News Commentary, Nutrition 101
The Great Fat Debate: Why Butter Isn’t “Back”
April 4, 2014
R.D. Kristy Del Coro explains why the latest headlines on saturated fat may be misleading the public.
Health experts have long maintained that foods with high saturated fat content (e.g., butter, beef, pork, lamb and full fat dairy) may increase the risk of heart disease. It follows that risk of heart disease is significantly decreased when high saturated fat foods are replaced with foods rich in unsaturated poly- and mono-unsaturated fats (e.g., fish, nuts and vegetable oils).
Headlines surrounding a newly-published report in the Annals of Internal Medicine have led the public to believe that this previously accepted “truth” is in fact a myth. With headlines titled “Butter is Back,” “Saturated Fat Link with Heart Disease Questioned” and “The Diet-Heart Myth: Cholesterol and Saturated Fat Are Not the Enemy” the message quickly spread that new data had surfaced unraveling years of evidence-based research surrounding diet and cardiovascular disease.
The report in question is a meta-analysis of 72 studies examining how different fats influence the risk of a heart attack or other cardiac event. These studies include trials in which participants were randomly assigned to different diets as well as observational studies in which questions were posed to participants about their dietary intake.
The scientists from Europe and the United States involved in the research compared individuals with the highest and lowest intake of saturated fats as well as those with the highest and lowest intake of unsaturated “healthy” fats and concluded that there was no significant difference in their incidence of heart disease in either group. This led the authors to state as a conclusion that "current evidence does not clearly support guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats," subsequently triggering the headlines above.
The results in context
What the headlines fail to address is the context of the study’s results. Researchers found that when foods high in saturated fat are replaced with refined carbohydrates and added sugar, the associated risk for cardiovascular disease may be increased even though saturated fat intake is low. Thus saturated fat intake must be looked at in the context of the diet overall rather than in isolation in order to accurately assess its relationship to health.
In a recent interview about the study results, one of the co-authors of the meta-analysis, Dr. Dariush Mozaffarian of the Harvard School of Public Health, confirmed that the relative risk of saturated fat intake is dependent on what you are eating in its place. An excess intake of refined carbohydrates and added sugar (found in many “low fat” processed foods, snack foods and sugar-sweetened beverages) are more detrimental to the diet than fats that contain some saturated fat. In a National Public Radio interview,he states that “the results of this study found that the focus on a single nutrient like saturated fat alone may not be the best approach to fight heart disease.”
Focus on dietary patterns rather than a single nutrient
Just as singular vitamins and minerals should not be isolated as being a cure-all, in the context of chronic diseases, a single type of fat cannot be isolated “as good or bad” without considering the dietary pattern overall. Mozaffarian further points out that consuming a low-fat deli turkey sandwich, fat free bagel or sugar sweetened beverage is far worse than eating an avocado or vegetable oil with some amount of saturated fat. He argues that people need to move away from merely looking at numbers on a food label to thinking about the quality of the actual food they are eating.
When explained like this, results of this study actually reinforce what we have known all along and support adherence to a Mediterranean eating pattern rich in fruits and vegetables, whole grains and plant-based fats (which have a high ratio of unsaturated to saturated fatty acids). The Mediterranean diet is also low in red meat, refined carbohydrates and added sugar – all of which is in line with SPE Certified nutrition criteria.
The dangers of misleading headlines
The recent headlines have been grossly misleading. The truth is that it remains undisputed that saturated fat intake raises the blood concentration of LDL (“bad” cholesterol), and the real takeaway from this study was not that eating red meat and cheese is healthier than eating nuts and plant-based fats but that there are worse choices that people are making that warrant further examination and discussion.
The comparison of fat intake to carbohydrate intake is the key element of this study, but unfortunately did not make headlines. Eric Rimm ScD, ACE, FAHA, researcher and member of SPE Certified’s Scientific Committee, states:
“It is dangerous to say that saturated fat is not bad for you when we have 40 years of biological studies finding just the opposite. This study found, similar to what many before it found, if you replace saturated fat with highly refined carbohydrates you see similar cardiovascular risk. However, what was missed by this study and what has been found in many others is that increasing mono-unsaturated and poly-unsaturated fats are beneficial compared to saturated fat.”
Perhaps a more accurate – albeit less controversial -- headline would have been “Reducing saturated fat alone is not enough to reduce risk of heart disease.” That, or “Foods high in added sugar and refined carbohydrates linked to heart disease.”
Instead, headlines have likely left people more confused than ever, and now are feeling justified for their extra helping of bacon and sausage at Sunday brunch. As a response to these sensationalized headlines, some scientists are calling for a retraction – claiming that not only were the summarized conclusions misleading, but also that there were errors in the actual reporting when the study was first published. These errors have since been corrected, but a relatively small percentage of people who read the initial report will have heard about the corrections.
What’s the takeaway?
So where does that leave us? When looking at dietary intake and heart disease, it is essential to look at the whole picture. Eating small amounts of whole foods that contain some saturated fat as part of an otherwise healthy dietary pattern may not necessarily have a detrimental effect on your diet. But choosing more foods higher in unsaturated fats such as fish, avocado, and other plant-based oils is still preferable.
The bottom line? Olive oil is still healthier than butter. The principles of SPE Certified -- which encourage the consumption of produce and healthier fats while reducing saturated fats and sodium – are consistent with the Mediterranean eating pattern and are already well aligned with these findings. The problem arises when total fat intake is decreased and is then replaced with heavily processed foods high in salt and refined carbohydrates.
You should still hold off on that extra helping of bacon, but in some instances that fat-free sugar-laden muffin might be even worse!
Are you confused by the latest headlines on saturated fats? Let us know your thoughts on the study in the comments below.
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