Heart Specialist Calls for Major Repositioning on Saturated Fat, as It’s NOT the Cause of Heart Disease

Story at-a-glance

  • For the past 60 years, conventional medical authorities have warned that saturated animal fats cause heart disease and should be severely restricted in a heart-healthy diet
  • An important editorial written by an interventional cardiology specialist in the British Medical Journal says it’s time to bust the myth that saturated fat consumption causes heart disease
  • Reducing saturated fat intake reduces large, buoyant (type A) LDL particles. But it’s the small, dense (type B) particles that are implicated in heart disease, and these respond to reductions in carbohydrate consumption
  • A high-sugar diet raises your risk for heart disease by promoting metabolic syndrome—a cluster of health conditions, including: high blood pressure, insulin and leptin resistance, high triglycerides, and visceral fat accumulation
  • To reverse or avoid insulin and leptin resistance, you need to: Avoid sugar, fructose, grains, and processed foods; eat whole foods; and replace the grain carbs with high-quality healthful fats


This is an older article that may not reflect Dr. Mercola’s current view on this topic. Use our search engine to find Dr. Mercola’s latest position on any health topic.

By Dr. Mercola

For the past 60 years, conventional medical authorities have warned that saturated animal fats cause heart disease and should be severely restricted in a heart-healthy diet.

As of 2010, recommendations from the US Department of Agriculture1 (USDA) call for reducing your saturated fat intake to a mere 10 percent of your total calories or less. This is astounding, considering the fact that many health experts now believe you likely need anywhere from 50 to 70 percent of healthful fats for optimal health!

It's virtually impossible to estimate how many people have been prematurely killed by the persistent promulgation of this myth, grown from a flawed study published over half a century ago, that has since been soundly debunked by many decades of research subsequently published.

Most recently, an editorial in the British Medical Journal2 titled: "From the Heart, Saturated Fat is Not the Major Issue," has garnered much media attention as it sends a contrary message by saying  it's time to bust the myth that saturated fat consumption causes heart disease.

Saturated Fat Does NOT Promote Heart Disease

The avoidance of saturated fat actually promotes poor health in a number of ways, compounding the health risks of following this completely outdated and dangerous advice. As stated by the author, Aseem Malhotra, an interventional cardiology specialist registrar at Croydon University Hospital in London:

"The mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for almost four decades. Yet scientific evidence shows that this advice has, paradoxically, increased our cardiovascular risks...

The aspect of dietary saturated fat that is believed to have the greatest influence on cardiovascular risk is elevated concentrations of low density lipoprotein (LDL) cholesterol.

Yet the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles (responsive to carbohydrate intake) that are implicated in cardiovascular disease.

Indeed, recent prospective cohort studies have not supported any significant association between saturated fat intake and cardiovascular risk Instead, saturated fat has been found to be protective." [Emphasis mine]

We've long acknowledged that the Western diet is associated with increased rates of obesity, diabetes, heart disease, hypertension, and cancer. Yet the conventional paradigm is extremely reluctant to accept that it is the sugar content of this diet that is the primary culprit.

Furthermore, it's been firmly established that it's the trans fat found in margarine, vegetable shortening, and partially hydrogenated vegetable oils that is the true villain when it comes to heart disease, as they increase your LDL levels, or "bad" cholesterol, while lowering your levels of HDL, known as "good" cholesterol. Trans fats also contribute to type 2 diabetes and other serious health problems.

Carbohydrates/Sugar, Not Fat, Is the Root of Heart Disease

Unfortunately, many doctors and health officials alike are still trying to assure you that you can safely indulge in sweet treats, provided it's in moderation. This line of reasoning completely falls apart however, if you eat a diet consisting primarily of processed foods, because virtually ALL of them are loaded with processed carbohydrates and fructose.

Cutting out a few desserts or restricting the amount of sugar you add to your coffee or sweet tea, for example, will barely make a dent if you're consuming a lot of processed foods and beverages besides pure filtered water.

I've previously written about how various foods and beverages contain far more sugar than a glazed doughnut. Take Vitamin Water, for example. One 20 oz bottle contains 33 grams of sugar, which equates to THREE Krispy Kreme original glazed doughnuts!

One of the reasons for this overabundance of sugar in processed foods is due to the fact that when you remove the fat, the food tends to lose its taste.

Food companies compensate by adding processed fructose, salt, and other proprietary flavorings. Making matters worse, refined sugars are highly addictive, and cause metabolic dysfunction that leads to overeating and stubborn weight gain.

A high-sugar diet dramatically raises your risk for both type 2 diabetes and heart disease by promoting metabolic syndrome, which includes the following cluster of health conditions:

  • High blood pressure
  • Insulin and leptin resistance
  • Raised triglycerides
  • Visceral fat accumulation

In short, when you reduce saturated fat and increase refined carbohydrates, you end up promoting obesity, diabetes and heart disease. This is a perfect example of how it can take the conventional medical establishment DECADES to catch up to the truth, and I'm pleased to see that this issue is finally gaining some well-deserved press.

Still, I fear it may be many years before the conventional medical wisdom fully appreciates the value of saturated fats... As for the disease-promoting actions of sugar, two brilliant researchers in this area are Dr. Robert Lustig and Dr. Richard Johnson, both of whom I've interviewed and featured on a number of occasions. According to Dr. Lustig:3

"The problem with sugar isn't just weight gain... A growing body of scientific evidence is showing that fructose can trigger processes that lead to liver toxicity and a host of other chronic diseases. A little is not a problem, but a lot kills -- slowly."

Busting the Calorie Myth

Another related myth is that eating fat causes weight gain, and associated health problems. This too has been firmly debunked (see research below). Eating healthful fat does NOT make you fat. Eating refined carbohydrates/sugar, trans fat and highly processed vegetable oils does. And Dr. Johnson's work shows that while excess sugar in any form is harmful, fructose is the worst of the bunch. So far, scientific studies have linked fructose to about 78 different diseases and health problems.4

Fructose raises your uric acid levels, typically generating uric acid within minutes of ingestion, which in turn can wreak havoc on your blood pressure, insulin production, and kidney function. Increased uric acid also leads to chronic, low-level inflammation, which has far-reaching consequences for your health. For example, chronically inflamed blood vessels lead to heart attacks and strokes.

Another MAJOR part of why fructose is worse than other sugars is because it is "isocaloric but not isometabolic." This means you can consume the same amount of calories from fructose or glucose, fructose and protein, or fructose and fat, but the metabolic effect on your body will be entirely different despite the identical calorie count. In the featured editorial,5 Dr. Malhotra addresses this as well, saying:

"The notoriety of fat is based on its higher energy content per gram in comparison with protein and carbohydrate. However, work by the biochemist Richard Feinman and nuclear physicist Eugene Fine on thermodynamics and the metabolic advantage of different diet compositions showed that the body did not metabolize different macronutrients in the same way.

Kekwick and Pawan carried out one of the earliest obesity experiments, published in the Lancet in 1956. They compared groups consuming diets of 90 percent fat, 90 percent protein, and 90 percent carbohydrate and showed that the greatest weight loss was in the fat consuming group. The authors concluded that the 'composition of the diet appeared to outweigh in importance the intake of calories.'

The 'calorie is not a calorie' theory has been further substantiated by a recent JAMA study showing that a 'low fat' diet resulted in the greatest decrease in energy expenditure, an unhealthy lipid pattern, and increased insulin resistance in comparison with a low carbohydrate and low glycaemic index diet." [Emphasis mine]

You simply MUST pay attention to the source of the calories. Fat is far more filling than carbohydrates, so replacing refined carbs with healthful fats will automatically reduce hunger. Furthermore, as your body shifts from burning carbs and sugars to burning fat as its primary fuel, your food cravings will significantly diminish. Once you're fully fat adapted, cravings will be a distant memory. You can use this knowledge to assess your individual fat needs. If you've reduced your carb intake and replaced it with healthful fat but still struggle with hunger pangs, it's a sign that you need to add more fat to your diet.

How Government Dietary Guidelines Promote Obesity and Chronic Disease

It's important to realize that the government's nutritional guidelines are in large part mirrored by agricultural subsidies. They're NOT built upon sound nutritional science. In short, the reason you're told to make grains the cornerstone of your diet is because that's what farmers are paid to grow in the US. There's a lot of it, and it's inexpensive compared to healthier foods like vegetables, for which few subsidies are offered.

The wacky and nutritionally inappropriate 1992 Food Pyramid had grains as the largest bottom block of the pyramid, encouraging you to eat 6-11 servings of bread, cereal, rice and pasta each day. This excess of carbohydrates, most of them refined, is precisely the kind of diet that promotes fat accumulation and drives insulin resistance and related diseases, including diabetes, heart disease and cancer. At the very top of the pyramid was fats and sugar, and while sugar clearly belongs there, fats do not.

food pyramid

As mentioned earlier, most people would benefit from getting anywhere from 50 to 70 percent of their total calories from healthy fats. Saturated fats from animal and vegetable sources provide a number of important health benefits, and your body requires them for the proper function of your:

Cell membranes Heart Bones (to assimilate calcium)
Liver Lungs Hormones
Immune system Satiety (reducing hunger) Genetic regulation


The food pyramid was replaced with "MyPlate" in 2011, which slightly downplayed grains as the most important dietary ingredient, making vegetables the largest "slice." One of the most glaring problems with MyPlate is that it virtually removed all fats from the equation! In fact, except for a small portion of dairy, which is advised to be fat-free or low-fat, fats are missing entirely.

my plate

There is no mention of the importance of dietary fats, even the "politically correct" ones like the monounsaturated fats in olive oil and nuts, such as pecans (canola oil is also in this category, but I advise avoiding it and using coconut oil instead). Even one of the most critical of all fats is absent from the plate, namely animal-based omega-3 fats. Deficiency in this essential fat can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year... For more information about omega-3s and the best sources of this fat, please review this previous article. In an effort to remedy this atrocious situation, I've created my own Food Pyramid for Optimal Health, which you can print out and share with your friends and family.

Dr. Mercola's Food Pyramid for Optimal Health Preview

Studies Showing Saturated Fat Is Not Associated with Increased Heart Disease Risk

As mentioned earlier, mounting scientific evidence supports saturated fat as a necessary part of a heart healthy diet, and firmly debunks the myth that saturated fat promotes heart disease. For example:

  • In a 1992 editorial published in the Archives of Internal Medicine,6 Dr. William Castelli, a former director of the Framingham Heart study, stated:
  • "In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum cholesterol. The opposite of what… Keys et al would predict… We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active."

  • A 2010 meta-analysis,7 which pooled data from 21 studies and included nearly 348,000 adults, found no difference in the risks of heart disease and stroke between people with the lowest and highest intakes of saturated fat.
  • Another 2010 study published in the American Journal of Clinical Nutrition8 found that a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients, such as carbohydrates.
  • When you replace saturated fat with a higher carbohydrate intake, particularly refined carbohydrate, you exacerbate insulin resistance and obesity, increase triglycerides and small LDL particles, and reduce beneficial HDL cholesterol. The authors state that dietary efforts to improve your cardiovascular disease risk should primarily emphasize the limitation of refined carbohydrate intake, and weight reduction.

How to Regain Your Health and Avoid Heart Disease

Remember, insulin and leptin resistance are at the root of most chronic diseases, including heart disease. To safely and effectively reverse insulin and leptin resistance, you need to:

  1. Avoid sugar, fructose, grains, and processed foods
  2. Eat a healthful diet of whole foods, ideally organic, and replace the grain carbs with:
    • Large amounts of vegetables
    • Low-to-moderate amount of high-quality protein (think organically raised, pastured animals)
    • As much high-quality healthful fat as you want (saturated and monosaturated). Most people need upwards of 50-70 percent fats in their diet for optimal health.

Remember, one of the most important fats your body needs for optimal health is animal-based omega-3. Deficiency in this essential fat can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3s and the best sources of this fat, please review this previous article. Besides animal-based omega-3 fats, other sources of healthy fats to add to your diet include:

Avocados Butter made from raw grass-fed organic milk Raw dairy Organic pastured egg yolks
Coconuts and coconut oil Unheated organic nut oils Raw nuts, such as almonds, pecans, macadamia, and seeds Grass-fed meats

Healthy Fat Tips to Live By

As reported by Medical News Today:9

"Dr. Malhotra urges doctors to 'embrace prevention as well as treatment.' Drugs can alleviate symptoms but they can't change the 'pathophysiology,' he says, and concludes: 'It is time to bust the myth of the role of saturated fat in heart disease and wind back the harms of dietary advice that has contributed to obesity.'"

The most effective prevention strategy you'll likely ever find is your diet—the foods you do and do not eat every day. Dr. Malhotra recommends a Mediterranean-style diet, which has been shown to be three times more effective than statin drugs at reducing cardiovascular mortality.

A Mediterranean-style diet is basically a whole-food diet. And that is indeed key for any healthy diet. As Dr. Sanjay Gupta accurately points out in the featured video, the answer is to EAT REAL FOOD. This change alone will dramatically reduce the amount of refined sugar and processed fructose in your diet. It will also address the issue of healthful versus harmful fats in your diet. Believe me, you'd be hard-pressed to find a processed food containing healthful fat... Besides eliminating processed foods, the following tips can help ensure you're eating the right fats for your health:

  • Use organic butter made from raw grass-fed milk instead of margarines and vegetable oil spreads.
  • Use coconut oil for cooking. It is far superior to any other cooking oil and is loaded with health benefits.
  • Use olive oil COLD, drizzled over salad or fish, for example. It is not an ideal cooking oil as it is easily damaged by heat.
  • Following my nutrition plan will teach you to focus on healthy whole foods instead of processed junk food.
  • To round out your healthy fat intake, be sure to eat raw fats, such as those from avocados, raw dairy products, and olive oil, and also take a high-quality source of animal-based omega-3 fat, such as krill oil.


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