Saturated Fat: Friend or Foe?

There’s lots of conflicting information circulating the internet about saturated fats. Some “experts” say they’re harmful, while others say they’re necessary for good health. In this article I’ll briefly discuss this issue with the hope that you’ll be a little more food for thought on the subject.
Saturated fats are typically solid at room temperature and are found naturally in animal products, like meat, dairy, and eggs, which are also high in cholesterol. Some plant-based oils, such as coconut and palm oil also contain high amounts of saturated fats, but do not contain cholesterol. Eating foods that contain saturated fats are known to raise cholesterol levels in your blood, which in turn increase your risk of cardiovascular disease.^3,4
In 2015, TIME magazine’s eye-catching, click bait “Eat Butter” issue, proclaimed that “the case for butter just got stronger” saying “butter may, in fact, be back.”  It still remains unclear if this was a desperate attempt to rekindle declining magazine sales or a breakthrough story aimed to dismantle the inconvenient truth that saturated fat was the villain that years of nutritional science had made it out to be. To TIME magazine’s credit, their article was based on a recent meta-analysis published in a credible journal, which concluded that the “current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.” This was huge news because current worldwide dietary recommendations focus on reducing saturated fat intake, to prevent chronic diseases, including heart disease. Did the scientists of the past have it wrong? Are saturated fats actually healthy for us? Have we vilified saturated fats unjustly, when really there were other culprits to blame, namely processed carbohydrates and sugar? Unfortunately, this meta-analysis does not answer those questions. It only shows that when it comes to heart disease there is little evidence from their chosen data of either harm or benefit with consumption of different types of fats. There were no specific comparisons, such as butter vs. olive oil, so from this meta-analysis we can’t conclude that one is worse than the other, even though many other studies have shown that certain unsaturated plant-based fats and oils, such as olive oil are indeed healthier or less detrimental to our health when compared with saturated fat.⁶ 
The questions that everyone wants to know are: “Do saturated fats contribute to heart disease?” and “ Can I eat my bacon, cheese, and ribeyes without having to worry about clogging my arteries?”  Many of the high-profile proponents of high-fat diets would tell you to go ahead and eat your meat, eggs, and dairy, but just be sure to limit your intake of carbohydrates, especially simple carbohydrates to a minimum. Some high fat proponents even go as far as saying that a ketogenic diet, which limits carbohydrate intake to less than 50g/day is an optimal diet to prevent and halt cardiovascular disease. While high-fat, low-carbohydrate diets (e.g. Atkins, ketogenic, paleo, etc.) have been used to treat conditions like obesity, diabetes, and even neurological disorders with good results, there is no real evidence to show that these types of diets are safe for longterm or overall health. In fact, the evidence shows that high fat, low carb diets can be detrimental to our health, especially cardiovascular health.^2,5 For example, an Atkin’s-style diet may initially help you to lose weight and stabilize elevated blood sugar, it may still lead to stiffened arteries.^2,5  It is also well known that foods high in saturated fats increase total and LDL (bad) cholesterol, which is a well-established risk factor for cardiovascular disease.
So for now, I recommend that the majority of my patients follow the American College of Cardiology/American Heart Association’s recommendations to aim for no more than 5%-6% of calories from saturated fat³, which were devised from a collaboration of hundreds of studies showing the strong association between saturated fat and cholesterol.⁴ Do I think this is the healthiest way to prevent cardiovascular disease? Not, necessarily – stay tuned for future posts for further explanation. Do I think people can be healthy eating diets high in saturated fat? Yes, some people are healthy following a diet high in saturated fat. However, in these cases I believe it is important to schedule regular check-ups with your doctor to monitor cardiovascular and overall health, especially if there is a family history of cardiovascular disease, cancer, or diabetes.
Cardiovascular disease is complex and every patient’s story is unique. When it comes to dietary saturated fat and other fats, people tend to respond differently from one another. A diet high in fat may be safe for one person while a similar diet may be deadly for another. Because of this, medical evaluation and proper monitoring are recommended so you can avoid being a victim of a preventable disease.
Dietary information is often conflicting, usually with good arguments on both sides. It goes to show that there is still much to be learned. When it comes to dietary information I urge you to: never believe anything you hear for the first time, always ask questions, and strive for a deeper understanding.
– Barry Burris, ND 
References

1. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 2014;160(6):398-406.
2. Schwingshackl L, Hoffmann G. Low-carbohydrate diets and cardiovascular risk factors. Obes Rev. 2013;14(2):183-4.
3. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-99.
4. Clarke R, Frost C, Collins R, Appleby P, Peto R. Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies. BMJ. 1997;314(7074):112-7.
5. Merino J, Kones R, Ferré R, et al. Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk. Br J Nutr. 2013;109(7):1241-7.
6. Estruch R, Ros E, Salas-salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.