Peter Attia· MD
So, um, >> I almost wish I brought a a chalkboard to draw on, but anybody who's taken a biochemistry class will remember this, but a cis double bond forces the two carbons up or down, but they are on the same side of the double bond. So, that's the real kink. >> Whereas a trans double bond, you have a carbon here, a double bond, and then the other carbon is here. That stays much straighter than if you force the kink up or down. And as we're going to talk about later when it comes to like LDL aggregation and whatnot, the actual membrane fluidity is actually very important when it comes to the progression of cardiovascular disease. So the the membranes and the fatty acid composition of these lipoproteins actually becomes very important and it's very important to keep that in mind. But when we're talking about unsaturated fat, it's important to point out that trans fats are very unique in terms of the research literature very clearly showing an aogenic effect. >> Yeah. And the aogenic effect of trans fats was so significant that they have effectively been banned by the FDA. >> Right. It's also important to understand how they came about when the uh when the belief and realization around saturated fats which have been you know I think probably overdemonized historically you know uh when that took place food makers looked for a substitute right and you brought up an interesting point a moment ago which is if you have a trans fat you can have something that is not saturated but behaves as saturated. So if you think of one of our favorite saturated products, it's butter. Of course, as maybe we will talk about later, there's no food that is purely one thing. So it's not like butter is just saturated fat. Um, in fact, it's probably made up of mono and polyunsaturated fats if my memory serves correctly, as is even the fattiest ribeye. >> And actually has some natural trans fats in it as well. >> Low low amounts. So, but if you're trying to, you know, what makes butter appealing is that it is solid at room temperature. So, in an effort to create something that looked, felt, tasted, and behaved like butter, you and you and and we were going to deprive you of saturated fat. We had to put in something that at least behaved like saturated fat. So, when that margarine that was made up of high amounts, 25% is really high. 25% of that is trans fats. Hey, you you initially thought that was a win because you got the benefit of solid at room temperature. It was only after a few years we realized actually this was creating far more heart disease than we were seeing even with saturated fat. >> Yep. And and part of that is likely because and again as we'll talk about in a little bit um it makes the membrane very rigid because those fatty acid tails can get packed in tighter with saturated fat and trans fat. Whereas when you have those kinks with mono and polyunsaturated fats, it essentially creates space in the membrane. And that is actually very critical in terms of particle recognition by the LDL receptor and also aggregation, but we'll get into that a little bit later. So not only do you have trans fats being able to be packed into lipoproteins in a similar way as saturated fat, but now they have a double bond that can be oxidized as well. So you're getting kind of the worst of both worlds with trans fats. >> So do we know how much trans fats was consumed by the low saturated fat group in the Minnesota coronary experiment? >> So as far as I understand, we don't have the specific numbers. We just know that it was likely a significant portion of the polyunsaturated fat they ate based on they essentially got a lot of their polyunsaturated fats from either corn oil or margarine. Now, we don't, as far as I know, we don't know the exact composition of each. I wasn't able to find >> Chris Ramston at the NIH, who I believe did a re-evaluation of this, was he able ever to identify the raw data on that? >> I'm not sure to be quite honest with you, I didn't see it anywhere. And so maybe if uh people smarter than me are are watching or familiar with it, I would love to know if they did. I I do know like there's some other studies where um they kind of looked at dietary adherence by looking at LDL in the blood or looking at like