It’s easy to find ready sources that say dietary fat is bad news. Many clinicians still hold that saturated fats like coconut oil, butter and beef cause weight gain, clogged arteries, high cholesterol and heart disease. But, what if it it’s time to re-evaluate fat’s bad reputation? This blog will fill you in on the research and debunks one of the big myths still surrounding this well-known macronutrient.

Does Eating Saturated Fat and Cholesterol Increase Risk of Heart Disease?

Today, many doctors still tell their patients to limit saturated fat and cholesterol intake (found in red meats, butter, eggs and oils like palm and coconut) and recommend a statin drug when their cholesterol is over 200 mg/dL. This is probably due in part to misleading evidence that suggested that cholesterol levels are directly correlated to risk of heart disease. One such study was performed by a researcher by the name of Ancel Keys in the 1980’s that looked at 22 countries and found that dietary fat intake was related to increased risk of heart disease. However, data on only 7 of those 22 countries was published – those that fit his hypothesis. Since then, many researchers and physicians have refuted this study, and yet, the recommendations that come down the pipe from the American Heart Association and the USDA continue to perpetuate that dietary fat and cholesterol are bad for us.

Research has and continues to show that high quality animal fats and eggs aren’t the real culprit in heart disease. One of the most notable studies that shows this was called the Women’s Health Initiative, which studied over 48,000 postmenopausal women and the connection between a low fat diet and the risk of heart disease. After a mean of 8 years, the group that reduced overall fat intake and increased intake of whole grains, fruits and vegetables did not experience reduced risk of CHD, stroke or CVD over the control group. There are other studies that have found similar results, indicating that low fat diets don’t really have much impact on heart disease risk. A report published in 2010 by the American Journal of Clinical Nutrition stated that there was no substantiated link between saturated fat intake and outcomes of obesity, CVD, cancer or osteoporosis. And, if you need even more proof, a meta-analysis of 21 medical reports and studies also published in 2010 in the American Journal of Clinical Nutrition concluded that, “the intake of saturated fat was not associated with an increased risk of coronary heart disease, stroke or CVD.”

If not fat, then what?

So, if saturated fats aren’t the culprit in CVD and atherosclerosis, then what is? Cue carbohydrates. And not just any kind of carbohydrate, but the highly refined grains, starches and sugars that most Americans are consuming daily. As a society, our diets are high in processed and packaged foods like pastries, fast food, crackers, cookies and cakes. Eating these foods causes surges in blood sugar and taxes the pancreas, whose job it is to produce insulin to shuttle the sugar into our cells to be used for energy or stored for later. Over time, our cells become resistant to insulin and sugar remains in the bloodstream instead of being transported into the cells. Sugar in the blood stream sticks to protein molecules like LDL cholesterol (called “bad cholesterol”). This changes the structure of the LDL and causes an inflammatory cascade which leads to plaques in the arteries and the inability of LDL to carry cholesterol where it’s needed, especially to the brain. So, now we have a simple equation. Too many carbohydrates cause inflammation, which leads to oxidized or damaged LDL and atherosclerosis. This is what usually leads to heart disease, not eating too much dietary saturated fat and cholesterol.

What are some of the benefits of eating more fat?

So, what does the science tell us about a high fat diet? Research is showing that a high fat, lower carbohydrate diet is beneficial for:

• Heart health
• Boosting the immune system
• Brain function (and reduced risk of Alzheimer’s, cognitive impairment and dementia)
• Blood sugar control
• Weight management

High fat diets, and even ketogenic diets are being studied for their efficacy in treating Parkinson’s, Alzheimer’s, ALS, Epilepsy and even ADHD. In particular, cholesterol is especially protective of brain function. One famous study called the Framingham Heart Study found that those with low serum cholesterol performed less well on cognitive function tests than their counterparts with borderline or high cholesterol levels. We can deduce from that that cholesterol has a protective effect on the brain. (On a side note, think of the ramifications for those who take a statin drug to lower cholesterol. One known side effect of statin drugs is problems with memory and cognition.) The ketogenic diet is certainly not for everyone, but we wanted to include the research to show that eating more fat can be protective of cognitive function!

What kind of fat should I eat?

The good news is that it’s easy to start enjoying the benefits of a higher fat diet. Along with non-starchy vegetables (think asparagus, cauliflower, broccoli, kale, swiss chard and spinach), lower sugar fruits (grapefruits, oranges, apples, berries, melon, pears, cherries, grapes, kiwis, plums, peaches and nectarines) and starchy roots veggies or beans enjoying  foods higher in fat helps with hormone balance, cellular and gut health, satiety and appetite regulation.

Just to be clear: Not all fats are created equal and the news that saturated fat is not the main culprit when it comes to heart disease is not permission to eat all kinds of fat with abandon! So, we devised this traffic light system for fats to help guide you:

Green Light:

• Avocado (and avocado oil)
• Olives (and olive oil)
• 80% or darker dark chocolate
• Nuts and seeds (Walnuts, Almonds, Cashews, Macadamia nuts, etc.)
• Nut butters (Only ingredients should be nuts and salt)
• Wild caught cold water fish (salmon, herring, sardines, mackerel)
• Free range, organic eggs
• Coconut oil (unrefined) – Although coconut oil is generally fine for most people to enjoy it does effect cholesterol levels, so be cautious if you have a history of heart disease.

Yellow Light:

• Grass fed cheese, yogurt and butter (whole or 2% and organic preferably, skip the non-fat options)
• Grass fed beef and lamb
• Uncured pastured bacon

Red Light:

• Trans fats (Margarine and many processed foods, condiments and nut butters. If the ingredients list includes the word hydrogenated, its a trans fat.)
• Vegetable oils (Soybean oil, Safflower or Sunflower oil)
• Canola oil (Unless organic and cold pressed)
• Cured meats (bacon, hotdogs, pepperoni, lunch meats, etc.)

If you want to know more about how to cook with oils, check out that blog here.

Eating Fats in Balance 

Including more fat in the diet does not mean that you should start a ketogenic diet or eat saturated fats with abandon! But, don’t be afraid to ditch that low fat yogurt and have eggs for breakfast! A balanced diet that includes lots of fiber, healthy fats and adequate protein is important for your hormonal health and the health of your microbiome.

We are here to help!  If you are looking for guidance and help in understanding nutrition for your body, give us a call! Or, check out our virtual Back to Basics Program on our homepage.

Contributed by Elizabeth McKinney MS,CNS,LDN