Why Saturated Fat Is Feared

Let me first start this post off with my disclaimer.  If you are inactive and already eating a diet high in excess carbohydrates, your are likely in constant fat storage mode due to excess levels of the hormone insulin.  In this case, eating liberal amounts of saturated fat is not healthy.  Please don’t use this post as an excuse to add a potentially fattening food to an already fattening diet.  If you’re eating lots of sugar, sweets, and even rice, beans, bread and excessive grains in the context of a fairly sedentary lifestyle, adding ghee, butter or full fat dairy will only make matters worse.  When it comes to their health, many people have a tendency to do selective research and pick out what they desire… “chocolate, red wine and saturated fat are good for me, but I’ll push aside the part about cutting back on carbs, eating at least 6-8 servings of multi-colored vegetables and fruit, and increasing activity levels.”  Now let’s move on.

A recent study in the Annals of Internal Medicine concluded that current evidence does not clearly support a link between high saturated fat intake and increased heart disease risk.  If you sit two groups of researchers at the table, one pro-saturated fat and one anti-saturated fat, they can spend hours in a tennis match citing studies back and forth.  Multiple confounding factors and the impact of variables like the healthy user bias make it very difficult to interpret these studies.   In this post I’m not going to delve into these studies.  Just appreciate that there are plenty of thoughtful, very capable scientists and physicians who question the link between saturated fat and heart disease.   Even many mainstream doctors including Dr.Oz have changed their longstanding stance on saturated fat as you can see here. My focus in this post  is not on citing studies, but on the psychology of saturated fat and why despite the rising amount of evidence showing saturated fat to be more of an innocent dietary bystander, individuals including physicians and scientists, struggle to pardon saturated fat as the primary dietary offender in heart disease risk.  Below are three key reasons for this:

REASON #1-The Word “Saturated”

There is an almost visceral sensation people get when they even hear the word “saturated.”  If you’ve clung to the outdated concept of heart disease being due to “clogged arteries,” much like clogged plumbing, then you will be susceptible to this association.  Why do we even call fat “saturated” in the first place?  Is it because it truly saturates your arteries like clogged plumbing?  Not at all.  It has to do with the relationship between the carbon atoms (“Cs”) and hydrogen atoms (“Hs”) shown in the image below which illustrates the chemical structure of saturated and unsaturated fat.



Notice how the region I circled for the unsaturated fat only has two attached hydrogens(Hs),while the saturated fat has four Hs (2 on top and 2 on the bottom).  So the chemical structure is “saturated” with more hydrogen.  This has nothing to do with fat saturating the inside of your arteries!  If only the chemist who coined the term “saturated” knew how badly this word would be misconstrued.

REASON #2-Saturated Fat is Solid at Room Temperature

What about the notion that saturated fats like the ghee (clarified butter) pictured below are solid at room temperature, therefore they can clog your arteries.  Another completely irrational idea that goes back to our plumbing concept.  Do foods that stay solid at room temperature stay solid after you swallow them and then deposit directly into your arteries as solids?  If that’s the case, then perhaps we should avoid all solid foods including broccoli since I don’t want it blocking up my arteries.  I’m sure drinking liquids like soda would be far better.  By the way, coca cola is known to unclog drains, so it must be the same case with my arteries, right?   You can see how irrational this notion is, completely overlooking the complex process of nutrient digestion, absorption and metabolism.

Melted butter (ghee)


 REASON #3-Heart Attack Causing Plaques Look Like Saturated Fat

This is one of the most powerful barriers to getting over saturated fat, especially for physicians like cardiologists and heart surgeons who come face-to-face with greasy plaques like the one below in this top down view of an artery partially obstructed by a plaque.  The plaque looks far more like butter or the ghee pictured above and nothing like the sugar, sodas, abundant portions of rice, breads and other excessive carbohydrate sources that are the real dietary culprits behind plaque formation and artery blockage leading to heart attacks and strokes.



plaque pic


The saturated fat-heart attack plaque-clogged plumbing association was difficult for me to overcome as well.  However, after truly understanding the more complex process of inflammation and plaque formation and seeing my share of Indian heart attack patients, especially vegetarians who ate very little saturated fat but tremendous amounts of carbohydrates in the form of flatbreads, lentils, and large servings of rice prior to their heart attack, I now get it.  I discuss this process and the connection between carbohydrates and heart disease in detail in my book.  We really need to focus on eating highly nutrient dense foods rather than the completely impractical and ineffective recommendation to “keep saturated fat to less than 7% of your daily calories.”  If I’m eating a plate of nutrient dense vegetables and healthy protein sources, cooking or topping that food with ghee or butter is not an issue.  It adds flavor and richness to your food and keeps you full. Saturated fat should be renamed “Satiating fat” since it can complement healthy meals and keep your brain satisfied and your stomach full, which prevents you from overeating all of the other garbage you crave throughout the day.

So remember, the spoonful of ghee on top of that large pile of rice or the stack of flatbreads is not the culprit.  It’s the rice and bread.  The small stick of butter or spoon of sour cream in your baked potato is not the culprit. It’s the potato.  The creamy guacamole you’re dipping your chips into is not the culprit.  It’s the chips.  The cream in your coffee is not the culprit.  It’s the biscuits, whole wheat toast slices,bagels or pastry next to your cup of coffee.  As I mentioned, these sources of fat may become an issue if consumed with excessive carbohydrates, but the key driver to excess fat-storing insulin are the abundant carbohydrates in your diet.  Do not fall prey to oversimplifying this complex process and making loose associations between dietary fat and heart disease.  This will only prevent you from making the critical lifestyle changes necessary to lower your risk of chronic conditions like heart disease and achieving optimal health.




  • http://www.spoonfulofdelight.net Sarah

    Isn’t your disclaimer in the beginning of this post and the last paragraph of this post contradicting ideas?

    • Ron

      No, because even when you have your carb with fat, it’s the carb-induced insulin surge that ushers the fat into the fat cells. So the carb is truly the “culprit” and the carb alone is also more potentially inflammatory. However I see how my language may be misinterpreted so I did change
      the phrasing a bit at the end. Thanks for pointing that out.

  • Raj

    Thanks, Dr. Sinha, for another enlightening post. I started following your blog after an excellent talk you gave at HP a couple of months ago. You have a talent for explaining things clearly, and you somehow speak “our language” — a language that we millennials (and techies) can resonate with! I tried signing up to be your patient (my current physician is “old school” and seems beholden to some of the orthodoxies you call out above), but was disappointed to hear you are not accepting new patients. I look forward to reading your book. Thanks!

    • Ron

      Thanks for your kind comments and I do think I was a techie in my previous life which is why I speak the language! Yes I no longer see primary care patients but I do work with primary care doctors closely to help manage common issues
      like insulin resistance (cholesterol, bp, diabetes, weight control, etc.). More info on scheduling is here.

  • Jeanne Wallace

    I’d love to hear your opinion on safe starches or resistant starch. Do they have a role in our diet?

    • Ron

      I’ll do a separate post on this later, but safe starches are “safe” in the sense that they do not contain toxins. However, they are not safe for many of my patients who are insulin resistant, sedentary and are carrying excess body fat. Once we reverse these conditions, optimize body composition and raise activity levels they can be safely re-introduced into the diet.

      • Laurie Latour

        Thanks for talking about “safe” starch. I thought it would help my gut microbiome so added 1Tablespoon of raw potato starch to my food daily. I have been low carb (about 30-40g carbs per day mostly veggies and a little fruit) for 6 months or so and at a normal wt. I had finally conquered being hungry all the time, but when I added the potato starch, I was constantly hungry all day although I’d made no other changes to my diet. I tried decreasing the starch a bit but still was hungry and craving sweets and things I’d not craved in months. I stopped the starch and within a couple of days returned to my normal self! Can such a small amount of resistant starch provoke so much hunger? I eat sauerkraut and take VSL3 probiotic so do I even need resistant starch?
        Thanks for all your helpful writings!

        • Ron

          I personally had no benefit either so think it’s reasonable to try and stop if no benefit or side effects as you reported.

  • http://www.caloriesproper.com Bill Lagakos

    If we were to assume the composition of an atherosclerotic plaque is what caused it, we’d need to blame protein, too, as much of the plaque is comprised of smooth muscle cells.

    • Ron

      Exactly…great point and further contributes to how nonsensical this logic is.

  • Alice Knox

    Dr Sinha,

    Although your discussion of the term “saturated” in section 1 of this article is correct in terms of the diagrams and your discussion of the bonding within them, you may wish to exchange the term “molecule” for “atom” when referring to hydrogen and carbon. The two fatty acids you’ve shown are each a molecule, but the individual particles (carbon, hydrogen, oxygen) within them are atoms.

    An interested (if pedantic) chemistry teacher