicely applicable to most individual situations and can be explained without too much difficulty to just about anyone.

A Challenge

Charlie Hoehn: The final question I have for you is to give our listeners a challenge–what is the one thing that you would like them to do this week from your book that will have a positive impact?

Evan Allen: I talk about this all the time and I think a top five approach is a really good quick and easy approach.  I have used it in the office multiple times, and it is something that people who are rushed for time and really just want to get good advice in a short period of time can do. Get rid of the top five sources of saturated five. Those top five are pretty easy to remember once you’ve gone through the list, and they are: cheese, pizza, grain-based desserts, dairy-based desserts and chicken. If people remove those top five sources of saturated fat from their diet, most people see significant improvements in their health.

I’ve had patients who just didn’t want to hear anything else that I had to say but followed that advice and they dropped weight. Their asthma improves, their cholesterol comes down, and they see improvements across the board when they’re able to make those changes.