Fred Kummerow, Trans Fats, and Heart Disease

Fred Kummerow, Trans Fats, and Heart Disease by Jeffrey Dach MD For fifty-eight years, America was told to eat margarine instead of butter. In 1957, a University of Illinois biochemist named Fred Kummerow examined the arteries of people who died of coronary artery disease and found something else. Trans-fats were present in the plaque. Kummerow asked the FDA to ban trans-fats and he was ignored. The government finally acted in 2015 when he was one hundred years old. This is not a mystery novel. It is a story about a 50 year public-health delay. Above Header image: Book Cover courtesy of: Cholesterol Won't Kill You, but Trans Fat Could: Separating Scientific Fact from Nutritional Fiction by Fred A. Kummerow (Author), Jean M. Kummerow (Author) Why Not Examine the Wall of the Artery? In 1957 Dr. Fred Kummerow published his paper in Science after examining autopsy and biopsy tissue from people who had died of heart disease. The diseased vessels contained trans fatty acids, fats that barely exist in nature and came mainly from hydrogenated vegetable shortening and margarine. The authors asked a simple question: what do these industrially made fats do to normal metabolism? Dr. Fred August Kummerow was a lipid chemist at University of Illinois Champaign-Urbana campus who studied tissue from about two dozen subjects and found trans fats in every sample examined. What are trans-fats? Trans fats are made by Hydrogenation, the process of bubbling hydrogen through the vegetable oil. This hydrogenation process made margarine spreadable and gave processed foods a long shelf life. It also created a new synthetic fat not fit for human consumption. In 2013, Melanie Warner wrote in the New York Times about Dr. Kummerow's discovery of trans fats. At the time, Dr. Kummorow was a young nutrition scientist who persuaded the local hospital pathology department to give him samples of arteries from patients who had died of heart attacks. The fat packed into those arteries was not the butter-and-egg fat the population was told to fear. It was the artificial trans fat from hydrogenated oils. A Lonely Voice, Then a Lawsuit In 2017, Katie Hafner (2017) wrote again in the New York Times Dr. Kummerow's story. When he published his report in 1957, he was dismissed and ignored. The cooking oil, margarine, trans-fat industry had friends in high places, on legislative committees and they had firm control of the narrative which blamed saturated fat and cholesterol for causing heart disease, not trans-fats. Although Kummerow's research funding had dried up, he kept his laboratory open into his nineties. In 2015, Fred Kummerow was 100 years old, and he was still spunky and outspoken. His campaign to get trans fats out of the food supply began in earnest in 1968. He sat on an American Heart Association subcommittee, measured the trans fat in grocery-store margarine and shortening, and pressed manufacturers to reduce the content. His pleas were partially successful. Trans-fat content fell from roughly forty-three percent to about twenty-seven percent. Heart-disease death rates also began to decline after 1968. This was no coincidence. Above left image: Courtesy of Fred Kummerow and The Chronicle. Article is entitled: Even at 100, Professor Keeps Up Fight Against Trans Fats. Dated: February 16, 2015 In 2014, Geoffrey Cannon reviewed Dr. Fred Kummerow's efforts to ban trans-fats. Taking the first step, the American Heart Association drafted a warning label for partial hydrogenation and trans-fats. However, the shortening and margarine trade group voiced their opposition to the drafted AHA trans-fat warning, which was then discarded. Even so, a deal was made secretly behind closed doors. Margarine/Trans-fat Industry agreed to reduced trans fats quietly on their own, making a public statement avoiding naming a problem with trans fats. Eggs in Butter, Not Margarine This heading is not a breakfast slogan. It is the point of Kummerow’s whole career, stated in food language. In 2013, Melanie Warner visited Fred Kummerow when he was ninety-nine and still directing a small laboratory at the University of Illinois. She watched how he actually ate. Breakfast was an egg scrambled in butter. He drank whole milk every day. He ate red meat several times a week. He did not use margarine. He could not remember the last time he ate anything deep-fried. Kummerow's diet was the opposite of official advice for half a century. From the 1960s onward, the public was told that cholesterol and saturated fat, eggs, butter, whole milk, red meat, clogged arteries. Margarine and hydrogenated vegetable shortening were sold as the “heart-healthy” replacement. Kummerow rejected this narrative because he had already looked at the tissue samples of arterial walls showing the trans-fats in the plaque. In 1957, when Dr. Kummerow examined arteries from people who died of heart disease. What did he find? He found the fat packed into those vessels included trans fatty acids made by partial hydrogenation of vegetable oil. Those are the same industrial fats that made margarine spreadable and gave cookies, crackers, and shortening a long shelf life. The 1957 paper did not find Kummerow's “breakfast” in the plaque. Instead they reported factory made trans-fat inside the arterial plaque. Saturated fat from butter, cheese, and meat, eaten in moderate amounts with fruit, vegetables, and whole grains, was not the arterial villain the guidelines claimed. Fed Kummerow called eggs one of nature’s most complete foods: all the essential amino acids needed to build cells, plus vitamins and minerals. Eating only egg whites, he said, was a mistake. Dr. Kummerow argued for decades that oxidized and industrially altered fats were the problem, not the cholesterol the body makes and uses for cell membranes and hormones. How to Make a Healthy Breakfast In 2014, Dr. Kummerow described his own plate to Richard Passwater: one egg scrambled in butter each morning, three glasses of whole milk, meat or another protein at meals, and a large amount of fruit and vegetables. No processed or fried food. No margarine. That was not a publicity stunt. It was the diet that matched what he had measured in tissue and in animals. When Kummerow analyzed diseased human arteries, he did not find the fat from an egg cooked in butter. He found trans fats from hydrogenated margarine and shortening. He therefore ate the foods the committees had condemned and avoided the foods the committees had blessed. He lived to one hundred two. What does that tell you? (11) In 2017, Katie Hafner made the same point after Kummerow's death at one hundred two: Kummerow argued that moderate amounts of saturated fat from butter, cheese, and meat were not the arterial culprit the guidelines claimed. The industrial trans fat was. The Petition the FDA Ignored In August 2009, at age ninety-four, Kummerow filed a citizen petition with the Food and Drug Administration asking for a ban on artificial trans fats and partially hydrogenated oils. Kummerow 's petition stated that "Artificial trans fat is a poisonous and deleterious substance, and the FDA has acknowledged the danger." Federal rules give the FDA agency one hundred eighty days to respond. Four years later, there was still no answer from the FDA. Kummerow wrote that anything under half a gram trans-fat per serving could still be labeled zero trans fat, so people were eating the stuff without knowing it. How to Sue the FDA On 9 August 2013, at age ninety-eight, Fred Kummerow sued the FDA and HHS to force a decision. Court records list the case as filed in the Central District of Illinois. Three months later the FDA issued a tentative determination that partially hydrogenated oils were not generally recognized as safe. In June 2015 the final determination followed. Manufacturers received three years to remove the fats. The gap from the 1957 paper in Science to the 2015 rule was fifty-eight years. Conclusion: The official industry funded narrative was that the dietary villains causing heart disease are eggs and butter, and meat. Everyone was told a healthier substitute was the hydrogenated oils and margarine, and that would be better for your health. Nothing was further from the truth. This was just another of the many errors in modern medicine. Heart Book: How to Keep Your Heart Healthy by Jeffrey Dach MD My book is available on Amazon: Link to Kindle Version Link to Paperback Version Heart Book is a journey through the confusing maze of literature on coronary artery disease, the number-one killer in America. With his years of practice in vascular radiology, Dr. Dach has the background, credentials, and experience to transform your understanding of heart disease. The old medical paradigms have been upended, yet mainstream cardiology clings to these tired dogmas as if nothing has changed. Be prepared to be shocked, amazed, provoked, and gratified as this book empowers you to take control of your own heart health. Jeffrey Dach MD 7450 Griffin Road, Suite 190 Davie, Florida 33314 954-792-4663 www.jeffreydachmd.com Articles with related Interest: Challenging the Cholesterol Hypothesis Part four Atherosclerotic Plaque and Infection Part Two The Failure of Cholesterol Lowering Drugs Coronary Artery Disease: Questions and Answers Does Cholesterol Cause Coronary Artery Disease ? Calcium Score Determines Who to Treat with Statin Drug Calcium Score Diabetes and Statin Drugs Plant Based Diet, Health Benefits for Coronary Artery Disease LDL-Cholesterol Does Not Cause Coronary Artery Disease Low Level Endotoxemia, Depression, Endocrinopathy and Coronary Artery Disease Fibrinolytic Enzymes, Nattokinase, Lumbrokinase Prevent and Reverse Atherosckerosis Reverse Heart Disease with Coronary Calcium Score Low Level Endotoxemia LPS Theory of Coronary Artery Disease Calcium Score Paradigm Shift in Cardiology Coronary Calcium Score Benefits of Aged Garlic The Art of the Curb Side Cholesterol Consult Evolocumab Are You Joking Me? Cholesterol and Atherosclerosis:Autopsy Studies Show No Correlation Statin Denialism Internet Cult with Deadly Consequences Defending the Cholesterol Hypothesis in the Elderly Does High Cholesterol Cause Heart Disease ? Familial Hypercholesterolemia and Statin Drugs Donating Blood Prevents Heart Disease Does Cholesterol Cause Heart Disease ? Part two Atherosclerotic Plaque as Infected Biofilm on Electron Microscopy Coronary Calcium Score Paradigm Shift Podcast References 1. Johnston, Patricia V., Ogden C. Johnson, and Fred A. Kummerow. “Occurrence of Trans Fatty Acids in Human Tissue.” *Science*, vol. 126, no. 3276, 11 Oct. 1957, pp. 698–699. https://www.science.org/doi/10.1126/science.126.3276.698.b 2. University of Illinois Archives. “Kummerow, Fred A.” https://archives.library.illinois.edu/archon/index.php?pcreators/creator&id3018 3. Warner, Melanie. “A Lifelong Fight Against Trans Fats.” *The New York Times*, 16 Dec. 2013. https://www.nytimes.com/2013/12/17/health/a-lifelong-fight-against-trans-fat.html 4. Hafner, Katie. “Fred A. Kummerow, an Early Opponent of Trans Fats, Dies at 102.” *The New York Times*, 1 June 2017. https://www.nytimes.com/2017/06/01/science/fred-kummerow-dead-biochemist-ban-trans-fatty-acids.html 5. “At Long Last, a Ban on Transfat.” *Illinois Times*, 11 June 2015. Interview with Fred Kummerow. https://www.illinoistimes.com/news-opinion/at-long-last-a-ban-on-transfat-11444816/ 6. Cannon, Geoffrey. “Fred Kummerow. The Biochemist Who Walked Alone.” *World Nutrition*, 2014. https://worldnutritionjournal.org/index.php/wn/article/download/282/231/ 7. Kummerow, Fred A. Citizen Petition to the U.S. Food and Drug Administration. Docket FDA-2009-P-0382, filed 7 Aug. 2009. https://www.regulations.gov/document/FDA-2009-P-0382-0001 8. *Kummerow v. U.S. Food and Drug Administration*, No. 2:13-cv-02180 (C.D. Ill. filed 9 Aug. 2013). https://www.courtlistener.com/docket/4248631/kummerow-v-us-food-and-drug-administration/ 9. “Nonagenarian Researcher Petitions FDA to Ban Trans Fats.” University of Illinois / MedicalXpress, 3 Sept. 2009. https://medicalxpress.com/news/2009-09-nonagenarian-petitions-fda-trans-fats.html 10. U.S. Food and Drug Administration. Final Determination Regarding Partially Hydrogenated Oils, 16 June 2015. Coverage and contemporaneous reporting: Hafner (2017), above; also FDA Federal Register notice of the 2015 determination. 11. Passwater, Richard A. Interview with Fred Kummerow. *WholeFoods Magazine*, Sept.–Oct. 2014. https://www.wholefoodsmagazine.com/articles/8604-from-pellagra-to-trans-fats-and-beyond-how-a-legendary-nutritional-scientist-is-still-saving-countless-thousands-from-premature-deaths 12. Cholesterol Won't Kill You, but Trans Fat Could: Separating Scientific Fact from Nutritional Fiction by Fred A. Kummerow (Author), Jean M. Kummerow (Author) Format: Paperback 13. Johnston, Patricia V., Fred A. Kummerow, and C. H. Walton. “Origin of the Trans Fatty Acids in Human Tissue.” *Proceedings of the Society for Experimental Biology and Medicine*, vol. 99, no. 3, Dec. 1958, pp. 735–736. https://doi.org/10.3181/00379727-99-24483 (or summary at https://eurekamag.com/research/014/133/014133385.php). Confirmed dietary origin; no *trans* in fetal tissues. 14. Heckers, H., F. W. Melcher, and K. Dittmar. “Occurrence of Individual Trans-Isomeric Fatty Acids in Human Myocardium, Jejunum and Aorta in Relation to Different Degrees of Atherosclerosis.” *Atherosclerosis*, vol. 28, no. 4, Dec. 1977, pp. 389–398. https://doi.org/10.1016/0021-9150(77)90065-X. Capillary GC found individual *trans* isomers in all samples; mean total *trans* <1% of fatty acids and unrelated to atherosclerosis grade. 15. Ohlrogge, J. B., E. A. Emken, and R. M. Gulley. “Human Tissue Lipids: Occurrence of Fatty Acid Isomers from Dietary Hydrogenated Oils.” *Journal of Lipid Research*, vol. 22, no. 6, Aug. 1981, pp. 955–960. https://www.jlr.org/article/S0022-2275(20)37333-8/fulltext (PubMed: https://pubmed.ncbi.nlm.nih.gov/7276754/). *Trans*-octadecenoate 0.4–5.0% (average 2.7%) in heart, brain, liver, aorta, and adipose; positional isomers matched dietary hydrogenated fat. 16. Thomas, L. H., J. A. Winter, and R. G. Scott. “Concentration of 18:1 and 16:1 Transunsaturated Fatty Acids in the Adipose Body Tissue of Decedents Dying of Ischaemic Heart Disease Compared with Controls: Analysis by Gas Liquid Chromatography.” *Journal of Epidemiology and Community Health*, vol. 37, no. 1, Mar. 1983, pp. 16–21. https://pmc.ncbi.nlm.nih.gov/articles/PMC1052248/. Higher “lower” (16:1 and 18:1) *trans* acids—more characteristic of commercial hydrogenation—in adipose of 136 IHD deaths versus controls who died of other causes. 17. Thomas, L. H., J. A. Winter, and R. G. Scott. “Concentration of Transunsaturated Fatty Acids in the Adipose Body Tissue of Decedents Dying of Ischaemic Heart Disease Compared with Controls.” *Journal of Epidemiology and Community Health*, vol. 37, no. 1, Mar. 1983, pp. 22–24. https://pmc.ncbi.nlm.nih.gov/articles/PMC1052249/. Companion paper; higher total *trans*/ruminant-fat ratio in IHD cases. 18. Stachowska, Ewa, et al. “Trans Unsaturated Fatty Acids Are Components of Atheromatous Plaque.” *Acta Angiologica*, vol. 8, no. 3, 2002, pp. 99–104. https://journals.viamedica.pl/acta_angiologica/article/view/9952. Elaidic acid and other *trans* isomers present in plaques from 21 surgical patients. 19. Stachowska, Ewa, et al. “Dietary Trans Fatty Acids and Composition of Human Atheromatous Plaques.” *European Journal of Nutrition*, vol. 43, no. 5, Oct. 2004, pp. 313–318. https://doi.org/10.1007/s00394-004-0479-x (PubMed: https://pubmed.ncbi.nlm.nih.gov/15309454/). All 31 plaques contained *trans* isomers (elaidic acid most abundant); linolelaidic acid (exclusively industrial) also present. Adipose *trans* pool correlated poorly with plaque *trans*. 20. Dlouhý, Pavel, et al. “Higher Content of 18:1 Trans-Fatty Acids in Subcutaneous Fat of Persons with Coronarographically Documented Atherosclerosis of the Coronary Arteries.” *Annals of Nutrition and Metabolism*, vol. 47, no. 6, 2003, pp. 302–305. Cited in later reviews as supporting higher industrial *trans* in people with documented coronary atherosclerosis. 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Fred Kummerow, Trans Fats, and Heart Disease