butter on dish, saturated fats, nutrition

Have you ever heard the saying “you can’t teach an old dog new tricks”? It’s not true. Many old dogs learn new tricks with the right training and motivation.

It turns out that it could be a lot harder to teach old docs new tricks, especially when it comes to nutrition. Even though medical schools taught very little nutrition science decades ago, some physicians just can’t let go of the lessons they learned.

What Did Doctors Learn About Nutrition?

During the middle of the 20th century, medical students were told that fat in general and saturated fat in particular caused high cholesterol. It was seen as the driving force behind heart attacks. Patients were urged to switch to margarine instead of butter, cut back on eggs and cheese and forego ice cream and burgers. After all, the thinking went, these foods are high in cholesterol and cholesterol is found in plaque in arteries.

Dietitians often recommended a “heart-healthy” breakfast of cornflakes with skim milk, toast with margarine and a glass of orange juice. Another option might be pancakes cooked on a nonstick griddle.

Margarine vs. Butter:

Before the century closed, nutrition science had found that margarine with its trans fats was actually causing more harm than butter. But health professionals have been reluctant to give up on fat as a dietary demon. That is why low-fat products like skim milk and non-fat yogurt dominate the dairy case. The American Heart Association still advises patients to limit saturated fat and select skim and low-fat dairy products.

New Data from a PURE Nutrition Study:

Now, however, the definition of healthy eating is shifting, based on actual data. Recent research called the Prospective Urban Rural Epidemiology (PURE) study carefully collected dietary information from 135,000 people (Dehghan et al, The Lancet, online Aug. 29, 2017).  After seven years, almost 6,000 people had died and more than 4,700 had suffered heart attacks or strokes.

High-Carb Diets Were More Dangerous:

Analysis showed that the people who had been eating a high-carbohydrate diet were more likely to end up among the deceased or diseased. Those whose diets were richer in fat were less likely to have died. One particular correlation stands out: those consuming more saturated fat were at lower risk for strokes.

Previous Studies on Saturated Fat:

This is not the first study to suggest that saturated fat is not our enemy. The Minnesota Coronary Experiment ran from 1968 till 1973. In this randomized controlled trial, 9,000 patients were served meals high in saturated fat or unsaturated vegetable oil. The corn oil lowered cholesterol but did not improve survival. If anything, those eating corn oil were somewhat more likely to die (Ramsden et al, BMJ, April 13, 2016).

Another classic trial had similar results. The Sydney Heart Study randomized 458 Australian heart attack survivors to continue on their usual 1960s diet high in saturated fat or to substitute safflower oil for sat fat. The data were not published at the time, but the men on the low sat fat diet were more likely to have heart attacks and die (Ramsden et al, BMJ, Feb. 5, 2013).

Rethinking Nutrition Dogma on Saturated Fat:

These findings led the investigators to question the diet-heart hypothesis so esteemed in nutrition circles. As new data (as well as new analysis of old data) demonstrate that old dietary beliefs were mistaken, health professionals need to rethink their advice. (Indeed, a few have begun to do so.) Sugar and other highly processed carbohydrates appear to be more hazardous to health than fat.

Learn More:

We have spoken with several physicians who have become convinced that we need to worry more about refined carbohydrates and sugar in our diets than about minimally processed fat. You can listen to our interviews with Dr. Robert Lustig, author of Fat Chance; Dr. Jacob Teitelbaum, author of The Complete Guide to Beating Sugar Addiction; and Dr. David Ludwig, author of Always Hungry.

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  1. Colette S
    toms river nj

    I gave up Sugar for Lent about 50 yrs ago so I never add sugar to anything. Also salt gave that up too I just worry about Fat in frying potatoes which I eat alot of .4 times a week out at a restaurant’

  2. Cindy M. B
    Seattle, WA

    I was hoping to get PP’s opinion on coconut oil. I used to shun coconut oil because it was a saturated fat; then I started using a lot of it because it was touted to be so very good for you! Now the thinking has changed again, or “halfway” so; i.e., about half the resources I use say coconut is good for you and to keep on using it. The other half say just the opposite. These are all respected sources. What to do?!?? Makes me angry and frustrated.

  3. Mary

    I really wish these reports would differentiate between animal, plant fat, and “carbohydrates” Are we talking about Twinkies, or steel cut oatmeal? Is the fat from avocados or bacon? Nuts or pork chops? This information may actually say that we should abandon fruits, vegetables, and nuts and whole grains in favor of animal fat, but we need way more specific information.

  4. Barbara
    Albany, NY

    Not half as scary as chronic, low-grade inflammation!

  5. Ed

    This is rather long, but I will be as succinct as possible.

    Any farm boy knows that if you want to make your livestock FAT, feed them grain, not grass. I have been eating a diet of high natural fat (not margarine), some protein (seafood, beef, chicken, pork, organ meats), and a little carbohydrates (above ground, dark greens, peppers, onions, garlic) pretty much my entire adult life. Favorite breakfast is 4 strips of bacon, three eggs fried in butter over sauteed greens and onions, with a whole avocado and coffee.

    The difference is satiety. With the above meal, I often will not eat again until the next day. Only eat when you are hungry, and don’t overeat.

    I’m 70 years old and weigh the same 210 lbs I did at 25. At 5’9″ that makes me grossly obese according to the BMI scale used by most doctors, but with a 34″ waist, 52″ chest and 10% body fat, I am healthier than any doctor I have ever visited. Very high cholesterol, very low triglycerides, very low SED (inflammation) level. Cholesterol is not the problem, inflammation is, and simple carbs (sugar, grains) and seed oils are the cause of inflammation.

    Exercise is essential. I have done heavy lifting three times a week for forty years, no “cardio” but plenty of walking. If you want to stay fit, kill your television.

    Oh yes, and my 50 year old wife is very pleased that I still wake up every morning “at the ready” shall we say. No pills, no supplements, no medications, just good clean eating and plenty of exercise.

    This is NOT genetic! My 350 lb brother has had numerous cardiac events, including open heart surgery. He loves his carbs, his lounge chair and his big screen TV, and takes 10 prescription medications a day. Another brother and sister have passed away far too early, with years of declining quality of life due to smoking, poor diet, little exercise and lots of medical intervention. At the time of his death, my brother was taking 17 medications a day, had a pacemaker and defibrillator. He did and took everything the doctors told him to, and they never suggested diet or exercise, just pills and procedures. Revenue generators, he had excellent insurance.

    YOU are in charge of your health and your life. Do not abdicate that responsibility to any doctor. They are paid advisers, and not necessarily in agreement with each other. Educate yourself, it’s your life and health.

    People’s Pharmacy is an excellent resource to learn differing approaches to maintaining good health that have worked well for others, as well as what you might want to avoid.

    Have a great day.

    • Bob


  6. John
    Croydon, PA

    It is widely accepted that refined carbohydrates are a poor choice. However, your selective summary on saturated fat research supports your point of view, suggests that it is settled science, and that those people who do not agree, are dogmatic. You could be citing other research, which supports limiting saturated fat. Your articles do motivate me to keep revisiting this topic because it is not settled science.

  7. Ed

    Similar to many “studies”, using “questionnaires, no mention is made of the “type” of carbs these people were consuming! Answering questions about food consumption is vague and the distinction between refined, processed carbs and plant and vegetable, natural carbs is seldom revealed.
    Please make an effort to make available the viewpoints of Doctors McDougall and Esselstyn regarding their low fat, high carb diets, which are remarkably low in sugar, and result in fewer inflammatory omega 6s, fewer high glycemic carbs, and much less fructose!
    Edward H. M.

  8. Jerry R W
    South Carolina

    It seems like there is always a new study that provides new guidelines for nutrition. The information that is usually omitted in articles that report on the new study is how the study was designed, any details of the study populations and who sponsored the study. The study quoted in the “Just How Scary Is Saturated Fat?” article was sponsored by numerous research organizations but also by unrestricted grants from AstraZeneca (Canada), Sanofi­Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma.

    I believe individuals are responsible for investigating new recommendations before throwing “old” data out the window. Common sense should also be considered. In my own experience to control cholesterol my PCP suggested that I eliminate saturated fats and minimize other fats. It worked! All my cholesterol readings are well within normal range and my overall feeling of good health has improved greatly.

  9. Dan

    Where do the fats of red meat fit in here? It’s highly saturated but not trans. Does that mean it’s not as harmful as we’ve been told, ad infinitum?

  10. Larry M
    Raleigh, NC

    In the 1973 Woody Allen movie “Sleeper” the protagonist wakes from a cryogenic sleep after 200 years. The following dialogue between his caregivers ensues:

    Dr. Melik: This morning for breakfast he requested something called “wheat germ, organic honey and tiger’s milk.”
    Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
    Dr. Melik: You mean there was no deep fat? No steak or cream pies or… hot fudge?
    Dr. Aragon: Those were thought to be unhealthy… precisely the opposite of what we now know to be true.
    Dr. Melik: Incredible.

  11. Dennis F
    Reading, PA

    Great work! Thanks much!

  12. Henry
    Mocksville, NC

    Looks like Ol’ Doc Adkins was right!!!

  13. Andy
    South Carolina

    I agree that sugar and refined carbohydrates are a serious health risk, and whole plant based foods are a much better choice. I’m concerned that giving saturated fats a “green light” could be misleading. There is a proponderance off evidence that plant based fats such as olive oil, nuts, nuts and seeds are the healthiest route. Check out the Blue Zones and Plant Pure Nation websites as a start

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