How long have health experts told us that saturated fat - the kind found in meat, cheese and butter - was bad for our heart's health? Forever, it seems.
But now a large, new international study, published in the Annals of Internal Medicine, says those experts may have gone overboard demonizing one kind of fat.
Researchers analyzed 72 studies on heart risk and fat consumption, involving more than 600,000 people in 18 countries, and found no evidence that cutting back on saturated fat lowers the risk of heart disease.
Health experts have urged us to for decades to swap out the so-called "bad" saturated fat for "good" unsaturated fat in fish, nuts, seeds and vegetable oils, but the study found no evidence that people who ate more saturated fat had more heart disease than those who ate less. And those who ate more unsaturated fats didn't have less heart disease either.
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Also unhelpful: adding omega-3 or omega-6 fatty acid supplements to the diet. They didn't reduce heart disease risk, according to the researchers.
This isn't the first big study to question whether saturated fat was really the sole culprit in heart disease. An earlier analysis involving 300,000 people came to a similar conclusion.
The one piece of advice confirmed from the new findings: Trans fats should be avoided. Eating more of these hydrogenated fats, which are often added to packaged foods to help keep them fresh longer, was linked to a greater risk of heart disease.
So why the apparent backtracking on saturated fats? It's complicated. No, really it is. Researchers say the relationship between cholesterol level and heart disease is a very complex one that's not well understood.
While diets low in saturated fat may lower LDL cholesterol levels (also considered the "bad" kind, compared with "good" HDL), it's a gross oversimplification to say that cutting out saturated fat is the only thing that's needed to prevent a heart attack. That's partly because when people cut out saturated fat, they often replace it with more simple carbohydrates such as bread and sugary foods, which can have an adverse effect on cardiovascular health.
In fact, some experts believe that the big fat-free push of the '70s led to a national carb binge that has fueled the country's obesity and, by extension, heart disease problem. It may even have started back in the 1950s, when the association between fat in the diet and heart disease was first made and people were urged to cut back on high-calorie fat, argues James DiNicolantonio, a cardiovascular research scientist at Saint Luke's Mid America Heart Institute, in an editorial in Open Heart.
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So what does this mean for you? Can you now binge on bacon-cheddar triple cheeseburgers? Not quite.
Some experts still say that a Mediterranean diet, which is low on red meat and sugar, is the way to go. A large clinical trial last year, not included in this analysis, showed that eating more nuts and extra-virgin olive oil reduced heart attacks and strokes when compared with a lower-fat diet with more starches, the New York Times reported.
If anything, explained study coauthor Dariush Mozaffarian, M.D., with Harvard's School of Public Health, it's sugary foods and an excess of carbohydrates that should be avoided.
As he told the Times: "It's the high-carbohydrate or sugary diet that should be the focus of dietary guidelines. If anything is driving your low-density lipoproteins (LDL) in a more adverse way, it's carbohydrates."
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