Good Fats vs. Bad Fats


Advisory: Replacing saturated fat with healthier fat could lower cardiovascular risks






Replacing saturated fat with healthier fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs, according to an American Heart Association advisory issued Thursday.

“This important paper reaffirms the scientific evidence that saturated fat raises LDL cholesterol, a leading cause of atherosclerosis,” said Rachel Johnson, Ph.D., R.D. a professor of nutrition at the University of Vermont, who was not an advisory author. “Furthermore, replacing saturated fat with polyunsaturated fat reduces the incidence of cardiovascular disease.”

Atherosclerosis is the hardening and clogging of arteries that can lead to heart attacks, strokes and other cardiovascular diseases.

Cardiovascular disease was lowered by about 30 percent, similar to the effect of cholesterol-lowering statin drugs when vegetable oil replaced saturated fat in the diet, according to the advisory. The switch to healthier oils also was associated with lower rates of death from all causes.

The finding doesn’t mean that people prescribed statins to lower heart disease risk should give up medication. Nor should they eat too much saturated fat, said Frank Sacks, M.D. lead author of the advisory and professor of cardiovascular disease prevention in the department of nutrition at the Harvard School of Public Health.

“That statin is only going to go part of the way,” he said. “You’re going to mess up the effect of the statin if you’re eating all unhealthy foods.”

Researchers culled hundreds of research papers published since the 1950s, finding evidence supporting the AHA’s recommendation that saturated fat should make up less than 10 percent of daily calories for healthy Americans.

The tipping point that led to the advisory was a well-publicized 2014 study that concluded that the amount of dietary and saturated fat had no bearing on the risk of heart disease, said Sacks.

But the study had at least one major flaw: It didn’t consider what people ate in place of saturated fat, Sacks said.

“The people who were eating low saturated fats were eating a lot of junk food carbohydrates,” Sacks said.  Trading bad fat for bad carbs doesn’t reduce cardiovascular disease, he said. “You wouldn’t tell people, ‘Hey reduce your sat fat and replace it with sugary soft drinks or donuts.’”  You’d tell them to replace it with unsaturated oils, whole wheat bread, vegetables, nuts or beans, Sacks said.

The publicity surrounding the study and others has shaped public perception about saturated fats, partly reflecting the way nutrition studies are reported by news media, said Sacks.

“One of the real problems in transmitting health information is that generally people who are writing about it don’t look into what’s come before,” he said. The media also don’t pay much attention to new studies that support or extend current dietary recommendations. “The overall effect has misled the public on the science of dietary fats,” he said.

People are also quick to believe trends that aren’t supported by science, he said.  A prime example is coconut oil, widely touted for its health benefits. “I just don’t know” who is pushing it, but it’s not scientists, Sacks said. It may be driven by manufacturers looking to profit, or some countries’ economic dependence on coconut oil, he said.

According to the advisory, coconut oil is 82 percent saturated fat, and studies show it raises LDL “bad” cholesterol as much as butter, beef fat or palm oil. Canola oil, on the other hand, has only 7 percent saturated fat. All fats and oils have varying levels of saturated, monounsaturated and polyunsaturated fat.

One reason people may have a hard time reducing their saturated fat intake is the familiarity of foods made with it, Sacks said.

“People also have a strong emotional connection to what they eat,” Sacks said. “What you’re brought up eating, what people call their comfort food — there’s a lot of emotion in that.” But nutrition science may not support the health of that kind of eating, he said.

Overall fat intake was higher when early studies of saturated fats were done in the 1950s and 1960s, according to the advisory. The studies showed that reducing saturated fats lowered cholesterol, reduced the risk of heart attack and stroke, and in some cases lowered the risk of death from coronary heart disease.

Although people are eating less saturated fats today than in the 1950s, they still eat too much, Sacks said.  Most restaurants today cook with unsaturated fats, but foods like beef and bacon still contain saturated fat.

“If you have a cheeseburger or bacon burger, you get sat[urated] fat from almost everything except the bread,” Sacks said. Despite its lower fat status, a white bread bun isn’t particularly healthy either, Sacks said.

He advises people to reduce saturated fats by not cooking with butter, but with canola, or corn oil or soybean oil, or extra virgin olive oil.

Johnson said the main sources of saturated fats are butter, lard, beef tallow, palm oil, palm kernel oil and coconut oil. Healthier oils include canola oil, corn oil, soybean oil, peanut oil, safflower oil, sunflower oil, and walnuts, she said. Olive oil, avocados and tree nuts such as almonds, cashews, hazelnuts, pistachios, and pecans are low in saturated fats, and largely composed of monounsaturated fats, Johnson said.

Surprisingly, Sacks isn’t against frying foods, even deep frying.

“There’s nothing wrong with deep frying as long as you deep fry in a nice unsaturated vegetable oil,” he said.

The Need For Vitamin D

Getting enough vitamin D is important for overall health-and early studies suggest it may also be key for managing diabetes.  

If a vitamin D supplement isn’t in your medicine cabinet, it should be.  Data shows that many Americans are deficient in the sunshine vitamin.

That might be because vitamin D is a tricky little guy.  It’s present in very few foods, and even then it appears in relatively small amounts.

Lucky for us, nature built in a fail-safe: You can get vitamin D through sun exposure.  But that has its challenges, too.

So why make the effort for this elusive vitamin?  Because it’s crucial for so many aspects of your health, and new studies suggest it may help you manage your diabetes as well.

Why you need it

Vitamin D helps your body absorb calcium and promotes bone health (people with diabetes are at risk for fractures).  It’s also key for reducing inflammation and boosting immunity.  Researchers note that fewer hours sunshine in winter may be linked to why that time is cold and flu season.

Emerging research suggests that people with type 2 who have higher blood levels of vitamin D tend to have better blood sugar control.  And people at risk for type 2 with higher vitamin D levels are less likely to develop the disease.

Even more:  Studies show a link between low vitamin D levels and increased risk of nerve, kidney, and eye complications, as well as cardiovascular disease and hypertension.  But clinical trials about the effects of adequate levels of vitamin D are mixed and in early stages.

What we do know for sure:  Vitamin D is important for many aspects of your health, so you should make an effort to get the recommended dosage each day.

What’s right for you

So how can we get enough of the sunshine vitamin?  It’s especially important for those who have difficulty maintaining adequate levels, including obese people, older adults, people with limited sun exposure, people with darker skin, and those with inflammatory bowel disease or who have had gastric bypass surgery.

According to the USDA, fatty fish (salmon, tuna and sardines) is a top source.  You also get some vitamin D in egg yolks and beef liver.  In the American diet, fortified foods provide a lot-including milk, orange juice, breakfast cereal, and even mushrooms exposed to UV-B light.

Still, most of the foods have only timy amounts of vitamin D.  For example, you’d have to drink 13 cups of milk to get the 1.500-2,000 IU the Endocrine Society recommends for adults.

A guideline for boosting your body’s D production is to expose the most skin possible to sunlight, getting half the amount of sun exposure it takes for your skin to turn pink, according to the Vitamin D Council.

In the end, the best way to get enough vitamin D is to take a daily supplement.  These pills are easy to take, affordable, and widely available. If you’re concerned you’re deficient, ask your doctor to check with a simple blood test at your next visit.


Try the D-Minder Pro app to help you figure out how much vitamin D you can make from sun exposure in your location.  It takes into account your skin you expose.  Free at dminder.ontometrics. com.


The endocrine society recommends 1,500 IU, while the NIH recommend 600 IU for adults.  Ask your doctor what’s best for you.

Look for supplements labeled D3, the same form your body makes from sunlight.  D2 is not as potent as D3.

1,000 IU supplements are widely available in grocery stores and pharmacies; less potent versions mean more daily doses.

Supplements also come in gummies and chews, but note carbs so they don’t spike blood sugar.

Eat a fat source, such as peanut butter, avocado, or an egg, with your supplement to better absorb vitamin D.

References:  Diabetic Living Dec. 2016