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Why Did Saturated Fat Get a Bad Rep?

Why Did Saturated Fat Get a Bad Rep?

Even today, as new studies emerge showing saturated fat does not cause heart disease, you’ll occasionally find a misguided journalist incorrectly lump it with trans fat or use “artery clogging” to describe saturated fat.

The tiding is slowly changing. One recent meta-analysis in the Annals of Internal Medicine concluded “current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”

Other researchers ask we reconsider stigmatizing saturated fat.

“The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs [saturated fatty acids],” writes Glen D. Lawrence in a 2013 Advances in Nutrition review, who then asks “for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.”

The question becomes, why did saturated fat ever develop a bad reputation that it needs to be vindicated today? We have a very influential researcher named Ancel Keys to thank for that.

In 1955 at the World Health Organization in Geneva, Keys offered what became known as his lipid hypothesis, which claimed dietary fat raised cholesterol, subsequently increasing heart disease.

Initially, Keys targeted dietary fat as the culprit, but over time, he modified his argument to point the finger solely at saturated fat. Whereas unsaturated fat in vegetable oils could benefit health, he claimed, saturated fats create adverse affects.

The American Heart Association quickly embraced Keys’s hypothesis, warning that butter, eggs, meat, and other saturated fat-rich foods contributed to heart disease and emphasizing a low-fat diet to prevent heart disease.

Eventually, Keys presented his Seven Countries Study, which argued countries where people ate more fat—particularly saturated fat—had more cases of heart disease.

Why Saturated Fat Is Not the Enemy

“Saturated fat has been demonized ever since Ancel Keys’s landmark ‘seven countries’ study in 1970,” writes Aseem Malhotra in a British Medical Journal review appropriately calledSaturated fat is not the major issue.”

As Malhotra and numerous other researchers point out, correlation is not causation, and Keys neglected to account for many factors that could also contribute to heart disease. Keys cherry-picked his data, conveniently excluding whatever didn’t fit his hypothesis. In fact, the countries he studied that had the highest rates of heart disease also were the countries with the highest intakes of sugar and refined carbohydrates. Was it the fat or the sugar? Turns out it was the sugar!

Even though critics pointed out these and other fallacies in Keys’s work, the public bought into the saturated-fat-is-harmful myth, avoiding it like the plague for decades and choosing instead inflammatory vegetable oils and trans fats in fake foods like margarine.

The truth becomes much more complicated. Some fats do raise cholesterol, whereas others lower cholesterol. Even when saturated fat does, the type of cholesterol becomes more important than cholesterol itself. Saturated fat does raise the LDL or bad cholesterol, but it also raises the good or HDL cholesterol. But sugar lowers HDL cholesterol. And it is the ratio of total to LDL cholesterol that is a far more important predictor of heart attacks than LDL cholesterol itself.

Quality becomes paramount here. The saturated fat in a fast-food bacon cheeseburger will have an entirely different effect than saturated fat in coconut oil.

Let’s use grass-fed beef as an example. Although lower in saturated fat than grain-fed beef, roughly 40 to 50 percent of the fat in grass-fed beef is saturated.

Compared with grain-fed beef, grass-fed beef contains more stearic acid, a saturated fat that doesn’t increase cholesterol. In fact, one study in the journal Lipid found stearic acid lowered LDL cholesterol.

Grass-fed beef contains lower amounts of palmitic acid and myristic acid, two saturated fats that can potentially raise cholesterol.

Even then, the type of cholesterol becomes more relevant than raising cholesterol itself. Researchers now understand high density lipoprotein (HDL) and low-density lipoprotein (LDL), the molecules that carry cholesterol, come in several types. Larger, fluffy “good” molecules are harmless, whereas small, pellet-like “bad” molecules can actually create or exacerbate problems.

Interestingly, researchers find when folks consume more saturated fat—especially from healthy sources like coconut oil—their “good” LDL cholesterol increases and their “bad” LDL decreases. Saturated fat in foods like extra virgin coconut butter fuels your mitochondria, provides anti-inflammatory benefits, and could even improve your cholesterol numbers.

In her recent book, The Big Fat Surprise, Nina Teicholz, takes a deep dive into the world of fat, saturated fat, cholesterol and heart disease and comes up with a big fat nothing. The data linking dietary fat (other than trans fats) and heart disease is weak at best, and corrupt at worst.  She not only looks at the research, but the politics, money and personalities that demonized fat and why there is very little real evidence that fat is a problem, even saturated fat.  For anyone who wants to deep, honest look into this topic, I encourage you to read her book.

Why Sugar Is the Enemy

We must also consider other factors, other than saturated fat and cholesterol, that could contribute to heart disease. The purple elephant in the room—the one that researchers neglected to focus on for decades—is sugar, especially high-fructose corn syrup and other man-made sugars.

A century ago, we ate far more saturated fat but had less heart disease. Butter and lard were staples and heart attacks were rare and almost unknown. We also ate a lot less sugar, and zero of our sugar came from high-fructose corn syrup (HFCS). Today, the average kid consumes 34 teaspoons of sugar every day, largely as HFCS in sodas and processed foods. We went from eating about 10 pounds of sugar a year in the 1800s to 150 pounds today. That’s average; some people eat much more than that.

In the past 30 years since HFCS was introduced into our diet, we’ve gone from zero calories to 66 pounds of this Frankenfood annually. It’s no coincidence that, within that time period, we’ve seen obesity and chronic illness rates (including heart disease) skyrocket.

One recent study published in JAMA Internal Medicine found, even accounting for other risk factors, that those with the highest sugar intake had a four-fold increase in their risk of heart attacks compared to those with the lowest intakes.

Ironically, U.S. Dietary Guidelines today restrict saturated fat to no more than 10 percent of a person’s caloric intake; yet, they set no limit to added sugar. Can you see why we’ve gone after the wrong enemy for so long?

Among its many problems, sugar contributes to inflammation (the root of heart disease) as well as high triglycerides, lower HDL (good) cholesterol, and dangerous, small LDL (bad) cholesterol.

Many of the low-fat and fat-free Frankenfoods we’ve consumed over the past few decades have been higher in sugar, particularly HFCS.

“We’ve all been sold a bill of goods about so-called healthy low-fat foods like cookies and muffins,” writes Christiane Northrup, MD. “When you begin to read labels, you’ll quickly see how much sugar is added to just about everything, especially to low-fat foods.”

Lumping all saturated fats into one category over-simplifies things much like claiming all carbohydrates are bad. Broccoli and a hot fudge sundae are both carbohydrates, yet you know one benefits you and the other doesn’t.

Don’t be afraid of saturated fat. Instead, maximize healthy sources like coconut and grass-fed beef and you’ll automatically edge out unhealthy sources. Combine that with a diet free of added sugars and you have an effective strategy to normalize cholesterol, as well as reduce your risk for heart disease, obesity, type 2 diabetes, and numerous other chronic conditions.

Over the past decade, we’ve seen a paradigm shift from dietary fat to sugar becoming the enemy.

How has this awareness shaped your eating habits? Share your thoughts below or on my Facebook fan page.

Wishing you health and happiness,
Mark Hyman, MD

Mark Hyman MD is the Medical Director at Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

Comments (27)

  • I learned back in the late 80’s that sugar and carbs raised cholesterol along with stress at the time my cholesterol was 218 and when the doctor put me on the cholesterol diet I went back in 6 weeks and it had gone up 30 points so he told me to go back to eating the way I used to and in 6 weeks it went down again. Good someone is finally seeing the light.

  • It’s easy to confuse me on these subjects, but this seems to be a misprint. “especially from healthy sources like coconut oil—their “good” LDL cholesterol increases and their “bad” LDL decreases. ” the first one should be ‘HDL’. in the above article.

    Thank you for all of the great up-to-date information.
    Mike Dolan

    • I picked up on the same point. I thought i had to reread it again just in case i misunderstood it.Thanks for confirming that, however i hope someone corrects that or atleast lets us know if it is actually a misprint.

      • Mike and Saba, that might not be a misprint.

        Given that the good and bad LDL reference was after the discussion of LDL sized molecules (large and fluffy vs small and dense), Dr. Hyman may have been referring to good LDL (large and fluffy) vs bad LDL (small and dense).

        As he pointed out, the small and dense can cause problems over time.

      • No! it’s not a misprint. What he’s saying is that there is a good LDL that is needed and is the larger fluffy kind. This LDL actually has an important role and is not easily oxidized and problematic.
        It’s not a misprint.

    • Actually its correct, there is a good LDL, the big and fluffy one, and a bad LDL the small dense one. And then there is also HDL which is good too.

    • This is not a typo. Dr. Hyman is referring to “good” LDL cholesterol (the fluffy beach ball kind) vs “bad” LDL cholesterol (the small hard golf ball type). Even if your LDL is high, you’re okay if it’s mostly the fluffy “good” LDL.

    • It’s not a misprint. There are two types of LDL. He is referring to good LDL (fluffy) vs Bad LDL (pellet-like).

    • I believe Dr meant the “good” large particle LDL and the “bad” as small particle LDL. So it makes sense.

  • I decided to run an experiment for 6 months after reading your materials online and your book. My cholesterol was 266 and I started taking 10mg pravastain based on the recommendation of the Berkeley Heart Lab testing. I am 5’3 and weighed 120. I went on the Medifast diet and weighed 107 cholesterol went to 175 still taking the Pravastatin.For the last 6 months I went off the med and stopped eating sugar and white flour period! Today my cholesterol 198
    Triglycerides 77
    HDL 92
    LDL 91
    Weight 104.
    I’m 63 yrs old.

  • Dr. Hyman,
    It’s frustrating that my dad’s cardiologists send him home with information instructing him to specifically avoid healthy saturated fats such as those in coconut oil. He is a cardiac patient and Mom has Alzheimer’s. I have been trying to share this type of info with him for a long time. He finally began to embrace this “new” paradigm just before have another small heart attack. He came home from the hospital with instructions contradictory to what this article says, and told me that he will “follow Doctor’s orders”, regardless of the information I have been sharing. He even tried to share some of this information on healthy fat consumption with his cardiologist who said he would review it. Weeks later, he still hasn’t found the time to do so.
    Meanwhile, he is eating his margarine and processed carbs. What do we do against resistance like this?

  • I stopped using sugar several years ago, and I don not eat refined foods, I switched to organic veggies, and fruit, keep up the good fight, down with Monsanto and the other chemical idiots.

  • I gave up all grains especially flour in all forms I find if I eat flour or other grains I want to eat and eat and eat never feeling full. Also gave up white sugar due to type 2 diabetes, My only problem is I’m positive for factor 5 Liden and have a history of blood clots and pulmonary embolisims will be on blood thinners the rest of my life which means I have to curtail my intake of most Dark green veggies. Decided I’m going to eat them just not a huge amounts. If I have to get my blood drawn every 2 weeks so be it, Keep my carb count between 20 and 30 grams per day have lost 64 lbs. so far blood sugar levels are much improved with just Lantus insulin. have been able to decrease that amount and hope to be able to decrease that amount as I continue to drop weight . I eat everything I was told was bad for me, Eggs Beef ect. no white sugar or wheat of any kind. Use regular butter too. I agree with Charles Down with Monsanto and Bayer too as they both make toxic chemicals and count Du Pont in there also. Grow what you can if not find local farmers that offer organic meats and produce
    . Start A Co-op to be able to get better prices on large amounts of organic veggies and fruits research your area. Hang in there you will feel better. I WAS WALKING WITH A CANE NOW IT HANGS ON THE DOOR. THINGS ARE GETTING BETTER WITH EVERY POUND LOST.

    pont in that also.

  • It’s great to hear a prestigious MD speak out about the unwarranted demonization of saturated fat. As well as the researchers you cite, I think journalists such as Gary Taubes and Nina Teicholz deserve a great deal of credit for re-kindling debate on this issue.

    I hope that your new appointment as director of the Institute for Functional Medicine at the Cleveland Clinic will lead to a rehabilitation of the reputation of saturated fat in the cardiology community.

  • For the full story on saturated fat, read my book, The Big Fat Surprise. Published in May, this is the work that pioneered the arguments in favor of saturated fats. With thousands of footnotes and all the history/politics explaining how we got to our situation today, this is a book that could convince a cardiologist (and seems to have convinced Dr. Hyman, himself, since we sent him a review copy–great to see).

  • Could someone please tell me if high fructose corn syrup is also the same as just corn syrup when reading labels? I saw something that said no HFCS on the front of the box but still had corn syrup in the label? What should I be looking for then? Thanks!

    • Hi Traci,
      Corn syrup is different in that it contains only glucose but it is still important to reduce this and all sweeteners for optimal health.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Doc Hyman Its such a shame that Barry Sears a very celebrated scientist is so “unimpressed” or “misinformed” about coconut oil. He is STILL espousing the age old mantra that its a saturated fat and science and research has “shown” beyond a doubt that it is not good for your body – WISH we could get the two of you at a round table discussion Im certain that his new book to be released in January on Inflammation will not be complimentary to coconut oil I use coconut oil every day in my shake and morning oil pulling. Additionally I cook and roast with it. I have been very interested in the real life stories of folks like Dr Mary Newports experience with coconut oils impact on her husbands dementia. She wrote some pretty impressive papers on the effect of the medium chain tryglycerides on brain health and guess who wouldn’t listen to her??? YUP the national Alzheimers association. Like the cancer “industry” their only agenda is to protect their survival Thanks for your always wonderful gifts of truth!!

  • I eat grass fed beef, organic butter, coconut oil, nitrite free bacon , and lots of organic cheese – I don’t worry about fat but do limit sweets and bread although I wouldn’t say I’m on a low carb diet but compared to many I’ve seen I guess it is. My family has a lot of heart disease and my father died of it. But I have optimal blood pressure, good blood sugar and my recent cholesterol was 178 total with 82 HDL and 76 LDL and 108 triglycerides – this was about three hours after a breakfast that included bacon and cheese. Once when I was tested on a very low fat diet my total was 214. There was a time I believed in low fat diets but not anymore!

    • Hi Lizette,
      Thank you for sharing your experience and congratulations for taking charge of your health!
      Wishing you the best of health,
      Dr. Hyman Staff

  • Saturated fats reduce cell permeability and increase insulin resistance. Have you seen the movie, Simply Raw? It will be interesting to see what your colleagues at the Cleveland CLinic have to say about this.

  • I gave up all added sugar 6 months ago. If it is real, fake, or a sugar substitute and it shows up in the ingredients list, I don’t eat it. I took me 36 years to recognize I had a sugar addiction and I needed to take control. Now my heart scan is clear, my blood work is awesome, my body runs efficiently and real sweet foods like strawberries taste amazing. You couldn’t pay me to go back to eating like I used to.

  • It has been commonly believed that consumption of foods containing high amounts of saturated fatty acids (including meat fats, milk fat, butter, lard, coconut oil, palm oil, and palm kernel oil) is potentially less healthy than consuming fats with a lower proportion of saturated fatty acids. Sources of lower saturated fat but higher proportions of unsaturated fatty acids include olive oil, peanut oil, canola oil, avocados, safflower, corn, sunflower, soy, and cottonseed oils

  • He even tried to share some of this information on healthy fat consumption with his cardiologist who said he would review it. Weeks later, he still hasn’t found the time to do so.
    Meanwhile, he is eating his margarine and processed carbs. What do we do against resistance like this?

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