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Fat: Do I Really Have to Watch It?

Mmm, butter.  What’s not to like about it?

Depending on who you talk to, the seven grams of saturated fat in that tablespoon of butter may be a significant contributor to heart disease – the number one cause of death in the United States – or just a delicious morsel, especially if you can get it from organic, grass-fed, pasture-raised cows.

In the 1980s, the conventional wisdom was clear: Anything high in fat was out (La Berge 2008). This led to massive use of the marketing phrase “fat-free,” which continues today as a disingenuous come-on for anything from pasta sauce to heavily sugared, trans fat-containing non-dairy coffee creamers.

In the intervening years, it’s become clear that the low-fat diet craze was unhelpful for both Americans’ waistlines and their health. 

Since the 1980s, the amount of fat that Americans eat has decreased slightly even as obesity rates soared in concert with diabetes (Lichtenstein 1998; CDC 2012; CDC 2014).  Coronary heart disease deaths have dropped, but the number of people with heart disease has been stable, with nearly half of all American men and a third of women having heart disease during their lifetimes (Go 2014; CDC 2013a; CDC 2013b).

The problem is that low-fat diets placed the focus on Total Fat, and by doing so lost all nuance and threw the baby out with the bathwater. 

At best, the Total Fat listed on a product’s Nutrition Facts panel is just unhelpful. It promotes thinking of fat as a single entity that should be avoided altogether. 

But fat is not a single entity. Without delving too deeply into nutritional biochemistry, there are many different types of fats, and they come in complex mixtures in food. It’s best to think of them as a family – related, but with distinct personalities. And as with most families, you have to take the good with the bad (which you try to limit), and you do your best to avoid the ugly. Side note: It’s not desirable, or even achievable, to completely remove the bad (more on this later). 

Adding the good stuff and the bad stuff together into a Total Fat number is confusing; it’s like adding up your Total Vegetables for the day by counting both salad and French fries – when you lump them together you lose all the useful information.

One healthy and one unhealthy food with similar amounts of Total Fat

Here’s what you need to know about sorting out the various kinds of fat.

The good ones are the monounsaturated fats in foods like olive oil and avocados and the omega-3 fatty acids (a type of polyunsaturated fat) in many fish. The FDA doesn’t require that they be labeled, but sometimes manufacturers voluntarily list the amounts of monounsaturated and polyunsaturated fats in a food product.

Then there’s the ugly – manmade trans fats – an invention so ill-considered it’s estimated to be responsible for up to 7,000 deaths a year (Dietz 2012). They’re created by taking a healthier but less shelf-stable polyunsaturated fat and submitting it to high temperatures or pressures, forcing the molecules into an unhealthy configuration – so much so that the Institute of Medicine warns people to keep “consumption… as low as possible” (IOM 2005). Despite the known risks, trans fat products remain on the market because they’re cheap, lengthen shelf life, have nifty functional properties and thus boost manufacturers’ bottom lines. 

Last but not least are the saturated fats, long regarded as the bad stuff you should limit. Several hundred studies have assessed the effect of saturated fats on blood cholesterol. In general, the more saturated fat you eat, the higher your total cholesterol and LDL (bad) cholesterol concentrations and the greater your risk of developing coronary heart disease (Dietary Guidelines Advisory Committee 2010; IOM 2005). 

But just as there are many types of fat in general, there are many different types of saturated fats. Not all saturated fatty acids behave the same way in the body or raise bad cholesterol the same way (IOM 2005; Hunter 2010). More research is needed.

Low-fat diets do reduce bad cholesterol (LDL), but by minimizing the good fats, they also lower good (HDL) cholesterol (Nordmann 2006; Smit 2009). 

Replacement matters

Fat is a highly satisfying food, and a little goes a long way. When food manufacturers removed it to make fat-free cookies and mayonnaise, they had to add something tasty to replace it. Most of the time, that turned out to be sugar or other refined carbohydrates such as white flour or starch. 

Study after study has shown that when you take healthy fats out and replace them with sugar or other carbohydrates that spike your blood sugar, you’re doing yourself a disservice. It ends up lowering both the good and the bad cholesterol as well as increasing other unhealthy fatty molecules in the blood called triglycerides (Sacks 2002; Jakobsen 2009; Siri-Tarino 2010b; Dietary Guidelines Advisory Committee 2010). 

But if you replace saturated fat in your diet with heart-healthy unsaturated fats, you lower the risk of heart disease (Hu 2001; Jakobsen 2009; Mozaffarian 2010). This echoes common sense: It’s clearly healthier to eat a piece of fish for dinner in place of pizza or a double-bacon cheeseburger.

Recent controversy

Recently three meta-analyses (research that combines the results of multiple studies) found that there’s not enough evidence to conclude that saturated fat is really that bad for heart disease (Siri-Tarino 2010a; Chowdhury 2014; Schwingshackl & Hoffmann 2014).

Some point to these studies as conclusive evidence that a food’s saturated fat content can be safely ignored. But a review of the details reveals that these studies actually provide further support that replacing saturated fat with healthier fats matters. Here are the facts:

  • Patty Siri-Tarino and her colleagues at the Children’s Hospital Oakland Research Institute and the Harvard School of Public Health reviewed 21 studies and found that there was not enough evidence to conclude that saturated fat increased coronary heart disease (CHD), but they added that “existing epidemiologic studies and clinical trials support that substituting polyunsaturated fat for saturated fat is more beneficial for CHD risk than exchanging carbohydrates for saturated fat in the diet.” Again, this makes good sense—eating walnuts is better for your heart than filling up on cheesecake.
  • Rajiv Chowdhury and other United Kingdom scientists combined the results of 20 prospective studies using easily biased self reports of saturated fat consumption and found that those who had the lowest intakes had no lower risk of heart disease than those with the highest. They also found that those whose blood contained more of the omega-3 fatty acids found in fish did have a lower risk of heart disease.
  • Lukas Schwingshackl and Georg Hoffmann at the University of Vienna in Austria combined the results of 12 randomized, controlled trials and could not find any evidence that there’s a benefit to reducing or replacing saturated fat with polyunsaturated fat once people already have heart disease. Still, their analysis showed that it was reasonable to recommend “higher dietary omega-3 polyunsaturated fatty acids as a substitute for saturated fat… predominantly in the form of fatty fish.” 

In addition, the Cochrane Collaboration, an independent non-profit research organization, conducted the most extensive meta-analysis to date of 48 randomized, controlled trials. It concluded that reducing or replacing saturated fat with more healthful fats reduced the risk of heart attacks and other cardiovascular events by 14 percent (Hooper 2012).

More reasons to go easy

Keep these points in mind:

  • Saturated fat is not an essential nutrient and has no recommended dietary allowance (IOM 2005). The body can synthesize as much as it needs, so we don’t need to eat it.
  • Since they are not essential, saturated fats are part of the unhealthy triad (along with added sugars and trans fats) that make up “empty calories.” Saturated fat contributes an estimated 250 calories a day to the average American’s diet without making it any more nutritious (USDA & DHHS 2010). The more of these empty calories you eat, the more difficult it is to find room for foods with healthy fiber and essential vitamins and minerals – without consuming too many calories.
  • The top sources of saturated fat in the American diet are pizza, cookies, cakes and ice cream – foods that don’t contribute to anyone’s health or well-being – and cheese, which is often paired with the refined carbohydrates that promote heart disease (USDA & DHHS 2010; Siri-Tarino 2010b). 

Reasonable limits

The cold, hard truth is that the majority of scientists worldwide – at the World Health Organization, the U.S. Institute of Medicine, the Dietary Guidelines Advisory Committee, the American Academy of Pediatrics and the American Heart Association – all recommend a reasonable limit on Saturated Fat to reduce your risk of heart disease while keeping total calories down (WHO 2002; IOM 2005; Dietary Guidelines Advisory Committee 2010; Gidding 2006; Eckel 2014).   

And when you look at the top smugglers of saturated fat in the American diet, it’s easy to see why. If pizza, cookie and cakes, ice cream or cheese make regular appearances in your daily diet, it’s wise to keep an eye on it. 

Still, saturated fat has long been part of the human diet and is in lots of healthy foods. Avocados, olive oil, salmon and walnuts are all significant sources of saturated fat. Remember that saturated fat increases HDL (the good cholesterol) and reduces triglycerides – the fat that makes your blood thicker and more likely to clot, leading to heart attack or stroke (Smit 2009). Completely removing saturated fat from the diet is not the goal.

As with any other nutrient, whether it’s sodium or sugar or vitamin A, there’s an optimal range of consumption. Current, sensible worldwide guidelines call for limiting saturated fat to 10 percent of total calories. In a 2,000-calorie-a-day diet, that’s roughly equal to 14 slices of bacon a day (IOM 2005; WHO 2002; USDA 2013). 

For most people, that’s not a restrictive amount. In fact, it’s rather generous, unless you finish your day with a Hungry Man frozen meal.

How EWG’s Food Scores Tackles Fat

  • EWG’s Food Scores does not penalize a food for its Total Fat content.
  • EWG’s Food Scores gives foods a score boost if they contain significant amounts of the beneficial omega-3 fatty acids found in many fish.
  • EWG’s Food Scores penalizes a food only slightly for its Saturated Fat content.
  • Trans Fat, on the other hand, should be avoided as much as possible; EWG’s Food Scores penalize foods that contain Trans Fat or trans fat ingredients.

Many food manufacturers have responded to the public’s growing awareness of the dangers of Trans Fat by replacing partially hydrogenated oils with fully hydrogenated oils, which contain much less trans fat but are still sources of unhealthy solid fats and empty calories. Ignoring saturated fat makes these products appear much more healthful than they really are.

As new research becomes available, nutrition guidelines may get more specific about consuming the different types of saturated fats. If the consensus changes, EWG will modify its Food Scores algorithm accordingly. 

Right now the scientific consensus is clear that replacing saturated and trans fat with healthier fats, especially the omega-3s found in fish is beneficial to health.  It’s also clear that the replacement of saturated fat with refined, blood sugar-raising carbohydrates is not. The federal government’s Dietary Guidelines give equal weight to avoiding added sugars, saturated and trans fats; EWG’s Food Scores penalizes added sugars more heavily.

The fact that EWG’s Food Scores algorithm somewhat penalizes foods for saturated fat content doesn’t mean that it’s anti-fat any more than it’s anti-calories, which are also considered by the algorithm. Saturated fat contributes a small amount to the overall score – in stark contrast to the much greater weight given to added sugars. 

The take-away

As long as you’re not consuming too many calories and eating a balanced diet, it’s pretty safe to ignore Total Fat on a product’s Nutrition Facts label.

So can I just enjoy my butter in peace? 

It depends on you, really. Are you’re using a little to cook up some wild-caught salmon and home-grown green beans, or adding butter to Hamburger Helper Cheesy Baked Potatoes? Are you topping your salad with feta? Or nuking a frozen grilled cheese sandwich?

Want to make a delicious piecrust with lard? Go ahead. Pie – with all its accompanying added sugars – is never going to be a health food, even if the crust was made with fish oil (yum!), whole-wheat flour and honey.

EWG reviewed the most up-to-date science on saturated fat. We’re aware of the ill-considered low-fat fervor of the past, and that the onetime conventional wisdom turned out to be misguided. By narrowly focusing on fat as a single nutrient, we lost the nuance and probably even more importantly, the context – your overall diet

Right now, a new bandwagon is headed in exactly in the opposite direction, but that doesn’t mean disregarding the “14 slices of bacon rule” is right either. 

EWG’s Food Scores fits as many of these considerations as possible into one big math equation so you don’t have to. And for a multitude of good reasons, that equation includes saturated fat. 


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