The anti-saturated fat discussions that emerged in the late 1970’s remain among the most controversial topics in the world of nutrition today. Fringe elements in the nutrition community that first questioned the role of saturated fat consumption in heart disease are now mainstream. But much of the thinking behind the blanket exoneration of saturated fats has been questionable, beginning with the health of the Inuit.
Is Sugar All That Was Wrong?
While it is inarguable that the modern Western diet has brought disease to indigenous peoples across the world, there remains disagreement about which elements of the modern Western diet have been the most harmful. We have observed dramatic rises in heart disease, cancer, and type 2 diabetes among the island populations of New Zealand, among the Masai of Kenya, and among the Bedouins of Syria[1].
The low-carb and ketogenic communities rightly point to sugar as a culprit. When considering the monosaccharide fructose and the disaccharide sucrose, refined sugar consumption has been linked to not only type 2 diabetes, heart disease, and cancer, but also to gout, Alzheimer’s disease, and a host of other diseases common to Western Civilization[2]. The precipitation of these diseases begins with metabolic syndrome, formerly called syndrome X[3]. But is sugar all that is wrong with our diets?
The Inuit's Cardiovascular Health
Many nutrition experts seem to think so, and they often use the Inuit of Alaska, Canada, and Greenland as their evidence. The Inuit are known to have subsisted mostly on marine wildlife. Whale blubber, seal meat, and fish were year-round staples. Their diets were both high in saturated fat as well as polyunsaturated fat – the omega 3’s that many of us supplement with – and extremely low in carbohydrates. But the idea that the Inuit diet was healthy mostly springs from a single 1975 paper[4] in which an apparently unfounded statement was made: ‘coronary atherosclerosis is almost unknown among these people [the Inuit of Greenland] when living in their original cultural environment.’
How did the authors know that coronary atherosclerosis was unknown among the Inuit? Medical attention was hard to come by in remote locations before the 1960’s, and autopsies were rare. From the autopsy evidence that we do have, a good portion of the Inuit did have atherosclerosis. While the oldest studies that we have for reference show a lower risk for coronary heart disease, they also show a higher incidence of stroke and cerebrovascular events. On average, their cardiovascular health does not appear to have been superior to that of many Westerners, despite their average genetic predisposition to heart disease[5].
No Blue-Zones in Greenland
While some may have been misled by the statement originally made by Dyerberg et al. about the Inuit, we should all come to realize that even if the Inuit did have better cardiovascular health than their neighboring Westerners, they were certainly not known to be particularly long-lived. There was no ‘blue-zone’ in Greenland. There were never many Inuit centenarians. Moreover, we know that on average, some saturated fat consumption (particularly palmitate) is correlated to increases in biometrics that measure low-density lipoprotein count – the biometrics that are most strongly correlated to cardiovascular events[6].
The Inuit example has been overplayed - there is no evidence of ancestral Inuits having had exceptional health.
[1] Taubes, G. (2017). The case against sugar. Anchor Books [2] Trowell, H. C., & Burkitt, D. P. (Eds.). (1981). Western diseases, their emergence and prevention. Harvard University Press. [3] Reaven, G. M., & Laws, A. (Eds.). (1999). Insulin resistance: the metabolic syndrome X (Vol. 12). Springer Science & Business Media. [4] Dyerberg, J., Bang, H. O., & Hjørne, N. (1975). Fatty acid composition of the plasma lipids in Greenland Eskimos. The American journal of clinical nutrition, 28(9), 958-966. [5] Bjerregaard, P., Young, T. K., & Hegele, R. A. (2003). Low incidence of cardiovascular disease among the Inuit—what is the evidence?. Atherosclerosis, 166(2), 351-357. [6] Musunuru, K. (2010). Atherogenic dyslipidemia: cardiovascular risk and dietary intervention. Lipids, 45(10), 907-914.
