If you have high cholesterol, you were likely told to cut back on saturated fat, the so-called “unhealthy” fat found in foods such as red meat, eggs, milk, cheese, butter, coconut oil and palm oil. The U.S. Dietary Guidelines and the American Heart Association both promote the message that saturated fat should be limited, however, it might not be as bad for you as previously thought.
“Starting 80 years ago, as soon as cholesterol could be measured, [doctors] discovered a subset of people with extremely high cholesterol also had heart attacks at an earlier age,” explains David Diamond, PhD, a professor at the University of South Florida. “The first assumption was that high cholesterol was causing them to have heart attacks and the second assumption was if you eat food that has cholesterol, it will raise blood cholesterol and give you a heart attack. These assumptions turned out to be false. It turns out that cholesterol was irrelevant.”
In 2010, research in the American Journal of Clinical Nutrition looked at data from more than 350,000 people and found no association between the amount of saturated fat in their diets and the risk of developing heart disease.
While saturated fat does boost levels of LDL “bad” cholesterol, it also raises HDL or “good” cholesterol levels. Compared to an American Heart Association-approved low fat, calorie-restricted diet and a Mediterranean diet with little red meat and lots of vegetables, a low-carb diet with no calorie restrictions resulted in the healthiest ratio of LDL to HDL cholesterol even though it contained more saturated fat, according to a separate study.
More recent research published in the journal BMJ Evidence-Based Medicine also goes against conventional wisdom that saturated fat is connected to heart disease. Diamond, the study co-author, found sugar from processed carbohydrates posed a much greater risk. “All known risk factors for heart disease, [most] are improved by going low carb — the most important being blood pressure and blood sugar,” says Diamond.
In research published in The American Journal of Clinical Nutrition, Dr. Christopher Gardner, professor of medicine at Stanford University, also discovered the participants who consumed the highest levels of saturated fats in their diets had higher levels of HDL cholesterol and lower triglycerides; the group also consumed the fewest added sugars, refined grains and other carbohydrates. “Lowering carbs by eating less added sugars and refined grains can help to lower blood triglyceride levels and raise blood HDL cholesterol levels,” explains Gardner.
The quality of carbs and other foods you consume is still important to pay attention to when on a low-carb diet. Gardner suggests adding more whole grains, beans, legumes, nuts, seeds, avocado and fatty fish to your diet.
A true low-carb diet, which includes fewer than 20% of calories from carbohydrates, is ideal for heart health, says Diamond, but he notes that even small changes can lead to big results. “If you are getting more than 50% of your calories from carbohydrates, including a lot of added sugar, it doesn’t take a big reduction to improve health,” he says. Cutting back to 40% of your calories from carbohydrates — which is still considered a high-carbohydrate diet — can lead to noticeable improvements in blood sugar and blood pressure.
Ultimately, if you have high cholesterol, the cholesterol and saturated fat in your diet isn’t necessarily the most important factors to focus on. Rather, “it’s important to focus on cutting back on added sugar, especially in the form of processed carbs,” says Diamond. Consider tracking your intake with an app like MyFitnessPal to see how much added sugar you’re currently consuming and how you can reduce processed carbohydrates while adding more whole-food sources like whole grains, sweet potatoes and fruits like apples and bananas to your plate.
Discover hundreds of healthy recipes — from high protein to low carb — via “Recipe Discovery” in the MyFitnessPal app.
