Is Butter Really Back?

Hey, everybody. Welcome to my weekly house call. Your chance to ask me your questions. And this week's question is. Dr. Hyman, I have been so confused about saturated fat. The government still says to limit saturated fat, and yet I read in the news how maybe it's not really connected to heart disease anymore. Is butter really back? Well, the debates on diet have America spinning. Some advocate for putting dollops of butter in their coffee, while others shun avocados and nuts as harmful and heart disease promoting and fattening foods. So what's an eater to do now? Three recent studies add to an increasing body of evidence that saturated fat is not the evil heart disease producing substance that we once thought. I A recent large review of the research found that the higher the saturated fat intake in the population, the lower the risk of stroke. Another study of over 3000 people over 15 years led by Dr. Mazaffarian of Tufts University, examined not just dietary history, but the actual blood levels of fats and found that those with the highest levels of dairy fat, essentially butter in the blood, had up to a 44% lower risk of developing diabetes compared to those who had the lowest levels of dairy fat in their blood. And a third study just published after 40 years of over 9,400 people in mental hospitals who are fed either butter and saturated fats or corn oil, found really surprising results. Now this is a randomized controlled trial, which is an experiment, the best kind of study you can do. The corn oil group, the omega 6 fat group, had a much greater reduction in LDL cholesterol, or the bad cholesterol, about 30 milligrams per deciliter versus 5, but had a higher risk of heart attacks than the saturated fat group. And the lower the ldl, the more heart attacks. So it's super confusing. Is butter a health food? Probably not. Should it be shunned? For sure not. Reviews of the literature and a growing consensus among a large group of leading scientists suggest that we have recently, for far too long, unfairly maligned butter and saturated fats. You see, America first went low fat in earnest in 1980 when our government told us to cut the fat. That message was then reinforced with the USDA's infamous food pyramid, which encouraged us to eat six to 11 servings of bread, rice, cereal and pasta a day. Eleven servings of bread a day? That sounds a little crazy now, but back then, most Americans took that advice and we were told also to eat fats and oils only sparingly. As a result, we are now fatter and sicker than ever. With nearly 70% of us overweight and 1 in 2 with prediabetes or type 2 diabetes. And while death rates from heart disease are declining due to better treatments, the percent of the population developing heart disease is increasing significantly. What has happened to our diet over the last century? What are we eating? Well, According to the U.S. department of Agriculture records, our intake of saturated fat and eggs and meat has actually decreased. Butter has gone from 9 to 4.6 pounds, lard and tallow from 10.5 to 6 pounds per year. And red meat from 71 to 60 pounds per person per year. Egg consumption dropped from 374 eggs a year to about 250 a year per person. But our intake of refined vegetable oil, well, that skyrocketed from 9.8 pounds per year to 35.2 pounds per person per year. And chicken, well, chicken went up by 57% per person per year. And red meat went down. Sugar went up by 39% and grains up by 45% per person per year. Now, while our total calorie consumption has increased, right, we eat more of everything. Our fat consumption has decreased as a percent from 40 to 30% of our calories. And sugar and carb consumption has dramatically increased. And yet obesity and diabetes and the incidence of heart disease keeps increasing. Now, today we know some things we didn't know back when we originally received all that low fat dietary advice. First review, after review after independent review of the research shows that there seems to be very little link, in fact no link between saturated fat and heart disease. In the absence of refined sugary, starchy carbs and the presence of of adequate omega 3 fats, saturated fat itself is seems in no way linked to heart disease. So why all these mixed messages? Well, the fact is that dietary saturated fat raises total and LDL cholesterol, but not all cholesterol is created equal. In fact, saturated fat improves the quality of the LDL cholesterol by increasing the less harmful, large, fluffy LDL particles while also lowering triglycerides and raising your levels of good HDL cholesterol. Now, a low fat, high carb diet makes cholesterol quality worse. Small, dense, dangerous particles. So total cholesterol and especially LDL cholesterol is actually not the best predictor of heart disease, despite what we've all been taught. What matters is actually the total cholesterol to the HDL ratio and, and the LDL particle size and number. Now, these factors are the most predictive of heart disease. Eating more fat, except for trans fat and lowering sugar and refined Carbs is one of the best ways. In addition, eating non starchy veggies to improve the quality of your cholesterol. In fact, small LDL particles from low fat high carb diets are associated with three times the risk of heart attacks compared to total LDL cholesterol. In fact, saturated fat and fat in the context of a lower sugar refined carb diet increases the LDL particle size, which is a good thing. And the evidence also suggests that a bigger predictor of the extent of cardiac disease is actually the triglyceride to HDL ratio, not the total or LDL cholesterol. And that ratio is also improved by a higher total and saturated fat diet and worsened by by refined carbs and sugar. You see, the evidence tying higher fat diets to greater weight loss and improvements in cardiovascular risk factors have been repeated in many, many studies. Now what about all the calories in fat? Gram for gram, it has more than twice as many calories as carbs and protein. Shouldn't we cut out the fat to lose weight? While a shrinking number of health professionals still suggest that low fat diets are the best for weight loss, the overwhelming scientific consensus no longer supports that conclusion that total fat causes obesity. In fact, a recent review of 53 high quality randomized controlled trials which comprise research that compared low fat to high fat diets lasting at least a year in more than 68,000 people, the high fat diets led to greater weight loss than the low fat diets. The researchers included only the best quality studies, about 53 out of 3517 studies that they actually looked at. And this is exactly why the 2015 Dietary Guidelines have removed previous limits on total dietary fat. They also removed previous limits on cholesterol, saying, quote, it was no longer a nutrient of concern. And after reviewing the evidence, the U.S. dietary Guidelines Advisory Committee concluded that reducing total fat, replacing total fat with overall carbs, does not lower heart disease. And dietary advice should put the emphasis on optimizing the types of dietary fat and not on reducing total fat. So is butter really back? Well, in a word, yes. Now I want to hear from you. Have you added saturated fat back to your diet like coconut oil or grass fed butter? How has it affected you? Comment below or on my Facebook page. And if you like this video, be sure to share it with your friends and family on Facebook and Twitter and also submit your questions@drhyman.com so maybe next week I'll make a house call to you.