High-fat foods that are good for your heart (including steak and cheese)
There was a time, not so long ago, when fat was considered a killer. The message was simple: eating fat leads to high cholesterol, which results in heart disease and strokes. Today, a more complex picture has emerged, with experts recognising that certain types of fats, consumed in the correct quantities, are actually beneficial.
'Is all fat bad for your heart health? Not at all,' says Dr Oliver Guttmann, a consultant cardiologist at The Wellington Hospital, part of HCA Healthcare UK. 'Some fats are essential. Your body needs them, for example, to build membranes.'
Stephanie Moore, a clinical nutritionist, health coach and author of Eat Your Brain Happy, agrees. 'Our brain, our cell membranes, the coating of our nerves, our hormones – they all rely on fats to do their job,' she says. 'Things like essential fatty acids are, as the name suggests, essential for our body to function.'
The key is which type of fat. 'Saturated fats or trans fats – the kind we find in processed foods, red meats and baked goods – can raise your LDL ['bad' cholesterol], which increases your risk of heart disease and stroke because it contributes to the hardening and narrowing of arteries,' explains Dr Guttman. 'It can also raise your blood pressure and cause liver disease and diabetes. On the other hand, unsaturated fats can actually help to lower your cholesterol and improve blood vessel function, which of course is good for heart health.'
'It's also about how the fat is managed in the body and what it's combined with, especially refined carbohydrates and sugary, processed foods,' says Moore. 'There are numerous things that can turn good fats 'bad' in the blood, but one of the most common is high blood sugar.'
Here, the experts share their favourite high-fat foods that are surprisingly beneficial for your heart health:
Eggs used to get a bad press. Their yolks – which are made up of a mixture of saturated, monounsaturated and polyunsaturated fats – contain cholesterol, so the received wisdom was that eating them would raise your blood cholesterol level.
However, opinion has shifted in recent years, with research showing that the effect is not as significant as previously believed. One 2018 study found that eating six eggs per week actually lowered the risk of cardiovascular disease, while in February of this year, researchers in Australia published a study that found that for the over-70s, regularly eating eggs was associated with a 29 per cent lower risk of cardiovascular disease-related death.
'Eggs are a fabulous source of protein,' says Moore. 'They're also full of nutrients, vitamins, minerals and things called phospholipids, which are critical for brain health. Studies have also shown that people who eat more eggs tend to have that better ratio of LDL to HDL cholesterol. I wouldn't recommend having a six-egg omelette for breakfast every morning, but two eggs a day is a sensible amount.'
Good-quality beef is beneficial for heart health, Moore argues, 'because it contains omega-3, it's incredibly nutrient rich, it supports lean body mass, and it helps with muscle synthesis. Increased muscle mass leads to better metabolic rate, enabling us to burn calories off more easily – so that's very cardiovascular-protective. In grass-fed beef, you've also got the fat-soluble vitamins A, D and K. I'm not suggesting that you should eat a huge steak every night, but I would recommend some red meat – even in the form of a burger, assuming it's made from good-quality mince – up to twice a week.'
However, a review of studies that assessed more than 1.4 million people found that red and processed meat does increase the risk of heart disease, largely because of its saturated fat content. But, says Dr Guttmann, 'there's some nuance here. Red meat is good for you because it helps your blood to create haemoglobin. So, rather than trying to avoid fat entirely, which was the advice given 20 years ago, you should minimise the amount of saturated fat you eat and optimise the unsaturated fat in your diet. The key thing is to have the right balance.'
Despite being notably high in saturated fat, studies have found that cheese can reduce the risk of cardiovascular disease. 'Cheese contains a lot of nutrients, as well as certain fatty acids that help to improve heart health,' says Dr Guttmann. 'Something about the way the fat is packaged [in cheese] seems to have a positive effect on the way our bodies process it, compared with saturated fats from other sources. Mozzarella or cottage cheese are good lower-fat options, but I would also recommend eating small amounts of full-fat cheeses like cheddar or Gouda as part of a balanced diet.'
'The assumption was always that full-fat dairy would raise levels of LDL cholesterol,' Moore says. 'That's now being disputed, with research increasingly showing no correlation between heart disease and full-fat dairy. It's associated with modest reductions in risk for high blood pressure, reduction in risk of coronary heart disease and stroke, regardless of its fat content.'
She adds that cheese contains vitamin K2, which helps vitamin D get into where the body needs it, is often lacking in people's diets. 'Vitamin K2 is cardiovascular protective,' Moore says, 'and it's particularly high in 'holey' cheeses such as Emmental and Jarlsberg, as well as soft cheeses like brie and camembert.'
Oil is a controversial topic. When asked which oil is best for cooking, Dr Guttmann's responds: 'For me, olive oil, as we see in the Mediterranean diet, is the healthiest choice. Extra virgin olive oil, in particular, is rich in monounsaturated fatty acids and antioxidants, which help to reduce inflammation and improve your cholesterol. Sunflower oil, which contains more polyunsaturated fats but hardly any antioxidants, has a higher smoke point, so it's a good option for people who fry a lot. But for salads and vegetables, and if you tend to cook on a medium heat, olive oil is the best.'
Despite its high monounsaturated fat content and calorific concentration, cold-pressed extra virgin olive oil appears to possess miraculous health-giving properties. When it comes to cholesterol, for example, research has found that it helps balance our ratio of HDL to LDL, the so-called 'good' and 'bad' cholesterols.
For Moore, the antioxidants, vitamin E and unique polyphenols (which help stabilise our blood pressure) found in olive oil combine to make it the supremely healthy option, but she stresses the importance of it being extra virgin. 'First cold pressing, or mechanical pressing, brings a huge range of benefits – benefits that are lost when it's produced via heat extraction.'
'Eating fatty fish is very important for heart health,' says Dr Guttmann. 'It contains omega-3 fatty acids, which help to reduce inflammation and lower your risk of heart disease, as well as helping with brain health. We generally recommend eating a portion of around 100g, twice a week.'
'Omega-3s are very protective against cardiovascular and stroke risk,' adds Moore. 'They're anti-inflammatory, so they help with blood flow and blood vessel health, greatly reducing the risk of the high blood pressure, clots and atherosclerosis associated with heart disease.'
Omega-3 acids are almost always lacking in people's diets because they come from so few food sources, Moore explains. The vast majority are found in oily fish: mackerel, sardines, herring, anchovies and salmon (ideally wild not farmed, as the omega-3 comes from the krill they eat in the wild).
Is it possible to eat too much omega-3? 'Yes, in theory,' says Moore, 'But no one ever comes close. Omega-3 and omega-6 both enter cells through the same receptor site. Our modern diet is extremely high in omega-6, which blocks the doorway for the tiny bit of omega-3 that we are eating. I do blood tests to look at the ratio between these two essential fatty acids. The ratio should be around two or three to one in favour of omega-6. But when we look at people who've eaten a Western diet their whole lives, they tend to be 20 or 25 to one in favour of omega-6.'
It's easy to forget that olives are a high-fat food, but they do contain monounsaturated fatty acids, mainly in the form of oleic acid [a type of omega-9 fatty acid known for its potential anti-inflammatory and antioxidant effects], making them a heart-healthy fat source. 'Olives are full of fibre and polyphenols,' says Moore. 'They're also a fermented food, which brings a number of health benefits.'
Olives are also high in iron, plus an antioxidant called quercetin which has been proven to be good for heart health. But should we be wary of their salt content? 'Olives need go through a long fermentation process, which involves them being soaked in brine,' Moore explains, 'though the amount of sodium they actually absorb is limited. There's a of scaremongering about sodium. Our bodies actually need a fair bit of it and in natural foods like olives there's nothing close to the amount hidden in most processed foods.'
'Nuts are really good for you,' enthuses Guttmann, 'especially almonds, walnuts and pistachios, which have a good mix of fats, fibres and proteins. Walnuts, in particular, are a great source of omega-3.'
All nuts have a high fat content but the type of fat depends on the type of nut. Brazil nuts, cashews and macadamia nuts are higher in saturated fat than other nuts, which contain predominantly unsaturated fat (polyunsaturated in walnuts and pine nuts, monounsaturated in almonds, pistachios, pecans and hazelnuts). When it comes to heart health, Moore recommends walnuts, pecan and almonds because of their high omega-3 ratio. Pecans, she adds, have a high content of polyphenols, which are highly protective of heart and supportive of gut health. Almonds, meanwhile, are very high in vitamin E, which is beneficial for blood pressure and overall cardiovascular health.
One word of warning: you should restrict your nut consumption to a small handful per day, ideally in their raw form. 'Nuts are very easy to over-consume,' says Moore, 'especially when they've been roasted and salted. Not only does that process cause them to lose some of their benefits, but it also makes them more addictive. People tend to massively overeat them – so you end up getting a huge calorie hit without even noticing it.'
Unfortunately, there's no simple answer. 'The ideal amount is individual to each person depending on their age, activity levels and overall health,' says Moore. 'The way we respond to fat is also largely dictated by genetics. Certain individuals are more prone to inflammation and higher LDL cholesterol. In general, however, the recommendations are that we should get 20 to 30 per cent of our calories from fat. But bear in mind that eggs, meat, fish, dairy, all contain fat. If you then add olive oil, which is 120 calories per tablespoon, it can quickly mount up.'
As well as getting the right balance between saturated and unsaturated fats, portion control is crucial. NHS guidelines state that, per day, men should not eat more than 30g of saturated fat and women should not eat more than 20g. It's worth noting, however, that 'good' unsaturated fat can be harmful if you consume too much of it.
There are three main categories of dietary fat: saturated, monounsaturated and polyunsaturated. These all serve different purposes in our body, and all provide some benefit when consumed in their whole, natural form. Saturated fats, chiefly found in meat and dairy, are solid at room temperature, while unsaturated fats are liquid.
Both monounsaturated and polyunsaturated fats are good for your health, but differ slightly in chemical composition and health benefits. Monounsaturated fats, found in olive oil, avocados and nuts, contain some saturated fat (olive oil, for example, contains about 20 per cent saturated fat).
Polyunsaturated fats, found in things like fatty fish and sunflower oil, contain essential fatty acids including omega-3s and omega-6s, which are important for various bodily functions. According to the AHA, both monounsaturated and polyunsaturated fats can lower rates of cardiovascular disease and all-cause mortality. These fats also help to decrease bad cholesterol and triglyceride levels, both of which contribute to heart disease.
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