Why the War on Fat Was Misguided: How Sugar Replaced Fat—And Made Us Sicker
Introduction
For many of us edging toward 50—or already living our “second 50”—there’s a good chance we’ve spent decades hearing how fat is the dietary villain and cholesterol is something to keep as low as possible. But what if we got it all wrong? In a recent conversation with Alan Ogden on the Your Second 50 podcast, Alan unpacks the origins of cholesterol phobia, shines a light on the history of fat vs sugar health debates, and offers his unique perspective on how misguided advice nearly upended our health.
If you’ve ever wondered how we went from slathering butter on our bread to choosing “fat-free” snacks loaded with sugar—and why so many of us got sicker as a result—this is the explainer you didn’t know you needed.
The Origins of Cholesterol Fear
Alan shares how his education in Pharmaceutical Sciences coincided with the birth of cholesterol-focused guidelines. According to Alan:
“I was really fortunate. I went to university at the time when this whole controversy started…the public face of this was all of a sudden we needed to get fat out of food.”
So how did this obsession with fat begin? Alan recalls discussing these early guidelines with his pharmacology professors. He says a key figure in the anti-fat movement “cherry-picked just a few studies” in a meta-analysis rather than reviewing all available evidence. Alan’s mentor voiced concern about this narrow selection forming the bedrock for “cut-off” values for LDL cholesterol and, ultimately, treatment recommendations.
Alan explains that the initial push for cholesterol-lowering drugs was originally quite limited:
“…the original application for the use of cholesterol was very specific. It was for people who were genetically subject to something called apolipoprotein A…if people do have high apolipoprotein A, it’s very difficult to control through diet, exercise, and the things that most people would think of as controlling…”
In other words, the earliest statin approvals focused on a small subgroup—mainly men who’d already had a heart attack or those with clear genetic risk for elevated cholesterol. Women, Alan points out, were largely excluded because postmenopausal LDL rises were considered “normal.”
Cholesterol: What Is It, Really?
Before cholesterol was heavily policed, Alan and his colleagues asked a simple but profound question: why does the body make it? Alan emphasizes:
“…our liver is very good at making cholesterol. And why do we need cholesterol? …you make vitamin D from cholesterol. You make your hormones. So your insulin, your testosterone, your estrogen, your progesterone, all the hormones we depend on, have their root in cholesterol.”
Cholesterol, then, is far from a villain. It’s not only essential for hormone production but also for vitamin D synthesis and general cell function.
Fat vs. Sugar: A Misguided Trade
Alan points out that as fat took the blame, something else snuck into our foods:
“And unfortunately, we now know that the replacement was sugar, which had more devastating effect than actually the cholesterol or the fat in the food at the time.”
What happened when fat was stripped out of processed foods? Sugar became the go-to replacement. The industry responded to consumer fat-phobia by creating foods that were “fat-free” but amped up with sugars to restore lost taste and texture.
Alan stresses that this had consequences:
“If you look at those foods, what replaced it was sugar. And we now know that that, you know, is devastating.”
He stops short of reciting epidemiological trends, but the implication is clear—our mass substitution of sugar for fat did not improve health and may have worsened it, especially in terms of metabolic and cardiovascular risk.
Digging Deeper: Not All Cholesterol Is Created Equal
When discussing fat vs sugar health implications, Alan brings the discussion back to the more nuanced science of cholesterol:
“So when we eat fat, our body has to emulsify this fat. It’s going to make something called HDL cholesterol. Okay, so you can just take the H and remember heart. So HDL is cardioprotective cholesterol.”
The treatment of all cholesterol as equally harmful, Alan says, ignores how HDL (“good” cholesterol) is actually protective while only certain forms of LDL (“bad” cholesterol)—especially smaller particle forms—are damaging. He prefers a more comprehensive approach:
- First, look at specific genetics (e.g., predispositions to handle dietary fats or not)
- Evaluate not just basic LDL/HDL numbers, but do more advanced lipoprotein panels to see what’s happening at the molecular level
- Consider diet, liver, kidney, and gut function
Alan gives his wife Donna as a case study. On basic tests, her LDL was “very high,” yet with more advanced lipoprotein testing, the damaging subtypes were absent:
“So what that means is even though the LDL is high, it’s not damaging. It’s not doing the damage that originally this research…was indicating that it was doing because of this cherry picking of the information.”
This story illustrates how surface-level fat and cholesterol numbers don’t tell the whole story—and how replacing fat with sugar didn’t address root issues.
Changing Guidelines and Their Impact
As Alan remembers, the original cholesterol guidelines set high bars for who actually needed intervention, typically “a male, you’d had to have already had a heart attack, [and] they would start you on a statin drug, or you had to have genetically high cholesterol.” Over time, those thresholds dropped—putting more and more people on cholesterol-lowering drugs.
According to Alan, most physicians still don’t look for genetic susceptibility, meaning that LDL numbers can become the default trigger for medication, regardless of whether someone’s risk is actually elevated. Alan emphasizes:
“They just do a blood test. They look at some results and then they make this decision on whether or not you should be on a cholesterol drug.”
And, as seen when sugar replaced fat, changing guidelines and food industry practices can have unintended—and sometimes unhealthy—consequences.
Revisiting Dietary Fats and Holistic Health
Alan believes that the path to better health isn’t about demonizing a single nutrient. His approach includes:
- Genetic testing to identify actual risk factors
- Evaluating liver, kidney, and bowel function (all part of cholesterol and fat processing)
- Assessing the type and source of fats in the diet
- Considering adjuncts like natural supplements (e.g., Stericol for hyperlipidemia, as Health Canada allows)
Critically, Alan continues to recognize cases where statin therapy is required, particularly for those with overwhelming genetic risk or unwillingness/inability to change their diet. But he always returns to individualized care and deeper testing before intervening medically.
He also highlights how incentives can shape the narrative:
“…we have to remember is we’re fighting a $35 billion a year industry right now in cholesterol, right?”
This underscores why robust, individualized assessment is essential—and why advice that turns a nutrient (like fat) into the enemy, while ignoring context, can have ripple effects for entire generations.
Conclusion: Towards a Smarter Fat vs Sugar Health Conversation
The war on fat didn’t just miss the mark—it led many of us down a path toward sugar-laden foods, simplistic guidelines, and misplaced fears. As Alan Ogden explains, it pays to question old dogmas. Fat, cholesterol, and sugar affect every body differently, and only by looking at genetics, broader health markers, and lifestyle can we really make sense of the fat vs sugar health debate.
Are you curious how your own genetics affect your response to dietary fats? Or wondering whether your cholesterol numbers tell the full story? Reach out to your doctor or a trusted health professional who can guide you in digging deeper—because as Alan demonstrates, the details matter.
Ready for more insights and myth-busting discussions? Listen to Alan’s full episode on cholesterol and catch the latest science-backed strategies for living your best second 50 at LiveYourDNA.com.