Does Butter Still Deserve a Bad Rap? Controversial Doc Says No

Good news for indulgent diners: Turns out that foods like cheese, cream, and red meat have been "demonized" when it comes to heart health. At least that's the controversial claim of one British cardiologist, whose article published Tuesday in the British Medical Journal challenges much of what we've been taught to believe about saturated fat.

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"Let's bust the myth of its role in heart disease," writes Aseem Malhotra of Croydon University Hospital in London. Saturated fats, along with cholesterol, occur naturally in foods such as meats and dairy products. And they've generally been labeled as big no-no's for anyone at risk of heart disease. But Malhotra — contrary to more conventional dietary guidelines, and to the opinions of some nutrition experts who spoke with Yahoo Shine — believes we've been led astray.

"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," he writes. "Yet scientific evidence shows that this advice has, paradoxically, increased our cardiovascular risks."

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Malhotra points to recent cohort studies that have not supported any significant association between saturated fat intake and cardiovascular risk — and further states that saturated fat has actually been found to be "protective," not damaging. Because we've been directed away from saturated fats, he adds, we've been substituting them with processed low-fat products that tend to be high in carbs and lead to obesity.

Further, he says, "the government's obsession with levels of total cholesterol" has led to the overprescribing of cholesterol-lowering statins, which can have dangerous side effects. Moderating cholesterol through a change in diet is a better way to go, he says, as "adopting a Mediterranean diet after a heart attack is almost three times as powerful in reducing mortality as taking a statin."

"In the past 30 years in the United States, the proportion of energy from consumed fat has fallen from 40 percent to 30 percent (although absolute fat consumption has remained the same), yet obesity has rocketed," Malhotra notes. "One reason: when you take the fat out, the food tastes worse. The food industry compensated by replacing saturated fat with added sugar." And that, he says, has inspired a host of health problems, including metabolic syndrome, which includes a combination of hypertension, raised triglycerides, and low HDL cholesterol (the good kind).

But Cedars-Sinai cardiologist Mark Urman, a member of the American College of Cardiology Prevention of Cardiovascular Disease Committee, tells Yahoo Shine, "To say statins are particularly toxic is an overstatement." He explains, "They still have a critically important role in people who have a known cardiovascular disease, or have had a heart attack or stroke." He adds, "Does everybody need a statin? No. Should we rely on a pill instead of healthy lifestyle if there is no cardiovascular disease? No. It's all about balance."

Though Urman does not agree with many of the BMJ article's points, he does support the idea that the rules of heart-healthy eating are constantly evolving and worthy of frequent exploration.

The bottom line, though, is that Malhotra is defending saturated fats — and that is not generally in line with American dietary guidelines, Tufts University professor of nutrition, science, and policy Alice Lichtenstein tells Yahoo Shine. "The bulk of the data does not support that," she says, adding that, in the article, "the message is oversimplified and there's some selectivity in the information."

Marion Nestle, a New York University professor of nutrition, food studies, and public health, is also skeptical. "I think the evidence is mixed on many of his points," she tells Yahoo Shine. "One difficulty is that he is not taking calories into consideration.... Also, he doesn't seem to be taking into consideration how heart disease rates have been declining for years and are still declining."

Lichtenstein points out that Malhotra's worry about saturated fats being replaced with sugary, low-fat products is an outdated one, as the American Heart Association updated its recommendation from a low-fat diet to a moderate-fat one around 2001. "So this issue of a low-fat diet has been retired for over 10 years," she says.

And she still believes that saturated fats are not ideal and that they should be — and can easily be — substituted with polyunsaturated fats, which is a view also held by the American Heart Association. "When one looks at saturated fat content and substituting it with carbohydrates, then no, you don't get a cardiovascular-health benefit. But if you replace it with polyunsaturated fat, you do," she says, referring to fats found in soybean and safflower oils, walnuts, sunflower seeds, and fatty fish such as salmon and trout. "And it's a relatively easy switch, because saturated comes from animal products, and polyunsaturated comes from vegetable products."

Urman, who suggests that polyunsaturated fats also be used in moderation, notes that the healthiest fat is monounsaturated, the type found in olive oil. And he agrees that a Mediterranean-style diet can have "many potential health benefits."

But eating dairy and red meat in moderation can still be OK, too, the experts say. "We're fortunate that there's a plethora of nonfat dairy products available to us. And in terms of meat, there are plenty of leaner cuts on the market. So take advantage of the products that are currently on the market," Lichtenstein says. Of course, all this advice, she stresses, "is within the context of achieving and maintaining a healthy body weight."

Nestle has an easy-to-digest formula when it comes to heart health: "Balance calories, eat plenty of fruits and vegetables, don't eat too much junk food, and stay active."

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