Research: Fat is not as bad as we have been told.


High carbohydrate may lead to elevated cholesterol more than saturated fat consumption

Butter on plate
Butter on plate

Current and prior US dietary guidelines have suggested the evils of saturated fat despite the fact that there is nearly no evidence to support these recommendations. We have pushed low-fat, low cholesterol diets for decades with little to no effect on disease bus huge impact on individual quality of life.

New research looked to determine how much if any of the bump in cholesterol was due to dietary saturated fat intake​[1]​. Researchers have evaluated dietary recommendations for people diagnosed with familial hypercholesterolemia. This condition is a genetic condition in which increased LDL cholesterol might be associated with an increased risk for coronary heart disease.

In prior guidelines, experts have recommended that these individuals decrease their saturated fat intake. This researchers did a review of prior research to look for evidence to back this claim and as expected, they found limited to no evidence to back these recommendations. The supporting research they did find was biased or poorly supported the reduction in saturated fat.

The basis of this recommendation is the ‘diet-heart hypothesis’ is the reduction in saturated fat which is inhrenatly flawed. The belief that the consumption of food rich in saturated fat increases serum cholesterol levels is just not supported by research. The evidence is stronger that carbohydrate consumtion and insulin resistance is a more probable cause.

Researchers have challenged the rationale for current saturated fat dietary recommendations. The lack of evidence that low saturated fat and low cholesterol diets reduce LDL cholesterol and coronary events should be readily questioned and not blindly believed to be true in familial hypercholesterolemia or non-affected individuals.

The bottom line: High carbohydrate diets and insulin sensitivity make a more likely culprit of elevation of LDL cholesterol. Researchers in the research clearly points out that insulin resistance is the ultimate cause in familial hypercholesterolemia. I would argue that the same is true in the other groups and this theory is a better supported than current guidelines. I am nto recommending that start eating butter sticks, but I suggest that we be less worried about saturated fat.


  1. [1]
    D. M. Diamond et al., “Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone,” BMJ EBM, p. bmjebm-2020-111412, Jul. 2020, doi: 10.1136/bmjebm-2020-111412. [Online]. Available:
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About the Author

I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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