Today, I want to talk to you a little bit more about saturated fats and heart disease. If you’ve followed the media on this topic, you’ve likely been confused.
Is there a connection? What do you need to know about them? How might they be affecting your overall health? If you have been looking for more information on a topic like this, we will cover it all in this handy article.
During the 1960’s, the rate of heart attacks was absolutely skyrocketing. It has slowed since then, but it still remains unfortunately high. Sadly, in about one third of the cases, the very first sign of heart disease is a fatal heart attack - so it can sneak up on you in a hurry, and it can cause very real tragedy.
Researchers saw that those who had suffered from heart attacks like these had fatty plaque built up, ultimately blocking the blood vessels which give blood to the heart muscle. By this token, it seemed quite logical that if there’s this fatty, waxy, cholesterol-based stuff here, then some of what we are eating must end up there.
There is definitely a lot more levels of complexity behind this understanding, but the overarching thought is that dietary cholesterol, dietary fats, and especially saturated fats were the main culprit. So, let’s dive into this understanding and how it has changed over the years - and, most importantly - what the science is telling us today…
What is a fat?
Chemically speaking, a fat is a hydrocarbon. That means that it is merely a molecule that is made up of two atoms: carbon and hydrogen. Now, the carbons make a long chain, and the hydrogens fill in around the carbons. I do not want to get too deep into chemistry, but it helps to know that these carbons can make up to four bonds.
When a carbon bonds with another carbon, it takes away one of these four bonds. This ultimately means that the carbon has less of an opportunity to bond with hydrogen. When we think of a “saturated fat,” we need to know that it is a chain of carbons that is simply saturated with hydrogen.
Besides saturated fats, there are a couple other combinations which could be at play:
- Unsaturated Fats (a lack of bonds)
- Monounsaturated Fats (a single bond)
- Polyunsaturated Fats (many bonds)
Key Insight: When we start counting up from a carbon chain (from alpha to omega), the first “double bond” that we find dictates the kind of fat that we are dealing with. For example, if the first double bond was three carbons into the chain, it would be an omega-3 unsaturated fatty acid.
What does it mean for a fat to be “saturated”?
Sometimes we might hear the terms “fat” and “oil” used interchangeably, but a fat is specifically something that is solid at room temperature. If I had:
- Coconut Oil
All of these things would remain relatively solid when at room temperature. In this case, we might even be more correct in using the term “coconut fat” rather than coconut oil - you would really have to turn up the heat in the room to start seeing it melt.
The main difference here, though, is that the more saturated the fat is the more easily it “stacks up” - the more easily it fits together with the adjoining molecules. So, it stays solid. Whereas, with an unsaturated fat, it cannot stack up as easily. This means that it remains liquid even at lower temperatures (which we call a “less saturated fat”).
Why are these fats important?
These fats are important because they contribute to our cell membrane composition. Unsaturated fats are flexible and are able to bend. This creates a more liquid cell membrane which is better able to take in nutrients and excrete waste. When cell membranes have high amounts of saturated fats, they are less flexible and less able to regulate their own chemistry.
What are food examples of these fats?
First, it is important to note that all sources of fat do have a blend of saturated, monounsaturated, and polyunsaturated fats. None are exclusively one way or another, they all involve some sort of blend. To categorize a fat as having saturated fats usually means that it contains predominantly, and not entirely, saturated fats.
Key Insight: Have you heard that you need to be completely avoiding polyunsaturated fats? By their very nature, this would be impossible. All of these fats are blends, which means that you are never getting just one exact type and nothing else.
Most animal fats save for fish, lean, and wild game meats are primarily saturated. Grass-fed meats are most often considered as being sources of omega-3 fats. While they may have more omega-3 fats than conventional meat, overall they are still almost exclusively saturated fat - with no significant amount of omega-3 fats.
More examples of where you can find saturated fats include:
- Dark Meat Poultry
- Egg Yolks
- Most Cheeses
- Full-fat Dairy
As we previously mentioned, because of how temperature affects saturated, most vegetables with saturated fats only grow in tropical areas. Some of these include:
- Coconut (Oil and Meat)
- Palm Oil
What types of saturated fat are there?
Saturated fats can also be categorized by their carbon length, which is just how many carbon atoms that they have composing them. Some of the shorter ones can do really good things for our gut flora, while the longer ones have less definitive health benefits (because they are often found in large combinations, in other foods, it can be hard to get a read on what kind of benefit they might be providing).
The types, in order, are:
- Butyric acid (4 carbon atoms)
- Laurie acid (12 carbon atoms)
- Myristic acid (14 carbon atoms)
- Palmitic acid (16 carbon atoms)
- Stearic acid (18 carbon atoms)
CIS or Trans?
The last thing we want to cover in our discussion about fats is the distinction between CIS and trans fatty acids. Remember our chain of carbon from before? Initially, we talked about them being in something of a straight chain.
The reality is, though, that they can typically be found in a C-shaped chain. We call that a “CIS fatty acid” for that reason - it is a whole bunch of Cs, in one big c! In fact, a healthy cell membrane looks like a long row of these Cs forming one large line - all pushed up against one another.
When a fat become saturated under certain conditions, like a very high temperature or pressure, it can shift our C-shaped curve into an S-shaped curve. We can see trans fats in:
- Animal Fats
- Hydrogenated Vegetable Oils
- Partially-hydrogenated Vegetable Oils
Trans fats, as an active ingredient, you do not find them in foods as much anymore. Nowadays, we are more likely to see trans-fatty acids forming in baking goods that we might be more likely to find the center of our grocery stores.
Bottom Line: When we talk about the danger of trans fats, you need to know that even milligrams can hurt you. Unfortunately, poor labelling requirements have allowed for companies to make “0 trans fatty acids” claims - even though they have them. The devil is truly always in the details.
What do we know about saturated fats and heart disease?
There are a few different ways of going about answering this question. First, we might be able to consider “modelling” or “expert consensus.” That can be a lot like a thought experiment, where we see that plaque in the blood vessels is bad, that plaque contains saturated fat and cholesterol, therefore saturated fat and cholesterol in your diet is bad.
Key Insight: While it might make initial sense, this sort of research it is definitely not conclusive. At their best, though, thought experiments like these help propel us forward into the world of legitimate science and really getting to the heart of the issue.
The next is test tube studies, where we might simply pour saturated fats on cells and see what happens next. This is also a great way to validate further research, but it cannot influence future decisions too heavily. It is a great start, but it is definitely not the end.
The next level is animal studies, and finding out what happens when animals consume these saturated fats. Again, not conclusive, but a worthwhile launchpad for more research.
Bottom Line: Meaningful research starts from the level of human outcome studies. This is where we get a really good idea of what happens in the body, and we can really start to derive some decision-making steps. More people, more years, and more dramatic incomes - all of these things help.
The Inuit Effect
Have you heard of the “Inuit effect”? Inuit populations were considered to have very low rates of heart disease, even though they were enjoying diets which were high in fat. In the past, these diets were very high in marine fats, and yet these people had lower overall rates of heart disease. How could this be the case?
Oddly enough, and this is after I took a look through some of the research, but it turns out that this was a bit of a myth (1). So, they probably do not have lower rates of heart disease, and they probably did not throughout time.
Bottom Line: In colder environments, one needs more unsaturated fats in order to move around - due to the proximity of the cold, relative to your blood vessels. You cannot afford to have things “saturating,” or becoming solid in your system.
Successful Population Studies
There are two populations which have had the most dramatic differences in heart disease, they are:
- The Tsimane
- The Okinawan
The rate of heart disease is about one tenth to one fifth of what it is in modern populations. It is dramatically different, and therefore worth understanding more about.
The Tsimane were a really interesting case, where nearly a thousand people received CT scans to see if there is any plaque or not - which was a great, and objective, way of doing things. While there is a normal amount of plaque that forms, simply from age, but the Tsimane did not have plaque - and their older people, they did not have plaque either. A similar story was also the case for the Okinawan people, too.
Both of these peoples enjoyed diets that were extremely low on saturated fats. The Tsimane averaged about 11 grams of saturated fat per day (2), which was about 4% of their total calories. The Okinawans had about 2% of their calories consumed from total saturated fat (3)
Key Insight: Most Americans average about 15 - 20% of saturated fats from their total calories.
Is butter back?
The entire reason we are even having this conversation is due to a study, released in 2015, that really muddied the waters as it concerned the role of butter in our diets. It was Time Magazine that took this article, entitled “Is Butter Back?” and totally ran with it (4).
While some have taken this at face value and assumed that butter is an altruistic choice for our diets, the lead author of this study came out and said that the research was to state the case that butter should neither be demonized or glorified. A little bit here and there is fine, so nothing should really be demonized as being truly off-limits.
The study itself placed saturated fats against other things that we might have in our diets, such as:
- Refined grains
- Red Meat
- French Fries
- Partially-hydrogenated Oils
Basically, butter was no worse than any of these other options. Even though that is a pretty low bar, and I am certainly not making the case for butter as a health food, it is saying that butter is no worse than other trans-fatty acids.
Bottom Line: I really hope that, if you take one thing away from our discussion today, that you do not get trapped into binary thinking with your food. Foods are not entirely evil, and they are also not our saviors. They are the things we need to fuel us, and it is all about the proportions and the dosages. Saturated fats are fine, they are not evil and they are not a point of emphasis in our diets. Avoiding this mentality is so important when it comes to preserving your long-term health.
This sort of “butter renaissance” that we might have seen following this 2015 study was particularly dangerous, but it placed emphasis on the role of butter in our diets - you might have even seen people drinking a butter coffee here and there. To counter this, there were follow-up studies done to shown how too much saturated fats could have a negative effect on our health.
Basically, if you swapped out a certain amount of saturated fats in your diet for an unprocessed carbohydrated, you would be lowering your mortality rate by 8%. They even showed that ever 5% of saturated fat, swapped with polyunsaturated fat, corresponds with a 26% reduction in mortality.
These are huge and radical health differences when it comes to doing a little bit less in the way of saturated fats, and more good carbs or unsaturated fats.
How else can saturated fats affect my health?
Apart from heart disease, there are a few other ways that saturated fats can affect your health:
Bottom Line: There has been no evidence of saturated fats improving health outcomes, which means that we cannot spend time thinking of it as a saviour food or something that can benefit us long-term. In reality, increasing our consumption of saturated fat can harm our bodies in so many ways.
What’s the optimal dosage for saturated fats?
Your best option is going to be including 5 - 10% of your total calories as saturated fats. There is not much in the way of strong evidence that says you can harm your body when you stay in this range. The one argument here is when we consider the Tsimane and the Okinawans. They were lower than that threshold, and they thrived.
Key Insight: If you have cardiovascular risk, it would be best to keep the amount you put into your system at about 5% or less of your total overall calories.
Let’s say you are on a Mediterranean or standard American diet, you are probably already at 10 - 15% of your diet’s total calories coming from saturated fat. So, in this case, you should consider reducing how much saturated fat you put into your system.
We should also consider what might happen if you are on a totally fat-free diet. In these kinds of cases, even a tablespoon of butter would equal 4% of your total calories from saturated fat. Now, coconut oil is more dense in calories. Butter has some water, proteins, and lactose, and coconut oil does not.
Bottom Line: If you have cardiovascular health problems, you want to shoot for closer to 5%. 5 - 10% is safe for most folks, in terms of cancer and brain health risks. 10 - 20% we see risks begin to emerge, and in more than 20% we see very strong risks emerge. If you are on a low-carb diet, each tablespoon of butter can bring you closer to these dangerous levels.
Dispel Binary Thinking Today
What we covered today was all about learning that saturated fats are not supposed to be vilified, but we also cannot possibly turn to them as some sort of savior for our health. It does not work that way, and it should not work that way. While you are here, I would also recommend that you continue to expand your thinking and take the Thyroid Quiz today (12). It will help you gain a better idea about your overall health, so that you can make the right decisions for your body starting today.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, cure diabetes, and regain energy. Learn more about the surprising story that started his quest.