#118 Is Saturated Fat Safe for the Heart?

Is Saturated Fat Safe for the Heart? Dr. John Day
Dr. Day is a cardiologist specializing in heart rhythm abnormalities at St. Mark’s Hospital in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowships in cardiology and cardiac electrophysiology at Stanford University. He is the former president of the Heart Rhythm Society and the Utah chapter of the American College of Cardiology.

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Is Saturated Fat Safe for the Heart?

“I never eat red meat or butter,” Cindy said proudly at a recent dinner event as she put whole wheat bread and pasta on her plate.

Based on the ongoing guidance from our government and the American Heart Association, Cindy thought she was eating a heart healthy dinner as she was limiting saturated fat.  Do the scientific data support restricting saturated fat intake?

In this article, I will share the most recent medical studies answering this question, is saturated fat safe for the heart.  If you would rather skip directly to the video interview I did on this blog at KUTV, our local CBS affiliate in Utah, here is the link.

Saturated Fat Is Not Dangerous

This past week the prestigious British Medical Journal published yet another article, building upon recent research over the last decade, that saturated fat may not be dangerous for our heart health.  This study was based on an analysis of 73 recently published medical studies including a total of 339,090 people.

The main findings of this study are as follows:

1. Saturated fat didn’t increase heart disease or premature deaths

2. Replacing saturated fat with simple carbohydrates increases heart attacks

3. Replacing saturated fat with complex carbohydrates prevents heart disease

4. Replacing saturated fat with healthy fats prevents heart attacks

5. Trans fat causes premature death and heart disease deaths

Big Picture on Saturated Fat

The findings of this study may help to clarify the previous confusion about saturated fat from our government and large organizations like the American Heart Association.  It appears that saturated fat, like that found in animal meat, butter, cheese, etc. are relatively neutral when it comes to heart disease risk and premature death.

If we replace saturated fat with refined carbohydrates like those found in 99% of commercially available breads/pasta/cereal, white rice, processed foods, etc., much like we did in the 1980s and 1990s, our overall risk goes up.  In fact, many researchers feel that replacing saturated fat with refined carbohydrates was the single most important reason for the obesity epidemic we are now experiencing.

If our goal is optimal health then we should focus on replacing excess saturated fat with complex carbohydrates, like legumes, fruits, and vegetables or healthy fats like nuts, avocado, and oily fish.  Indeed, based on the results of this study, the heart disease risk goes down significantly if we eat more complex carbohydrates and healthy fats while minimizing saturated fat.

Trans fat, like what is found in microwave popcorn, commercially prepared bakery items, and processed foods is clearly dangerous to our health.  In fact, studies show that there is no safe level of trans fat that we can eat.

I need to emphasize that even though the food label states “zero trans fat” you can’t believe the label.  To determine if there is trans fat, you must read the ingredients due to legal loopholes in the government reporting guidelines.  If you see “partially hydrogenated” or shortening on the ingredient list, run as these fake foods are likely loaded with trans fat.

Is Plant-Based Saturated Fat Healthier?

Unfortunately, in this study, researchers did not look at whether the source of saturated fat matters when it comes to health.  For example, nuts, avocado, and coconut all have varying degrees of saturated fat.

My personal opinion is that unprocessed, plant-based sources, of saturated fat, like that which is found in nuts, avocado, and coconut, is much heart healthier than animal based saturated fat like animal meat, cheese, and full-fat dairy.  Hopefully, in the next few years we will have conclusive proof on this subject.

Is Natural Trans Fat Dangerous?

Another question that was not answered in this study is whether natural trans fat is as dangerous as the processed food form of trans fat.  For example, animal meat and dairy contain natural trans fat.  Is the natural trans fat in animal meat and dairy dangerous like the trans fat in microwave popcorn, commercially prepared bakery items, or processed foods?

Once again, conclusive proof is still lacking.  Personally, I suspect that the natural trans fat from real food sources, like organic, grass-fed animal meat and dairy, is probably much safer than what is made in an industrial “food” factory.

Take Home Message

Hopefully, this study lays to rest much of the confusion about dietary fat.  Based on this, and other emerging research, here is what I recommend to my patients trying to eat a heart healthy diet.

1. The worst foods for your heart are refined carbohydrates and industrial trans fat.

2. Complex carbohydrates are heart healthy.

3. We need more fat from nuts, avocado, and wild oily fish in our diets.

Do you feel that this study helps to clear up the dietary confusion we have been receiving from our government and large organizations like the American Heart Association?  Please leave your comments below for our community.

August 15th, 2015

Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.

11 Comments

  1. Love the newsletter. I learn about 14 things with each one I read. Thanks so much for taking the time to help us all.

  2. Did I miss something, or are you basing your recommendations on something other than the resources cited?

    Where do you get the idea that “If our goal is optimal health then we should focus on replacing excess saturated fat with complex carbohydrates..”? The research cited doesn’t mention anything about finding that replacing saturated fat with complex carbohydrates is good… Nothing.

    I would really appreciate actual research that backs up your claim, thanks!

    • Hi Justin,

      Thank you so much for your careful read of this article. Sorry if this statement was unclear.

      In probably the best study to date on saturated fat, involving 339,090 people which was published in the prestigious British Medical Journal, researchers concluded that saturated fat was neutral when it comes to heart disease.

      Interestingly, they found that if you replace saturated fat with processed carbohydrates, heart disease goes way up. However, if saturated fat is replaced by complex carbohydrates (carbohydrates from vegetables, fruit, and legumes) or omega 3 fats (from fish, walnuts, flax seeds, etc.) the heart disease risk goes way down.

      If you are interested, this is a great study that is very interesting to read. Here is the link: http://www.bmj.com/content/351/bmj.h3978

      Best,

      John

  3. About a month ago, my wife received the lab results back from her internal medicine physician. Her total cholesterol was above 250. Her physician discussed placing her on a statin medication. My wife came home and we discussed it together. I on the other hand exercise vigorously almost daily, at least an hour six days a week. My wife has been exercising routinely on a treadmill for about thirty minutes daily. However, my wife and I essentially have the same diet since I’ve been retired from full time work. If her cholesterol is high, mine may also be high. We have also been traveling more and eating out and that may have contributed to the higher cholesterol level.

    I turned to my wife and said, “desperate times call for desperate actions.” If you are willing to go on a plant based diet, I am too! I want to keep you around. It has probably been five weeks now and my wife has been completely abstaining from all meat and meat products. She has also eliminated dairy and dairy products from her diet. I was the one eating the left over cheese and meat stored in the freezer and refrigerator then so that she did not have to eat it. Those foods are now gone and so now I’m not even eating them. We probably have one to two slices of whole wheat bread per day.

    We’ve also been taking advantage of the farmer’s markets and the summer vegetable and fruit stands in our area. We grow have a few fruits and vegetables from our own garden. Breakfast includes a blended fruit smoothing with and organic plant based(non-soy)protein supplement. We have also been eating almonds and pecans. Lunch and dinner may consist of a vegetable/bean stew, salad, or veggie patty or tofu. Obviously, we are ingesting some soy products and I am concerned somewhat about that. I did download a vegetarian recipe app for my phone and we’ve found that to be helpful. I did have a piece of salmon with lentils and broccoli this week at one of the local hospital cafeterias. I have no idea whether it was fresh ocean or farm raised salmon.

    With the amount of exercise that I do, alternating between one hour of road biking, mountain biking, 1500 meter swim, or isometric type exercise, I suddenly lost ten pounds in two weeks and just bought a pair of jeans with a 33 inch waist.

    Here are my concerns and questions. I’m a little concerned with the amount of protein that I am getting in my diet, given the amount of exercise that I enjoy doing. I hope that I am getting enough. There is a lot of controversy on the internet about soy protein. How bad really is it for people over sixty? I noticed that one of your recipes had whole eggs. Are eggs okay if your trying to reduce your cholesterol? I feel great, but I’m now only 155 pounds and I’m six feet tall.

    My wife should be getting a repeat blood cholesterol test in a week or two. Hopefully it will have dropped significantly. If there are arteriosclerotic changes due to calcium and plaque build up, can it be reversed through diet? We are both non-smokers and always have been. We don’t drink alcohol either. My wife and I are our own human subjects in our own study. Any recommendations?

    • Hi Patrick,

      Congratulations on your health lifestyle.

      To answer your questions:

      1. Yes, if you are exercising vigorously then you will likely need more than the recommended 1 gram of protein each day for every kilogram of body weight. There are many apps that can track your protein intake. I personally use “Lose It.”

      2. Yes, soy is very controversial. There are some data from the U.S. that suggests harm. Data from Asia suggests significant benefits. I suspect this has to do with the nature of the soy. If it is the “whole bean” (not an isolated portion of soy or the form of soy found in processed foods) and organic. This is the way they have eaten it for years in Asia.

      3. Yes, data from Dr. Dean Ornish has shown that atherosclerosis is reversible with aggressive lifestyle changes.

      Good luck and let me know how much your cholesterol drops.

      Best,

      John

  4. Thanks for these studies. What I’ve been reading says fat from commercially raised beef loaded with toxins and antibiotics is bad for us, whereas the fat from grassfed/grass finished beef is cleaner, thus less toxic, and has more omega 3’s. I believe that would hold true with any animal, so pastured is best if you’re going to eat it. The same holds true for grassfed butter like Kerrygold. This information comes from Sarah Ballantyne, PhD, who wrote “Autoimmune Paleo”, and from her website Paleo Mom. Then there’s the issue of grains. I’ve read “Wheat Belly” by cardiologist Wm Davis, and “Seeds of Change” by…can’t remember right now, but suffice it to say, if I didn’t already abstain from them, I would start. I have allergic reactions to most grains, so am off of them anyway.
    Thanks for all you do!

      • I forgot to add that the toxins in the fat of conventionally raised beef is due to the feed. Moldy (aflatoxins) GMO corn, and soy (the phytoestrogen debate)etc, and then antibiotics. But I read recently the FDA is looking to ban those (I hope this is true) due to antibiotics’ failure with superbugs. Farmed fish, too. Some fish is becoming unsustainable, but looking into it recently, I found that fish farms feed with soy, wheat, and corn, not to mention antibiotics and colorings for their salmon, because wild salmon get their color from krill. The only safe farmed salmon locally is from Whole Foods. But this time of year, the price has gone down for Wild salmon at Costco.

  5. Dear Dr. Day,

    I have just come back from holidays and each day I had a large plate of fresh fruit at breakfast with a fruit yoghurt. I really miss fresh fruit in Nigeria although this week a friend brought me a complete watermelon which I am enjoying. I drink skimmed milk and eat a little butter and the best brown bread I can buy here. I eat 5-7 eggs a week in a variety of ways. I try and buy wholegrain breakfast cereal and I eat at least 3 hours before going to bed.I believe the labelling of many products is deceptive and they often put price tags etc over use by dates here.Keep up the great work.