Wed, May 11, 2011 a€” In recent years a fierce debate has raged among nutrition experts over the wisdom of prevailing dietary guidelines that emphasize eating less saturated fat.
CHAPEL HILL, NC a€” If you love bacon, butter and fried chicken, the idea that a high-fat diet might be good for you can be seductive. One expert at the University of California, San Francisco argues that we should worry more about sugar a€” which he calls both "toxic" and "evil" a€” than about fat. These ideas, referred to collectively as a€?the alternative hypothesis,a€? suggest that filling up on carbohydrates, which are found in foods such as cookies, bread, pasta and potatoes, is making Americans heavier and more prone to heart attacks, strokes and diabetes.
Amanda Holliday, MS, RD, LDN, a clinical associate professor in the Department of Nutrition at the University of North Carolina at Chapel Hill, said that eating fat does play an important role in maintaining good health. But the consensus within the scientific community still supports limiting your intake of saturated and trans fats, said Suzanne Hobbs, DrPH, MS, RD, FADA, a clinical associate professor of nutrition and health policy at UNC.
When nutritionists began to advocate a low-fat diet decades ago, Hobbs said, they recommended that consumers replace fat in their diets with healthier foods. In the midst of this advertising blitz, many consumers missed the message that achieving a healthy diet meant reducing their consumption of sweets, refined carbohydrates, saturated and trans fats, while increasing the intake of fruits, vegetables and whole grains.
Beware of diets that suggest avoiding entire food groups, such as high-protein, low-carbohydrate diets. Rather than trying to eliminate a particular food group, you should aim for a balanced diet, Holliday said. Avoid trans fats, which are healthy fats that have been transformed during processing into fats that wona€™t spoil quickly. Howevera€¦ many recent studies suggest that the true picture is more complicated than that. This article takes a detailed look at saturated fat and whether it is good or bad for your health. Each fat molecule is made of one glycerol molecule and three fatty acidsa€¦ which can be either saturated, monounsaturated or polyunsaturated. What this "saturation" stuff has to do with, is the number of double bonds in the molecule. Saturated fatty acids have no double bonds, monounsaturated fatty acids have one double bond and polyunsaturated fatty acids have two or more double bonds. Foods that are high in saturated fat include fatty meats, lard, full-fat dairy products like butter and cream, coconuts, coconut oil, palm oil and dark chocolate.
Even foods like beef also contain a significant amount of mono- and polyunsaturated fats (1).
Fats that are mostly saturated (like butter) tend to be solid at room temperature, while fats that are mostly unsaturated (like olive oil) are liquid at room temperature.
Bottom Line: Saturated "fats" are fats that contain a high proportion of saturated fatty acids, which contain no double bonds.
Back in the 20th century, there was a major epidemic of heart disease running rampant in America. It used to be a rare disease, but very quickly it skyrocketed and became the number one cause of deatha€¦ which it still is (2). Researchers learned that eating saturated fat seemed to increase levels of cholesterol in the bloodstream. This was an important finding at the time, because they also knew that having high cholesterol was linked to an increased risk of heart disease.
If saturated fat raises cholesterol (A causes B) and cholesterol causes heart disease (B causes C), then this must mean that saturated fat causes heart disease (A causes C). This hypothesis (called the "diet-heart hypothesis") was based on assumptions, observational data and animal studies (3). The diet-heart hypothesis then turned into public policy in 1977, before it was ever proven to be true (4). Even though we now have plenty of experimental data in humans showing these initial assumptions to be wrong, people are still being told to avoid saturated fat in order to reduce heart disease risk. Bottom Line: Saturated fats have been assumed to cause heart disease by raising cholesterol in the blood.
HDL and LDL, the "good" and "bad" cholesterols, aren't actually cholesterola€¦ they are proteins that carry cholesterol around, known as lipoproteins.
At first, scientists only measured "Total" cholesterol, which includes cholesterol within both LDL and HDL. Because saturated fat raised LDL levels, it seemed logical to assume that this would increase the risk of heart disease.
Small, dense LDL: These are small lipoproteins that can penetrate the arterial wall easily, which drives heart disease.


Large LDL: These lipoproteins are large and fluffy and don't easily penetrate the arteries.
The small, dense particles are also much more susceptible to becoming oxidized, which is a crucial step in the heart disease process (17, 18, 19). People with mostly small LDL particles have three times greater risk of heart disease, compared to those with mostly large LDL particles (20).
Soa€¦ if we want to reduce our risk of heart disease, we want to have mostly large LDL particles and as little of the small ones as possible.
Here's an interesting bit of information that is often ignored by "mainstream" nutritionistsa€¦ eating saturated fat changes the LDL particles from small, dense to Large (21, 22, 23). What this implies is that even though saturated fat can mildly raise LDL, they are changing the LDL to a benign subtype that is associated with a reduced risk of heart disease.
Now scientists have realized that it's not just about the LDL concentration or the size of the particles, but the number of LDL particles (called LDL-p) floating in their bloodstreams.
Low-carb diets, which tend to be high in saturated fat, can lower LDL-p, while low-fat diets can have an adverse effect and raise LDL-p (28, 29, 30, 31).
Bottom Line: Saturated fats raise HDL (the "good") cholesterol and change LDL from small, dense (bad) to Large LDL, which is mostly benign.
The supposedly harmful effects of saturated fat are the cornerstone of modern dietary guidelines.
Howevera€¦ despite decades of research and billions of dollars spent, scientists still haven't been able to demonstrate a clear link. Several recent review studies that combined data from multiple other studies, found that there really is no link between saturated fat consumption and heart disease. This includes a review of 21 studies with a total of 347,747 participants, published in 2010.
Another review published in 2014 looked at data from 76 studies (both observational studies and controlled trials) with a total of 643,226 participants. We also have a systematic review from the Cochrane collaboration, which combines data from numerous randomized controlled trials. According to their review, published in 2011, reducing saturated fat has no effect on death or death from heart disease (34). However, they found that replacing saturated fats with unsaturated fats reduced the risk of cardiac events (but not death) by 14%. This does not imply that saturated fats are "bad," just that certain types of unsaturated fats (mostly Omega-3s) are protective, while saturated fats are neutral.
Soa€¦ the biggest and best studies on saturated fat and heart disease show that there is no direct link. Unfortunately, the governments and "mainstream" health organizations seem reluctant to change their minds and continue to promote the old low-fat dogma. Bottom Line: The link between saturated fat and heart disease has been studied intensely for decades, but the biggest and best studies show that there is no statistically significant association. This is the diet recommended by the USDA and mainstream health organizations all over the world. This diet also recommends increased consumption of fruits, vegetables and whole grainsa€¦ along with reduced consumption of sugar. Other massive studies have confirmed thisa€¦ the low-fat diet provides no benefit for heart disease or the risk of death (39, 40).
Several studies that replaced saturated fat with polyunsaturated vegetable oils showed that more people in the vegetable oil groups ended up dying (41, 42). Of course, this graph alone doesn't prove anything (correlation does not equal causation), but it does make sense that replacing traditional foods like butter and meat with processed low-fat foods high in sugar had something to do with it. It's also interesting when looking at the literature, that in almost every single study comparing the "expert approved" low-fat diet to other diets (including paleo, vegan, low-carb and Mediterranean), it loses (44, 45, 46, 47). Bottom Line: Studies on the low-fat diet do not show a reduced risk of heart disease or death and some studies show that replacing saturated fat with vegetable oils increases the risk. The studies clearly show that, on average, saturated fat does not raise the risk of heart disease.
Perhaps most individuals see no effecta€¦ while others experience decreased risk and yet others experience an increased risk.
That being said, there are definitely some people who may want to minimize saturated fat in the diet. This includes individuals with a genetic disorder called Familial Hypercholesterolemia, as well as people who have a gene variant called ApoE4 (48). With time, the science of genetics will most surely discover more ways in which diet affects our individual risk for disease.


Bottom Line: Some people may want to minimize saturated fat intake, including people with Familial Hypercholesterolemia or a gene called ApoE4. For this reason, coconut oil, lard and butter are all excellent choices for cooking, especially for high-heat cooking methods like frying.
Foods that are naturally high in saturated fat also tend to be healthy and nutritious, as long as you're eating quality unprocessed foods.
Bottom Line: Saturated fats are excellent cooking fats and foods that are high in saturated fat tend to be both healthy and nutritious. The evidence points to saturated and monounsaturated fats being perfectly safe and maybe even downright healthy. We need to get these two types of fatty acids in a certain balance, but most people are eating way too many Omega-6 fatty acids these days (51). It is a good idea to eat plenty of Omega-3s (such as from fatty fish), but most people would do best by reducing their Omega-6 consumption (52).
The best way to do that is to avoid seed- and vegetable oils like soybean and corn oils, as well as the processed foods that contain them. Trans fats are made by exposing polyunsaturated vegetable oils to a chemical process that involves high heat, hydrogen gas and a metal catalyst. Studies show that trans fats lead to insulin resistance, inflammation, belly fat accumulation and drastically raise the risk of heart disease (53, 54, 55, 56). So eat your saturated fats, monounsaturated fats and Omega-3sa€¦ but avoid trans fats and processed vegetable oils like the plague. Bottom Line: The truly harmful fats are artificial trans fats and processed vegetable oils high in Omega-6 fatty acids. The health authorities have spent an immense amount of resources studying the link between saturated fat and heart disease.
Despite thousands of scientists, decades of work and billions of dollars spent, this hypothesis still hasn't been supported by any good evidence. The saturated fat myth wasn't proven in the past, isn't proven today and never will be provena€¦ because it's just flat out wrong. Humans and pre-humans have been eating saturated fat for hundreds of thousands (if not millions) of years, but the heart disease epidemic started a hundred years ago. When checked, Shutterstock's safe search screens restricted content and excludes it from your search results. Two experts from the UNC Department of Nutrition cut through the chatter and explain what you can do to eat healthy. Robert Atkins, the author of bestselling diet books, suggested that carbohydrates, not fats, were the true diet villains. You need to consume fats to obtain some vitamins, and the unsaturated fats found in plant oils, certain vegetables and fish can actually reduce the risk of cardiovascular disease. Most medical researchers believe that saturated fats, which are found in animal products such as butter, dairy and meat, increase the risk of cardiovascular disease. But then many companies started offering packaged foods that were low in fat but high in sugar and refined flour.
Such diets may deprive your body of essential nutrients and increase your risk of cardiovascular disease, Holliday said. Theya€™re usually listed on food labels as a€?hydrogenateda€? or a€?partially hydrogenateda€? oils. Later they learned that while LDL was linked to increased risk, HDL was linked to reduced risk (5, 6, 7, 8, 9, 10). Although they increase LDL in the short-term, plenty of long-term observational studies find no link between saturated fat consumption and LDL levels (24, 25, 26).
For example, palmitic acid (16 carbons) may raise LDL, while stearic acid (18 carbons) does not (27). Their conclusion: there is absolutely no association between saturated fat and heart disease (32).
It was a randomized controlled trial with 46,835 women, who were instructed to eat a low-fat diet. Meanwhile, articles from The New York Times to The Los Angeles Times have also advanced the notion that fat isna€™t as bad for you as conventional wisdom suggests. Trans fats, which are created during food processing, may be even more harmful than those that occur naturally.



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