Saturated Fat is Back, Or Is It?

No doubt you’ve seen the headlines declaring that butter is back.  You’ve probably read that we’ve got it all wrong.  Saturated fat is not a problem after all.  What’s the deal?  Should you be slathering your biscuits with butter and celebrating the good news with a 32-ounce Porterhouse? Not so fast.

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Don’t get me wrong.  I actually love butter and I feel like our historical fear of fat has lead people astray. Low-fat and fat-free are not always better (in fact, attempts to severely restrict fat can backfire).  But I think the recent media reports about the return of saturated fat could be doing more harm that good. I’m talking about the Questionable Link Between Saturated Fat and Heart Disease in the Wall Street Journal and Butter is Back by Mark Bittman in the New York Times, along with other articles exonerating saturated fat of all harm.  The journalists are basing their opinions on a meta-analysis in the March issue of the Annals of Internal Medicine.  And it turns out the WSJ reporter  Nina Teicholz has written a book about the topic:  The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet.


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I definitely believe that butter, meat and cheese can fit into a healthy diet.  I enjoy all three.  But more is not better.  The recent meta-analysis in the Annals of Internal Medicine is being misinterpreted.  Even though headlines declare that “saturated fat does not cause heart disease,” the paper didn’t actually make that conclusion.  Or it certainly didn’t show that adding more is beneficial — and that’s the jump people are making. As Dr. David Katz said in his Huffington Post column, The Greatest Dietary Guidance? If It Gets Cold, Reheat It! 

Is lack of harm really the new standard in healthful eating?

The new research that’s causing all the fuss is an analysis of previous studies that looked at coronary heart disease rates compared to intake of saturated, polyunsaturated and monounsaturated fats.  The authors conclude:

Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.

However, as Dr. Katz points out, many researchers have identified flaws in this new meta-analysis, including Harvard experts who suggest there are several errors and omissions. The investigators themselves have conceded those flaws, and an actual retraction of the paper is being discussed.

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Yes, the analysis did show that there was no major differences in coronary heart disease rates when comparing the top to bottom third of saturated fat intake, although there was a suggestion of more heart disease with more saturated fat consumption (it just wasn’t statistically significant).  But the big factor that the study didn’t consider was what replaced the saturated fat.  If something goes down, something else must go up.  So if you replaced saturated fat with sugar and starch (like the classic fat-free cookie example), then of course there’s no improvement.  As Dr. Katz explained:

So if eating less saturated fat means eating more sugar, it would at best be a lateral move in terms of health — and probably worse than that.  The study simply ignored this consideration.  Basically, this study showed that if you vary your intake of saturated fat or omega-6 fat without altering the overall quality of your diet, you are not likely to alter your health much either….But the headlines we are getting, while much more exciting, are entirely misleading. There was no suggestion at all here of any health benefits of saturated fat, and some hint of harmful effects despite the important study limitations.

As Walter Willet points out, if you replace saturated fat with “good fats,” then you have an entirely different story:

This paper is bound to cause confusion. A central issue is what replaces saturated fat if someone reduces the amount of saturated fat in their diet. If it is replaced with refined starch or sugar, which are the largest sources of calories in the U.S. diet, then the risk of heart disease remains the same. However, if saturated fat is replaced with polyunsaturated fat or monounsaturated fat in the form of olive oil, nuts and probably other plant oils, we have much evidence that risk will be reduced.

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This is the problem, in my opinion. We eat food, not nutrients.  You can’t take a one-nutrient-at-a-time approach.  You can’t look at saturated fat (or any nutrient) in isolation.  As David Katz so brilliantly concluded:

This new study shows that we can vary our intake of any given fatty acid and not alter the quality of our diet or health.  Well, duh. There is more than one way to eat badly.  And there are no good answers to misguided questions.  My advice is as it ever was. Chew carefully on headlines before choosing to swallow the hyperbole, and eat a diet of wholesome foods reliably associated with good health across a vast and stunningly consistent literature. Do that, and let the fatty acids and other nutrients sort it out for themselves.

Harvard’s Frank Hu told the New York Times:

The single macronutrient approach is outdated. I think future dietary guidelines will put more and more emphasis on real food rather than giving an absolute upper limit or cutoff point for certain macronutrients.

So what do I believe?

  • Enjoy your butter, just don’t over do it.
  • Don’t put so much faith in coconut oil or other trendy fats — use them because you like the taste, not because you think they’ll improve your health (or work miracles).
  • Just because a nutrient or food was found to be not as harmful as once thought, it does not mean it’s beneficial.
  • If you want the flavor of animal fats in your cooking (lard, duck fat, schmaltz), check it out. All things in moderation.
  • Rather than working so hard to increase saturated fat, find ways to swap in more good fats:  extra-virgin olive oil, nuts, olives, avocado.
  • Read beyond the headlines — and don’t rely on journalists as your main source of nutrition advice.

It’s not just the saturated fat debate. Fats are increasingly in the news:  from the ban on trans fats to the palm oil controversy (or the red palm oil as superfood frenzy).  And of course, there’s coconut oil, which is being practically worshipped these days.  Plus, you can now find all sorts of fancy oils to cook with and use on salads — including avocado, flax, hemp, rice bran and walnut oil. “Fried in duck fat” has become a trendy description on menus.  Lard and schmaltz are making a comeback in the kitchen. In fact,  Michael Ruhlman has even written a book (a “love song”) all about chicken schmaltz.   It’s not easy keeping up with all the fat conversations.  I liked how The Hartman Group broke down the fat dialogue today.

Key Terms                    Driver                Proposed  Benefit         Fat Type

Non-hydrogenated         Health                   Less processed                    Use coconut oil instead

Trans fat free                   Health                   Cardiovascular                    Extra-virgin olive oil

Palm oil free                    Sustainability       Save endangered species    Use canola oil instead

Essential fatty acids       Health                    Reduce inflammation        Walnut oil

CLA                                   Health                    Weight Management         Grass fed butter

Omega 3s                          Health                   Cardiovascular                    Hemp oil

High smoke point           Health                   Less carcinogenic                Duck fat

Non GMO             Health +  Sustainability   Diversity + Flavor             Swap soy oil for schmaltz

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Read more:

Bittman, Butter and Better Than Back to the Future by David Katz
The Greatest Dietary Guidance? If It Gets Cold, Reheat It! by David Katz
The New Dietary Fat Study: What You’ll Hear, and What It Really Means by David Katz
Is Saturated Fat a Problem? Food for Debate by Marion Nestle
Dietary Fat and Heart Disease Study is Seriously Misleading by Walter Willet, Frank Sacks and Meir Stampfer

 

Images:
Compound butters by Carolyn McCaffrey on flickr
Cheese burger by Craig Gaines on flickr
Marbled steak by Taryn on flickr
Olive oil by Smabs Sputzer on flickr

 

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4 Comments

  • diane boyd

    Great post! Especially love your point, ‘don’t rely on journalists as your main source of nutrition advice.” I believe they are part of the problem, certainly NOT the solution. Take Katie Couric’s Fed Up. Places blame, but offers NO solutions. And then there’s Shape magazine refusing to show America what real weight loss looks like!

    • You are right , journalist looks for killer reports and they don’t mind exaggeration or even created new nutrition rules!

  • Well- written! I think butter is great thing! But unfortunately you can easily overindulge it, so cautious is required! Thanks Janet for sharing your thoughts 🙂

  • Katie

    Thank you for doing the hard and much needed work of providing some balance, clarity, and perspective to the saturated fat conversation, Janet. I will be sharing with my readers!

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