The Big Fat Surprise — Higher Cholesterol Levels Associated with Better Health

Saturated Fat and Cholesterol are Important Parts of a Healthy Diet

Saturated fat and cholesterol have been wrongfully vilified as the culprits of heart disease for more than six decades. Meanwhile, research has repeatedly identified refined carbs, sugar and trans fats found in processed foods as the real enemy.

The first scientific evidence linking trans fats to heart disease while exonerating saturated fats was published in 1957 by the late Fred Kummerow,1 biochemist and author of “Cholesterol Is Not the Culprit: A Guide to Preventing Heart Disease.” Unfortunately, Kummerow’s science was overshadowed by Ancel Keys’ Seven Countries Study,2,3 which linked saturated fat intake with heart disease. The rest, as they say, is history. Later reanalysis revealed cherry-picked data was responsible for creating Keys’ link, but by then the saturated fat myth was already firmly entrenched.

Keys’ biased research launched the low-fat myth and reshaped the food industry for decades to come. As saturated fat and cholesterol were shunned, the food industry switched to using sugar and trans fats (found in margarine, vegetable shortening and partially hydrogenated vegetable oils) instead.

The Big Fat Surprise

Investigative journalist Nina Teicholz was one of the first major investigative journalists to break the story on the dangers of trans fats in a 2004 Gourmet magazine article.4 In the video below, Joe Rogan interviews Teicholz on her 2014 book, “The Big Fat Surprise,” which grew out of that initial exposé.

In it, not only does she dismantle the belief that saturated fat and cholesterol make you fat and cause disease, she also reveals that while the dangers of trans fats are now becoming widely recognized, the recommended replacement — vegetable oils — may actually be even more harmful. She also delves into the politics and shady underbelly of nutritional science, revealing how the food industry has manipulated the scientific discussion and built a largely false foundation for the nutritional recommendations we’re given.

Corruption is not the sole problem, though. Teicholz notes there is a very strong tendency to “fall in love” with your own ideas and beliefs, and this is as true for scientists as it is for regular people. And, when you strongly believe something to be true, you will tend to find the evidence you’re looking for and ignore anything that refutes it. So, it’s really a human psychology problem.

Scientists are not supposed to fall into this all-too-human trap. “They’re taught to distrust their beliefs [and] shoot down their own hypothesis,” Teicholz says, “but in the case of nutrition science, that didn’t happen … They cherry-picked the evidence and completely ignored and actively suppressed, even, anything that contradicted their ideas.” This certainly included Keys, who was passionately wed to his hypothesis that saturated fat caused heart disease.

Busting the Low-Fat Myth

Teicholz points out the fact that saturated fat has been a healthy human staple for thousands of years, and how the low-fat craze has resulted in massive sugar consumption that has increased inflammation and disease.5 The American Heart Association (AHA) started encouraging Americans to limit dietary fat, particularly animal fats, to reduce their risk of heart disease in 1961, and maintains this position to this day.

Just last summer, the AHA sent out a presidential advisory to cardiologists around the world, reiterating its 1960s advice to replace butter and coconut oil with margarine and vegetable oils to protect against heart disease. Yet historical data clearly shows this strategy is not working, because concomitant with low-fat diets becoming the cultural norm, heart disease rates have soared. The AHA also ignores research demonstrating the low-fat, low-cholesterol strategy does more harm than good. For example:

  1. In 2012, researchers at the Norwegian University of Science and Technology examined the health and lifestyle habits of more than 52,000 adults ages 20 to 74, concluding that lower cholesterol levels increase women’s risk for heart disease, cardiac arrest and stroke. Overall, women with “high cholesterol” (greater than 270 mg/dl) actually had a 28 percent lower mortality risk than women with “low cholesterol” (less than 183 mg/dl).6
  2. In 2013, prominent London cardiologist Aseem Malhotra argued in the British Medical Journal that you should ignore advice to reduce your saturated fat intake, because it’s actually increasing your risk for obesity and heart disease.7
  3. A 2014 meta-analysis published in the Annals of Internal Medicine, using data from nearly 80 studies and more than a half-million people, found those who consume higher amounts of saturated fat have no more heart disease than those who consume less. They also did not find less heart disease among those eating higher amounts of unsaturated fat, including both olive oil and corn oil.8,9

Related reading: Debunking More Bad Science – People With High Levels of ‘Bad Cholesterol’ Actually Live Longer Than Those With Low Levels

The following graph, from a British Journal of Nutrition study published in 2012, also shows how Europeans who eat the least saturated fats have the highest risk of heart disease, whereas those who eat the most have the lowest rates of heart disease — the complete opposite of conventional thinking and AHA claims.

Your Body Needs Saturated Fat and Cholesterol

Cholesterol is not only beneficial for your body, it’s absolutely vital for optimal functioning. For example, cholesterol is needed for the construction of your cell membranes and helps regulate the protein pathways required for cell signaling. Having insufficient amounts of cholesterol may negatively impact your brain health, hormone levels, heart disease risk and more.

Your body also needs saturated fats to function properly. One way to understand this need is to consider the foods ancient humans consumed. Many experts believe we evolved as hunter-gatherers and have eaten a variety of animal products for most of our existence on Earth. To suggest that saturated fats are suddenly harmful to us makes no sense, at least not from an evolutionary perspective.

Reducing saturated fat to extremely low levels, or shunning it altogether, also doesn’t make sense when you consider its health benefits and biological functions, which include but are not limited to:

Providing building blocks for cell membranes, hormones and hormone-like substances Facilitating mineral absorption, such as calcium Acting as carriers for fat-soluble vitamins A, D, E and K
Converting carotene into vitamin A Helping to lower cholesterol levels (palmitic and stearic acids) Antiviral activity (caprylic acid)
Optimal fuel for your brain Providing satiety Modulating genetic regulation and helping prevent cancer (butyric acid)

High-Carb Versus High-Fat Diets

As noted by Teicholz, by eliminating saturated fat and cholesterol-rich foods we’ve also eliminated many of the most nutrient-dense foods from our diet — eggs and liver being just two examples — and this also has its repercussions for human health and development. Vitamins A, D, E and K are fat-soluble, which means you need the fat that comes naturally in animal foods along with the vitamins in order to absorb those vitamins.

Additionally, fat is very satiating, so you’re far less likely to overeat on a high-fat diet than a high-carb diet. Most people who complain about “starving” all the time are likely just eating too many carbs (quick-burning fuel) and not enough fat (slow-burning fuel).

Then there’s carb-addiction, of course, which further fuels the cycle of hunger and overeating. What’s worse, when you eat a high-carb diet for a long time, it blocks or shuts down your body’s ability to burn fat, which means all of your body fat remains right where it is, as it cannot be accessed for fuel.

By shifting your diet from high-carb to high-fat, you eventually regain the metabolic flexibility to burn both types of fuel — fat and sugar — which solves most of these problems; the hunger and cycle of overeating, weight gain, inflammation and related disease processes. Cyclical ketogenic diets are very effective for this, as is intermittent fasting and longer water fasts for those who are overweight.

The Problem with Vegetable Oils

As mentioned earlier, Teicholz’s book also delves into a new nutritional twist that has developed as the dangers of trans fats have been exposed and accepted. While the U.S. Food and Drug Administration has removed partially hydrogenated oils — the primary source of trans fats — from the list of “generally recognized as safe” ingredients, the vegetable oils (such as canola, peanut, corn and soy oil) that have replaced them may have even more harmful health ramifications.

When heated, vegetable oils degrade into extremely toxic oxidation products. According to Teicholz, more than 100 dangerous oxidation products have been found in a single piece of chicken fried in vegetable oils. As early as the 1940s, animal experiments showed animals would develop cirrhosis of the liver or enlarged liver when fed vegetable oils. When fed heated vegetable oils, they died prematurely.

Cyclic aldehydes are among the most toxic of these byproducts, and animal research has shown even low levels of exposure cause serious inflammation, which is associated with heart disease and Alzheimer’s. Findings like these make the AHA’s recommendation to use margarine and vegetable oils all the more troubling.

In her book, Teicholz also cites research in which aldehydes were found to cause toxic shock in animals by damaging the gastrointestinal tract. We now know a lot more about the role your gut plays in your health, and the idea that aldehydes from heated vegetable oils can damage your gastric system is frighteningly consistent with the rise we see in immune problems and gastrointestinal-related diseases.

How a Cyclical Ketogenic Diet Can Improve Your Health

Two-thirds of the American population is overweight or obese,10 more than half of all Americans struggle with chronic illness,11 1 in 5 deaths in the U.S. is obesity-related12 and 1 in 4 deaths is related to heart disease.13 Saturated dietary fats and cholesterol are not to blame for these statistics. The evidence is actually quite clear: Excessive net carbohydrate intake is the primary culprit behind these disease statistics, primarily by decimating your mitochondrial function.

To address this, you need to eat a diet that allows your body to burn fat as its primary fuel rather than sugars, and to become an efficient fat burner, you actually have to eat fat. In my latest book, “Fat for Fuel,” I detail a cyclical or targeted ketogenic diet, which has been scientifically shown to optimize metabolic and mitochondrial health. A primary difference between this program and other ketogenic diets is the cyclical component.

See: A Beginner’s Guide to the Ketogenic Diet: An Effective Way to Optimize Your Health

It’s important to realize that the “metabolic magic” in the mitochondria occurs during the refeeding phase, not during the starvation phase. If you’re constantly in ketosis, you’re missing out on one of the most valuable benefits of the ketogenic diet. Basically, once you have established ketosis, you then cycle healthy carbs back in. As a general rule, I recommend adding 100 to 150 grams of carbs on the day or days each week that you do strength training. Some of the most important benefits of this kind of eating program are:

Weight loss

By rebalancing your body’s chemistry, weight loss and/or improved weight management becomes nearly effortless. Studies have shown a ketogenic diet can double the weight lost compared to a low-fat diet.14

Reduced inflammation

When burned for fuel, dietary fat releases far fewer reactive oxygen species and secondary free radicals than sugar. Ketones are also very effective histone deacetylase inhibitors that effectively reduce inflammatory responses. In fact, many drugs are being developed to address immune related inflammatory diseases that are HDAC inhibitors.

A safer and more rational strategy is to use a ketogenic diet, as it is one of the most effective ways to drive down your inflammation level through HDAC inhibition.

Reduced cancer risk

While all cells (including cancer cells) can use glucose for fuel, cancer cells lack the metabolic flexibility to use ketones, while regular cells thrive on these fats. Once your body enters a state of nutritional ketosis, cancer cells are more susceptible to being removed by your body through a process called autophagy. A cyclical ketogenic diet is a fundamental, essential tool that needs to be integrated in the management of nearly every cancer.

Increased muscle mass

Ketones spare branched-chain amino acids, thereby promoting muscle mass.15 However, make sure to implement cyclic ketosis. Chronic ketosis may eventually result in muscle loss as your body is impairing the mTOR pathway, which is important for anabolic growth. mTOR needs to be stimulated, just not consistently, as many people do with high protein diets.

Lowered insulin levels

Keeping your insulin level low helps prevent insulin resistance, Type 2 diabetes and related diseases. Research has demonstrated that diabetics who eat a low-carb ketogenic diet are able to significantly reduce their dependency on diabetes medication and may even reverse the condition.16

Lowering insulin resistance will also reduce your risk of Alzheimer’s. Recent research strengthens the link between insulin resistance and dementia even further, particularly among those with existing heart disease.17,18,19

Mental clarity

One of the first things people really notice once they start burning fat for fuel is that any former “brain fog” lifts, and they can suddenly think very clearly. As mentioned earlier, ketones are a preferred fuel for your brain; hence, the improved mental clarity.

Increased longevity

One of the reasons you can survive a long time without food is due to the process of ketosis, which spares protein breakdown.20 A fairly consistent effect seen in people on a ketogenic diet is that blood levels of leucine and other important structural proteins go up, allowing these proteins to perform a number of important signaling functions.

Ketones also mimic the life span extending properties of calorie restriction21 (fasting), which includes improved glucose metabolism; reduced inflammation; clearing out malfunctioning immune cells;22 reduced IGF-1, one of the factors that regulate growth pathways and growth genes and which is a major player in accelerated aging; cellular/intracellular regeneration and rejuvenation (autophagy and mitophagy).23

The Big Fat Surprise: Nina Teicholz on The Joe Rogan Experience

Sources and References:

Eating lots of cheese may help you lose weight

Forget what you have heard about cheese – we have Gouda news for you.

Eating cheese does not raise your cholesterol and could actually help you lose weight, scientists have found.

Research from Ireland found people who eat a lot of cheese do not have a higher cholesterol than those who don’t.

They also discovered that people who eat more dairy tend to have a lower body mass index.

But current health guidelines suggest eating foods high in saturated fat can increase your risk of high cholesterol.

Evidence strongly suggests that high cholesterol can increase the risk of heart attack, stroke, blood clots and angina.

It is often caused by an unhealthy diet or having a family history of stroke or heart disease.

For the study, 1,500 Irish adults kept a four-day food diary and were asked to note how much dairy they ate.

Their blood samples were then analysed for cholesterol levels and other metabolic health problems.They found that the adults with a lower body mass index ate more dairy.

However, lower blood pressure was associated with eating cheese more than other products like yogurt and milk.

They found that while adults who ate large amounts of cheese consumed more saturated fat, they did not have the associated higher cholesterol.

Dr. Emma Feeney, Food for Health Ireland’s program manager, said: “Simply looking at individual foods does not reflect the real story.

“What will really impact on our metabolic health, is the overall pattern in which whole foods are consumed.”


Saturated Fat Finally Vindicated in Long Buried Study

Story at-a-glance

  • A 40-year old previously unpublished trial—the largest, most rigorous study of its kind—shows that while replacing saturated fat with vegetable oil lowered total cholesterol by 14 percent, overall mortality increased
  • For every 30 point drop in total cholesterol there was a 22 percent increased chance of death
  • Many other trials have also found that replacing saturated fats with vegetable oils increase mortality risk from all causes, including coronary heart disease and cardiovascular disease

In all likelihood your doctor and nearly every public health authority has told you to stay away from saturated fats, warning you it will raise your LDL cholesterol and clog your arteries, putting you at increased risk for heart disease.

The 2015 USDA dietary guidelines also still advise limiting saturated fats to a maximum of 10 percent of your daily calories, warning of similar dangers.

Such recommendations are in fact based on an unproven hypothesis, and a large number of studies that have reexamined the theory have shown that saturated fat do not increase your risk of heart disease.

Interestingly, the latest study1,2,3,4,5,6,7,8 to emerge showing conventional wisdom on saturated fat has been completely wrong was buried, and is actually four decades old.

One of the original researchers was Ancel Keys—the man who initially proposed the link between saturated fat and heart disease—and it’s believed he was  largely responsible for suppressing and not disclosing this damning study, as it doesn’t support his original hypothesis.

Failure to Publish Clinical Research Can Undermine Truth

Only parts of the trial’s results were ever published, leaving out the controversial finding that replacing saturated fats with vegetable oil had NO benefit on mortality. The study was unearthed by Christopher Ramsden, who discovered the missing research data among the possessions of a deceased scientist. As reported by STAT:9

“Ramsden, of the National Institutes of Health, unearthed raw data from a 40-year-old study, which challenges the dogma that eating vegetable fats instead of animal fats is good for the heart.

The study, the largest gold-standard experiment testing that idea, found the opposite, Ramsden and his colleagues reported…in BMJ10… [H]is discovery and analysis of long-lost data underline how the failure to publish the results of clinical trials can undermine truth.”

Largest Most Rigorous Trial of Its Kind Finally Vindicates Saturated Fat

The study,11 conducted from 1968 to 1973, included 9,423 participants between the ages of 20 and 97, making it the largest trial of its kind. All participants were also residents of state mental hospitals and a nursing home in which all meals were prepared for them, making it one of the most rigorously detailed studies.

Many nutritional studies have the drawback of relying on self-reported consumption based on food questionnaires. Oftentimes people simply cannot remember what or how much they ate on any given day.

Here, the meals of every person were carefully logged. On the average, each patient was followed for about 15 months. Participants were randomly assigned to one of two groups, receiving either:

  1. A then-standard diet containing 18.5 percent saturated fat from animal fats such as milk, cheese, beef and shortening, and 5 percent unsaturated fat, based on total calories
  2. A diet in which 50 percent of the saturated fats were replaced with vegetable oil (a mainstay in today’s processed foods) and corn oil margarine (total 9 percent saturated fat and 13 percent unsaturated fat)

After analyzing the data, Ramsden and his team found that vegetable oils lowered total cholesterol levels by an average of 14 percent after one year. However, this lower cholesterol did NOT result in improved health and longevity, which is the conventional belief.

Instead, the research showed that the lower the cholesterol, the higher the risk of dying.

For every 30 point drop in total cholesterol there was a 22 percent increased chance of death. In the 65 and older category, those who received vegetable oil experienced roughly 15 percent more deaths compared to seniors in the saturated fat group.

Vegetable Oil Nearly Doubled Rates of Heart Attack

The vegetable oil also did not result in fewer cases of atherosclerosis or heart attacks.

On the contrary, autopsies revealed both groups had similar levels of arterial plaque, but 41 percent of the vegetable oil group showed signs of at least one heart attack compared to just 22 percent of those in the saturated fat group. According to the authors:

“Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid [vegetable oil] effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes.

Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.”

Why Vegetable Oils Would Be Expected to Increase Disease

If you understand molecular biology, the reason why vegetable oils cause these kinds of observations are clear, and hold true even if they’re organically grown and pristinely processed. In fact it would be precisely what you’d expect.

Why? Because these omega-6 polyunsaturated fats, when taken in large amounts, cannot be burned for fuel. Instead, they’re incorporated into cellular and mitochondrial membranes where they are highly susceptible to oxidative damage, which damages the metabolic machinery.

And that’s in the BEST case scenario. The reality is far worse as most of these vegetable oils are highly processed and grown as GMO crops, loaded with toxic herbicide residues like Roundup.

Most of these chemicals were not even invented when this BMJ study was done, so if it were repeated today with modern vegetable oils I’m highly confident the adverse effects of vegetable oils would be even  more pronounced.

In addition, while your body does need some omega-6, most get far too much of it compared to omega-3, and this lopsided ratio can also have adverse health consequences.

As noted in the Huffington Post,12 “this nuance isn’t reflected in the most up-to-date nutritional advice in the federal dietary guidelines, which state simply we should eat less saturated fat and more polyunsaturated fat without mention of omega-6 acids.”

Thirdly, when heated, vegetable oils tend to oxidize. According to Dr. Fred Kummerow13, who has researched lipids and heart disease for eight decades, oxidized cholesterol is the real culprit that causes heart disease. By triggering inflammation, they promote the clogging of arteries and associated cardiovascular problems, including heart attacks.

Four Similar Trials Fail to Show Benefit of Vegetable Oil

The researchers also analyzed four other trials14 looking at the effects of replacing saturated fats with vegetable oils. They too failed to show any benefit. In fact, replacing saturated fats with linoleic acid-rich vegetable oils increased mortality risk from all causes, including coronary heart disease and cardiovascular disease.

According to the authors:

“An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.”

In short, vegetable oils do not reduce your risk of dying from heart disease. Put another way, saturated fats do not increase your risk of dying from heart disease either. Moreover, reducing cholesterol is not necessarily a sign of improved health; it may actually raise your risk of death. As noted by Ramsden:15

 “One would expect that the more you lowered cholesterol, the better the outcome. But in this case the opposite association was found. The greater degree of cholesterol-lowering was associated with a higher, rather than a lower, risk of death.”

Other Studies Debunking Saturated Fat Myth

Other studies discrediting the notion that cutting saturated fat will help you live longer include the following. All of these studies used “hard endpoints,” which are considered the most reliable measurements. While the benefits for cardiovascular mortality and risk-factor reduction were mixed, none of these trials showed that restricting saturated fats reduced total mortality.

  • The Oslo Study (1968): A study of 412 men, aged 30-64 years, found eating a diet low in saturated fats and high in polyunsaturated fats had no influence on rates of sudden death.16
  • L.A. Veterans Study (1969): A study of 850 elderly men that lasted for six years and is widely used to support the diet-heart hypothesis. No significant difference was found in rates of sudden death or heart attack among men eating a mostly animal-foods diet and those eating a high-vegetable-oil diet. However, more non-cardiac deaths, including from cancer, were seen in the vegetable-oil group.17
  • London Soybean Oil Trial (1968): A study of nearly 400 men that lasted for two to seven years. No difference in heart attack rate was found between men following a diet low in saturated fats and high in soybean oil and those following an ordinary diet.18
  • The U.S. Multiple Risk Factor Intervention Trial (MRFIT): Sponsored by the National Heart, Lung and Blood Institute, this is another study that is highly misleading.  It compared mortality rates and eating habits of over 12,000 men, and the finding that was widely publicized was that people who ate a low saturated fat and low-cholesterol diet had a marginal reduction in coronary heart disease. However, their mortality from all causes was higher.19

Saturated Fats Provide Many Important Health Benefits and Few Risks

A 2015 meta-analysis20 published in the British Medical Journal also found no association between high levels of saturated fat in the diet and heart disease. Nor did they find an association between saturated fat consumption and other life-threatening diseases like stroke or type 2 diabetes.

Yet another meta-analysis21 that 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. Indeed, far from posing a risk, it’s known that saturated fats provide a number of important health benefits, including the following:

Providing building blocks for cell membranes, hormones, and hormone-like substances Mineral absorption, such as calcium Carriers for important fat-soluble vitamins A, D, E, and K
Conversion of carotene into vitamin A Helping to lower cholesterol levels (palmitic and stearic acids) Acts as antiviral agent (caprylic acid)
Optimal “clean” fuel for your brain and mitochondria Provides satiety Modulates genetic regulation and helps prevent cancer (butyric acid)

Sugar, Not Fat, Is the Root of Ill Health

The fear of healthy dietary fat is actually part of why we’re currently struggling with obesity, diabetes, and heart disease of epidemic proportions. As noted by Dr. Mark Hyman,22 director of the Cleveland Clinic’s Center for Functional Medicine and author of “Eat Fat, Get Thin”: “For 35 years we’ve been told to eat low fat, but the result is that we’ve cut fat and eaten a ton of carbs and sugar, which accounts for the corresponding surge in obesity, diabetes and other related ills over the same time period.”

Indeed, to improve our health, we really need to change how we think about dietary fat, and stop treating it like an enemy. Journalist Nina Teicholz, author of “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet,” has also stated that when researchers went back and analyzed23 some of the original data from Dr. Ancel Keys’ Seven Countries Study 24 (which was the basis for the saturated fat phobia) they found that heart disease was most correlated with sugar intake, not saturated fat as Keys claimed.

How Saturated Fat May Offer Protection Against Heart Disease

Despite all this evidence, some still like to refer to studies showing that reducing saturated fat can lower your levels of LDL cholesterol (often referred to as “bad” cholesterol). However, confusion has crept in here as well. The terms LDL and HDL refer to lipoproteins, i.e. proteins that carry cholesterol. LDL stands for low-density lipoprotein while HDL stands for high-density lipoprotein, and more important than their overall level is the size of these particles.

  • HDL cholesterol is actually linked to a lower risk of heart disease, which is why measurements of total cholesterol are useless when it comes to measuring such risk. If your total cholesterol is “high” because you have a lot of HDL, it’s no indication of increased heart risks; rather, it’s likely protective.
  • Large, fluffy LDL particles do not contribute to heart disease, and eating saturated fat may actually change the small, dense LDL in your body into the healthier large, fluffy LDL, thereby providing a protective effect.25,26
  • Small, dense LDL particles are easily oxidized, which may trigger heart disease. People with high levels of small, dense LDL have triple the risk of heart disease as people with high levels of large, fluffy LDL.27 Besides harmful trans fats, small, dense LDL particles are increased by eating refined sugar and carbohydrates, such as bread, bagels and soda.28 Together, trans fats and refined carbs do far more harm to your body than saturated fat ever could.

In 2013, an editorial in the British Medical Journal described how the avoidance of saturated fat actually promotes poor health in a number of ways, including through their association with LDL cholesterol.29 As stated by the author Dr. Aseem Malhotra, an interventional cardiology specialist registrar at Croydon University Hospital in London:

“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 factit 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.”

Saturated Fats Are Important for Optimal Health

Dietary fat serves as fuel and is a foundational structural component of your biology. Moreover, if you’re trying to lose weight, training your body to access your body fat is key (or else you cannot shed it), and supplying your body with dietary fat is an important part of this process. In order to make this conversion to allow your body to burn fat rather than sugar as its primary fuel, you need to:

1. Restrict net carbohydrates (total carbs minus fiber) to under 50 grams per day

2. Limit protein to 1 gram per kilo of lean body mass, and

3. Only consume high quality fat sources. Most Americans consume harmful fats like processed vegetable oils, which will invariably make your health worse.

So when we’re talking about healthy dietary fats, we’re referring to natural, unprocessed fat, found in real foods like raw grassfed dairy, meats, pastured eggs, seeds, nuts, butter, olives, avocado, coconut oil and raw cacao (a phenomenal source of healthy saturated fats and many beneficial polyphenols).

So, in summary, saturated fats:

  • Increase your LDL levels, but they increase the large fluffy particles that are NOT associated with an increased risk of heart disease.
  • Increase your HDL levels, which also compensates for any increase in LDL.
  • Do NOT cause heart disease as made clear in all the above referenced studies.
  • Do not damage as easily as other fats because they do not have double bonds that can be damaged through oxidation.
  • Serves as a “clean-burning fuel” for your brain and mitochondria, producing far less damaging free radicals than sugars and nonfiber carbs.

Saturated Fat Does Not Increase Heart Disease Risk

One of the great nutritional myths of the last century has finally been debunked. The war on healthy fats is drawing to a close. Overwhelming evidence supporting the beneficial role of fats continues to pour in. At the same time, the case against sugar is now overwhelming and carbs are now correctly viewed as the driving force behind the obesity and diabetes scourges that plague the US.

Medical News Today provided another link in the chain of evidence against the standard American diet. They reported on a study that demonstrated the quality of the food being consumed plays an important role in health and that saturated fat can increase good cholesterol levels.

Sadly, many health “experts” still need to get their facts straight. What they fail to understand is that by continuing to recommend diets low in saturated fats, in the face of overwhelming evidence, they are driving down life expectancy and driving up obesity rates.

The case for healthy fats is staring us in the face. In the decades following the release of fat-phobic dietary guidelines, Americans reduced their intake of animal fats and replaced them with grains, sugars and industrially processed vegetable oils. Adherence to these supposedly “healthy” guidelines resulted in a calamitous decline in U.S. public health.

The information provided in my nutrition plan debunks such outdated dietary dogma. It can guide you through the confusing maze of contradictory dietary information. Optimizing your diet is easier than you think. Consuming exclusively nourishing and whole foods is one the biggest steps you can take toward taking control of your health. It is also important to remove all processed foods from your diet.

Can saturated fat be healthy? Grass-fed butter increasingly seen as a nourishing, healthy food

Mention the word, “butter” to most people, and they’re likely to say they avoid it like the plague. After all, it’s long-been considered a no-no – the antithesis of “healthy.” If you want to lose weight, keep your cholesterol in check and just stay in overall good shape, you shouldn’t even think about butter.

Grass-fed dairy

Or should you?

On a seemingly regular basis, there’s news that confirms the health benefits of butter – but not just any butter. In particular, grass-fed butter is considered a viable choice for health-conscious individuals. A great deal of information has been surfacing showing that this kind of butter can produce positive biological results thanks to its many nutrients.

Here’s why you might want to consider incorporating more grass-fed butter into your diet.

Health benefits of eating grass-fed butter

For example, it’s loaded with healthy fatty acids in an amount that simply blows the lid off of more traditional butter from grain-fed cows. While the latter is filled with the fatty acid CLA (conjugated linoleic acid) – considered a fat loss supplement – butter from grass-fed cows is said to have a whopping five times the amount of CLA. Five times!(1)

Additionally, when compared to grain-fed butter, grass-fed butter has higher amounts of Omega-3 fatty acids and vitamin K2. Omega-3 fatty acids, which are also common in foods like flaxseeds and salmon, help do everything from reducing cancer to boosting heart and cognitive function. As for vitamin K2, it’s linked to keeping bone, prostate and heart health intact.(2,3)

Busting the saturated fat myth

What about saturated fat, which grass-fed butter contains? Avoiding it is a good thing, right?

Not so fast.

Interestingly, numerous studies show that consumption of it may not be as horrific as previously thought.

In fact, it’s even been found to have no correlation with heart disease, as was shown among people living in Costa Rica, where grass-fed butter is commonly consumed. In that particular study, which was published in the American Journal of Clinical Nutrition, it was determined that the more full-fat dairy eaten (like butter), the lower the risk of having a heart attack was, compared to people who consumed the least. Specifically, people were nearly 50 percent less likely to have a heart attack if they ate this kind of butter, along with other full-fat dairy foods.(1)

“Dairy intake was not associated with risk of MI, despite a strong risk associated with saturated fat intake,” the American Journal of Clinical Nutrition notes of that study. MI refers to myocardial infarction, which is more commonly known as a heart attack.(4)

Similar findings have also been found in other studies, including ones from Australia and many European countries; time and again, eating full-fat dairy has been associated with improved heart function and a reduced risk of strokes as well.(1)

Why choosing grass-fed foods are better than grain-fed foods

All of this also echoes what many experts have been saying all along: saturated fat is not the enemy we’ve been made to think it is. In fact, saturated fatty acids are beneficial for bone health, liver protection, toxin removal, digestive tract health and of course, heart health. Furthermore, when you make sure you’re getting such fats from grass-fed sources as opposed to grain-fed ones, you’re doing yourself a tremendous favor.(5)

For example, when it comes to beef, most American cattle live much of their lives confined in stalls, standing in their own manure. They’re highly susceptible to disease, and are fed grains that have been tainted with chemicals galore. In stark contrast are grass-fed cattle, which live in significantly cleaner, more natural open-field environments, where they’re free of such contaminants.(6)

Therefore, choosing grass-fed options is the healthier way to go, whether you’re enjoying meat or dairy.

Does Coconut Oil Live Up to the Hype?

The coconut craze could be good for waistlines and even OK for heart health, according to a recent paper published in the Journal of the Academy of Nutrition and Dietetics. The review paper combines results from 13 randomized controlled trials to see how two specific saturated fats — caprylic and capric medium-chain fats — found in coconut oil affect weight, belly fat and cholesterol.

Does Coconut Oil Live Up to the Hype?

“Foods like butter, chicken skin, meats and ice cream all have saturated fat. That doesn’t mean you should avoid them. Rather, choose leaner cuts of beef, use butter in small amounts and enjoy ice cream in moderation.”

Toby Amidor, M.S., RD national nutrition expert and author

Proceed With Caution

But don’t get too excited yet. There are many reasons to proceed with caution, including commercial bias in some of the research, some low-quality studies and conflicting results. For example, some studies showed caprylic and capric fats were satiating (good) or raised cholesterol (not so good), while others showed no effect. In addition, prominent health organizations continue to advise us to cut back on saturated fat. We could debate the merits and sins of various fats for days, but, more urgently, let’s discuss what this study means for you.

The findings suggest that replacing long-chain fats (LCT) with medium-chain fats (MCT) — for example, replacing olive oil with coconut oil — may lead to very modest weight loss without raising cholesterol numbers. We’re talking about a mere pound of weight and a centimeter from the waist and hips over two to three months.

The hypothesis is that MCTs give a modest boost to metabolism, fat burning and satiety. In addition, MCTs have fewer calories than other fats (6 to 8.5 calories per gram compared to 9).

Should MCTs Be Used for Weight Loss?

Even with the very small weight loss seen in the review paper, people may still be tempted to try anything that promises an advantage. Marissa Beck, M.S., RD, Seattle-based registered dietitian working in corporate wellness and sports performance, says she wouldn’t recommend MCTs for her generally healthy clients who want to lose weight. “The only time I really see MCTs being used is for malabsorption issues in the hospital,” she says.

Healthy Fats: What We Do Know

When new and exciting research comes out, it’s essential to put it into context. While this study on MCTs shows there’s more to learn about fats, what we do know is that we already have a robust body of science backing recommendations for what kinds of fats to eat. The Dietary Guidelines for Americans, American Heart Association, World Health Organization and the Food and Agriculture Organization, among others, recommend replacing saturated fat with unsaturated fat.

“We need fat — it is considered an essential nutrient,” says Toby Amidor, M.S., RD national nutrition expert and author of The Greek Yogurt Kitchen: More Than 130 Delicious, Healthy Recipes for Every Meal of the Day. Note that MCTs don’t provide essential fatty acids, so they should never be the only source of dietary fat.

Kristen Mancinelli, M.S., RD, a nutrition-communications consultant based in Los Angeles, comments further on the importance of fats, noting that “fats form the membranes of our cells, the bulk of our brain matter and the backbone for many hormones. They aid the absorption of fat-soluble vitamins and trigger satiety signals that tell you to stop eating when you’ve had enough.”

What’s for Dinner?

Whether you’re eating for weight loss or not, you should be eating mostly plants. Commit half the plate to vegetables, with smaller amounts of fruit, whole grains, plant or seafood protein and healthy fats. When it comes to healthy fats, current evidence strongly advocates for the unsaturated type. Beck agrees: “Unsaturated fats are healthiest.” She adds, “Unsaturated fats should replace saturated and trans fats because they lower total cholesterol, lower LDL (bad) cholesterol and lower triglycerides.”

It doesn’t mean saturated fat is forbidden. Amidor says, “Foods like butter, chicken skin, meats and ice cream all have saturated fat. That doesn’t mean you should avoid them. Rather, choose leaner cuts of beef, use butter in small amounts and enjoy ice cream in moderation (like a half-cup portion).”

Bottom Line

Don’t go throwing out your olive oil and avocados in favor of coconut oil just yet. These preliminary findings fly in the face of widely accepted evidence-based recommendations for pretty small returns when it comes to weight loss. Remember, there are tried-and-true ways to lose weight by making changes to your diet (more veggies, less chips and soda) and exercise routine (do it daily).

The big question remains: What should you eat? After balancing the weight of the evidence for unsaturated versus MCT saturated fats, if you adore the taste of coconut fat, use it responsibly: Incorporate a moderate amount of coconut oil into an overall healthful plant-based diet, with most of your fat coming from foods that provide heart-healthy unsaturated fats.

Butter Is Back.

Julia Child, goddess of fat, is beaming somewhere. Butter is back, and when you’re looking for a few chunks of pork for a stew, you can resume searching for the best pieces — the ones with the most fat. Eventually, your friends will stop glaring at you as if you’re trying to kill them.

That the worm is turning became increasingly evident a couple of weeks ago, when a meta-analysis published in the journal Annals of Internal Medicine found that there’s just no evidence to support the notion that saturated fat increases the risk of heart disease. (In fact, there’s some evidence that a lack of saturated fat may be damaging.) The researchers looked at 72 different studies and, as usual, said more work — including more clinical studies — is needed. For sure. But the days of skinless chicken breasts and tubs of I Can’t Believe It’s Not Butter may finally be drawing to a close.

The tip of this iceberg has been visible for years, and we’re finally beginning to see the base. Of course, no study is perfect and few are definitive. But the real villains in our diet — sugar and ultra-processed foods — are becoming increasingly apparent. You can go back to eating butter, if you haven’t already.

This doesn’t mean you abandon fruit for beef and cheese; you just abandon fake food for real food, and in that category of real food you can include good meat and dairy. I would argue, however, that you might not include most industrially produced animal products; stand by.

Since the 1970s almost everyone in this country has been subjected to a barrage of propaganda about saturated fat. It was bad for you; it would kill you. Never mind that much of the nonsaturated fat was in the form of trans fats, now demonstrated to be harmful. Never mind that many polyunsaturated fats are chemically extracted oils that may also, in the long run, be shown to be problematic.

Never mind, too, that the industry’s idea of “low fat” became the emblematic SnackWell’s and other highly processed “low-fat” carbs (a substitution that is probably the single most important factor in our overweight/obesity problem), as well as reduced fat and even fat-free dairy, on which it made billions of dollars. (How you could produce fat-free “sour cream” is something worth contemplating.)

But let’s not cry over the chicharrones or even nicely buttered toast we passed up. And let’s not think about the literally millions of people who are repelled by fat, not because it doesn’t taste good (any chef will tell you that “fat is flavor”) but because they have been brainwashed.

Rather, let’s try once again to pause and think for a moment about how it makes sense for us to eat, and in whose interest it is for us to eat hyperprocessed junk. The most efficient summary might be to say “eat real food” and “avoid anything that didn’t exist 100 years ago.” You might consider a dried apricot (one ingredient) versus a Fruit Roll-Up (13 ingredients, numbers 2, 3 and 4 of which are sugar or forms of added sugar). Or you might reflect that real yogurt has two or three ingredients (milk plus bacteria, with some jam or honey if you like) and that the number in Breyers YoCrunch Cookies n’ Cream Yogurt is unknowable (there are a few instances of “and/or”) but certainly at least 18.

Many things have gone awry with the way we produce food. And it isn’t just the existence of junk food but the transformation of ingredients we could once take for granted or thought of as “healthy.” Indeed, meat, dairy, wheat and corn have become foods that frequently contain antibiotics and largely untested chemicals, or are produced using hybrids or methods that have increased yield but may have produced unwanted results.

CV Risk and Saturated Fats: The Debate Roils On.

A meta-analysis has revived the debate over best dietary recommendations for cardiovascular health; specifically, whether there’s an evidence base supporting the traditional message to consume foods rich in long-chain omega-3 and omega-6 polyunsaturated fatty acids (PUFA) and avoid those laden with saturated fats[1]. But questions about the report emerged even before its publication today.

“We found essentially null associations between total saturated fatty acids [SFA] and coronary risk” in studies looking at dietary fat intake and those focusing on circulating fatty-acid levels, according to the authors, led by Dr Rajiv Chowdhury (University of Cambridge, UK). Nor were there significant associations between CV risk and dietary intake of long-chain omega-3 and omega-6 PUFAs. Other findings suggested that dietary supplements containing those fatty acids don’t significantly reduce coronary risk.

The group’s meta-analysis of over 70 reports, including prospective cohort studies and randomized trials, is published in the March 18, 2014 issue of the Annals of Internal Medicine.

“Our findings do not support cardiovascular guidelines that promote high consumption of long-chain omega-3 and omega-6 and polyunsaturated fatty acids and suggest reduced consumption of total saturated fatty acids,” they write.

The analysis shows “no strong evidence” to justify those cardiovascular guidelines, “especially for saturated fat,” senior author Dr Emanuele Di Angelantonio (University of Cambridge) told heartwire . So there’s a need for further trials to explore the issue, he said, to determine just what the recommendations should be.

But the meta-analysis has already been questioned. In an email exchange with heartwire Dr Eric B Rimm(Harvard School of Public Health, Boston, MA) said, “My colleagues were quite surprised at the findings. We uncovered a serious mistake in their review of PUFA that likely will change the results substantially.” And the parts of the meta-analysis focusing on PUFA didn’t summarize the relevant studies correctly, according to Rimm, who added that “the results are in serious question.”

Moreover, the group’s conclusion about saturated fat “has little context, because it likely represents the result of when you exchange saturated fat in your diet for refined grain. Thus, saturated fat is no better or worse than eating white bread. We have known that for decades, so [it] is not new.”

Rimm said he and his colleagues have contacted the report’s authors about their issues with the analysis.

Also contacted by heartwire Dr Alice H Lichtenstein (Tufts University, Boston, MA) replied by email, “The majority of the evidence suggests that replacing saturated fat with polyunsaturated fat reduces heart disease risk, whereas replacing saturated fat with carbohydrate does not. This new study only assessed one factor, an indicator of dietary fat, and not the whole picture, making the conclusions questionable.”

Regarding assertions of errors in the report, Di Angelantonio said, “We recently spotted some minor mistakes in some of the data that will not in any way affect the main results of the study.” He confirmed that another group contacted him and his coauthors about “some other minor mistake,” adding, “We are making an erratum that will be sent to [Annals of Internal Medicine] in the next 24 hours, so there will be an updated version. But it’s unlikely that the main conclusions will change.”

As for the analysis itself, it covered 45 prospective observational studies and 27 randomized controlled trials looking at dietary PUFA intake, levels of circulating PUFA, and intake of fatty-acid dietary supplements in populations throughout the most of the world.

Relative Risk (95% CI) for Coronary Events, Top vs Bottom Third of Total Dietary Fatty-Acid Intake Levels in Prospective Cohort Studies*


Fatty-Acid Type RR (95% CI)
Saturated 1.02 (0.97–1.07)
Monosaturated 0.99 (0.89–1.09)
Long-chain omega-3 0.93 (0.84–1.02)
Omega-6 1.01 (0.96–1.07)
Trans 1.16 (1.06–1.27)


*32 studies, 530 525 participants, mean follow-up 5–23 years. All adjusted for age, sex, smoking, diabetes, and blood pressure, and other influences on CV risk

“Among studies with available data,” the group writes, “there were moderate positive correlations between dietary intake and circulating composition of total omega-3 and omega-6 polyunsaturated fatty acids and weak positive correlations for total saturated and monounsaturated fatty acids.”

Relative Risk (95% CI) for Coronary Events, Top vs Bottom Third of Circulating Fatty-Acid Levels in Prospective Cohort Studies*

Fatty-Acid Type RR (95% CI)
Saturated 1.06 (0.86–1.30)
Monosaturated 1.06 (0.97–1.17)
Long-chain omega-3 0.84 (0.63–1.11)
Omega-6 0.94 (0.84–1.06)
Trans 1.05 (0.76–1.44)


*19 studies, 32 307 participants, mean follow-up 1.3–30.7 years

Also, there was evidence that “circulating levels of eicosapentaenoic and docosahexaenoic acids . . . and arachidonic acid are each associated with lower coronary risk.”

Consistent with the literature and guidelines, total dietary trans-fatty-acid intake was positively associated with coronary disease risk.

Relative Risk (95% CI) for Coronary Events in Randomized Trials, Fatty-Acid Dietary Supplements vs Control Group*


Parameter RR (95% CI)
Alpha linolenic 0.97 (0.69–1.36)
Long-chain omega-3 0.94 (0.86–1.03)
Omega-6 0.89 (0.71–1.12)


*27 trials, 103 052 participants, mean follow-up 0.1–8 years

Di Angelantonio pointed out that his group’s analysis is not the first to question the evidence base for an adverse effect of dietary saturated fat on cardiovascular health.

Soft drinks targeted by new government health campaign

Soft drinks

Families are being urged to ditch sugary drinks and cut down on saturated fat in the latest advertising blitz by England‘s public health watchdog.

Public Health England said a family of four could reduce their sugar intake by three-quarters of a 1kg bag of sugar in just one month by swapping fizzy drinks for healthier alternatives.

Changing whole milk for semi-skimmed milk could mean the average family cutting down their fat intake by a third of a pint over four weeks, the group said.

The advertising campaign, Smart Swaps, is seeking to capitalise on the millions of Britons who begin the new year with health-conscious resolutions after the festive period.

“Swapping like-for-like food in our diet could help cut out surprising levels of saturated fat, sugar and ultimately calories without having to give up the kinds of food we like,” said Professor Kevin Fenton, director of health and wellbeing at Public Health England.

He added: “We all eat too much saturated fat and sugar, which can increase our calorie intake. Together this increases our risk of obesity, cardiovascular disease, diabetes and some cancers.”

Families will be offered vouchers to encourage them to avoid sugary cereals and swap butter and certain cheeses for reduced-fat alternatives.

However, the move brought a backlash from the soft drinks industry. The British Soft Drinks Association (BSDA) claimed its products were being shown in a misleading and “deliberately negative” way.

Gavin Partington, director general of the BSDA, said: “It is particularly frustrating for an industry which has been working with the Department of Health to promote healthier behaviours, reformulate products so they are lower in calories, make available smaller pack sizes and focus more of its marketing investment on low- and no-calorie options.”

He took issue with the depiction in the adverts of a two-litre bottle of pop, claimed to contain the equivalent of 52 sugar cubes.

“It is also disappointing to see our products depicted by the campaign in such a deliberately negative way,” he said. “That two-litre bottle shown in the ad is not intended to be consumed by an individual, certainly not by one child. Such an extreme depiction of the consumption of soft drinks undermines the key message of the campaign, namely that it’s very easy to make a smart swap to a no-calorie, diet soft drink.”

The Children’s Food Campaign welcomed the initiative but said it would be undermined unless supermarkets made healthier foods more affordable and easier to find in stores. The body also said that vouchers offered as part of the Public Health England scheme might not be cheaper than buying own-brand healthy foods.

In a separate study released on Thursday, Cancer Research UK said tripling the tax on cigarettes would cut smoking by a third and prevent 200m premature deaths by the end of this century.

The charity called on governments across the world to raise tax on tobacco, a move it said would encourage smokers to quit and help stop young people taking up the habit.

Harpal Kumar, Cancer Research UK’s chief executive, said: “Worldwide, around half a billion children and adults under the age of 35 are already – or soon will be – smokers, and many will be hooked on tobacco for life. So there’s an urgent need for governments to find ways to stop people starting and to help smokers give up.

“This immensely important study demonstrates that tobacco taxes are a hugely powerful lever, and potentially a triple win: reducing the numbers of people who smoke and who die from their addiction, reducing the healthcare burden and costs associated with smoking and yet, at the same time, increasing government income.”

Meanwhile the cost of joining a gym this year is continuing to rise, according to a Labour survey of 95 local authorities.

Nearly two-thirds of council-run fitness centres have increased the cost of annual membership in the last three years, some by up to £100, the survey found. A yearly gym pass now costs £368 on average, an increase of £15 since 2010, according to the research.

Luciana Berger MP, the shadow public health minister, said there was a desperate need to make leisure facilities affordable for all. “Millions of people across the country will want to kickstart 2014 by getting fitter and more active. There is a real risk however that many people will be put off from keeping to their new year’s resolutions by soaring gym charges and David Cameron’s failure to tackle the cost-of-living crisis.”

Editorial Claims Bad Rap for Saturated Fat, Disputes Dietary Dogma.

The contention that dietary saturated fats aren’t the bad guys that policies and guidelines have portrayed for decades has reemerged in the literature, this time in an “Observations” opinion piece in published in BMJ.

“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,” according to the author, Dr Aseem Malhotra (Croydon University Hospital, London, UK). “Yet scientific evidence shows that this advice has, paradoxically, increased our cardiovascular risks.”

Moreover, he writes, “the government’s obsession with levels of total cholesterol, which has led to the overmedication of millions of people with statins, has diverted our attention from the more egregious risk factor of atherogenic dyslipidemia.”

To back his claims, Malhotra cites reports suggesting that:

·         Low-saturated-fat diets cut levels of lower-risk large, buoyant LDL particles rather than the small, dense LDL particles thought to worsen cardiovascular disease.

·         Dietary saturated fat may actually protect against cardiovascular risk.

·         Low-fat diets promote an atherogenic pattern of blood lipids and worsen insulin resistance.

·         Low total-cholesterol levels are “associated with cardiovascular and noncardiac mortality, indicating that high total cholesterol is not a risk factor in a healthy population.”

·         Even in secondary prevention, no cholesterol-lowering drug besides statins has shown survival benefit, supporting the hypothesis that the benefits of statins are independent of their effects on cholesterol.

·         The “Mediterranean diet” confers three times the survival benefit in secondary prevention, compared with statins; it led to a 30% improvement compared with a “low-fat” diet in the PREDIMED study.

“It’s risky to pick and choose studies on which to base judgments” and to tell only part of a large story, according to Dr Alice H Lichtenstein (Tufts University, Boston, MA), who directs her center’s Cardiovascular Nutrition Laboratory.

In just one example cited for heartwire , she said that “the PREDIMED trial did show that in high-risk people the Mediterranean diet achieved a 30% improvement over a ‘low-fat’ diet.” However, a low-fat diet in PREDIMED meant 37% of calories from fat, not the usual definition. “And the benefit was seen only for stroke, an outcome most closely associated with blood pressure, not plasma cholesterol levels,” Lichtenstein said.

She continued, “Based on the totality of the data, the best advice we can give is to consume a moderate-fat diet (25% to 35% of energy) and substitute polyunsaturated fat for saturated fat—that is, vegetable oils for animal fats, including meat and dairy—all within the context of a calorie intake that is consistent with achieving and maintaining a healthy body weight. Given the plethora of food choices currently available, that should not be a difficult task.”