The Right Fat in the Right Places

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Good fat, bad fat, red fat, who fat. It's not all bad, as long as we're getting the best fat to the right people in good places.

FatMAIN2.jpgflickr/Steve Snodgrass

People with more fat may well be healthier than people with less, depending where it is. In an interview today with abdominal MRI specialist Dr. Jimmy Bell at Imperial College London, The New Scientist discusses the ups and downs. Like so many things, looking at fat as all good or all bad ("splitting," in psychology terms) is itself an all bad thing. 

Of course we need fat -- in, on, and around us. You'd die without it, right away. The point Dr. Bell makes is that we'd do well to focus more on the location of our fat and less on the overall quantity. He mentions fat in the following places:

  • Liver: bad
  • Around internal organs: bad
  • Butt: good
  • Under your skin: good

I might add, anecdotally:

  • Cheeks: good 
  • Fingertips: bad 
  • Scalp: good 
  • Soles of your feet: great 

But controlling where you send the fat you eat isn't something we've got down. Some people say that if you eat the meat of a certain part of an animal, it goes to that part of you. Like a good flank steak will really beef up your flanks. Or like how cannibals eat brains and think they're taking on that person's spirit in some way. I never really believed that! Plus you can get degenerative brain diseases like kuru from eating human brains, which is this whole other thing.

We do know that the type of fat you eat, in terms of chemical structure, is extremely important. The different types of fats act in different way, some in good ways, some in bad. Just like cholesterol. To review, here are the four main types (worst to best):

1. Trans. The worst. Illegal in some places. Never eat anything that says "partially hydrogenated _______ oil" in the ingredients, even if the Nutrition Facts say there's no trans fat. There usually is, it's just less than one gram so they get to round down to zero. But a gram of trans fat is a lot, so less than a gram is not insignificant.

2. Saturated. The main fat in beef, cheese, pork, etc. Increases your risk of heart disease.

3. Monounsaturated: Olive, canola oil. Increases good cholesterol, lowers bad cholesterol, probably lowers your risk of heart disease.

4. Polyunsaturated. Overall great, especially omega-3, in flaxseed oil and some fish. Decreases your risk of heart disease.

But the biggest barriers to the intuitive logic -- just eat the right fats -- are that the good ones are expensive, harder to find, and not as ingrained in some cultural diets (like ours). There was a great Gallup poll today about obesity in Americans across races. For reasons that are assuredly complex but involve a mix of socioeconomic, cultural, and genetic predispositions, prevalence of obesity varies very, very widely:

RACE OBESTIY.gif

The same poll links lower income and unemployment to obesity:

EMPLOYMENT OBESITY.gif

Obesity is never healthy -- and eating good fats won't spare you from it -- but this data might underscore the cultural and economic factors that keep us from getting the good fats to the places they're needed. Should we be subsidizing, advertising, and distributing flaxseed oil? Incentivizing consumption of good fats with tax breaks or trophies or dream vacations? Or would that just drive us to other vices

In the other direction, New York's ban on trans fat has effectively cut consumption and seems to have been a good move, so far. As long as bad fats are delicious, all around us, and cheap, it's tough to argue that even an informed, health-conscious society will change its habits of its own accord.

When you move into the discussion of governmental regulation of industries like fast food, it's clearly going to raise political contention. Especially in the setting of health care moving toward a more centralized system, we would be remiss not to look at it from both ends. If we're going to pay to treat heart disease with taxpayer money, taxing the things that appear to cause the heart disease warrants continued study and discussion. 

Ultimately, it is about getting the right fats to the right places.

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James Hamblin, MD, is The Atlantic's Health editor.

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