Many of us will know the gustatory gratification butter can give us, whether spread on a piece of bread or toast, infused in mashed potato or melted over some veggies. However, we also likely to be only too aware of butter’s rich stash of saturated fat, which we’re warned raises our risk of heart disease via an elevating effect on cholesterol. Butter has inevitably been damned tonutritional hell by official health bodies, which have eagerly advised us to opt for lower-fat and cholesterol-reducing spreads instead.
This week, though, a British Medical Journal article by cardiologist Dr Aseem Malhotra which urges us to choose butter every time hit the headlines. So, are our beliefs about the ‘heart-healthy’ properties of margarine built on solid scientific foundations, or just the result of slick marketing and misinformation? Is it time we got our fats straight?
While the saturated fat that makes up the bulk of butter might boost cholesterol levels in our blood, any effect here is actually irrelevant: it’s the impact it has on health that counts. All the most recent, major scientific reviews of the evidence simply fail to find any link between intakes of saturated fat and risk of heart disease…
A comprehensive review of the literature encompassing almost 50 such studies was published by researchers from the respected Cochrane Collaboration in 2012. Reducing and/or modifying fat in the diet did not reduce the risk of heart disease (or stroke, or any other chronic disease) at all. Life expectancy was not extended by a single day either. The evidence as a whole strongly suggests that our belief that saturated fat causes heart disease and has broadly harmful effects on health is a myth…
The original health claims for margarine centred on its lower saturated fat content compared to butter. But, seeing as the evidence essentially exonerates saturated fat, this claim has no legs.
Margarine’s principal ingredient comes in the form of ‘vegetable’ oils such as sunflower, corn or safflower oil. These oils are rich in so-called omega-6 fats – one of the two main forms of ‘polyunsaturated’ fats. Omega-6 fats are vigorously promoted as ‘healthy’, but in general terms promote inflammation and blood clotting – two things that would be expected to raise heart disease risk. In recent years, many researchers have raised concerns about the considerable glut of this type of fat in the diet, including from processed foods…
Recent years have seen the emergence of cholesterol-reducing spreads into the market. It’s often assumed that cholesterol reduction is beneficial to heart health. However, several cholesterol-modifying drugs have not been found to deliver on their promise, and some have been found to actually harm heart health. Plus, overall, taking dietary steps to reduce cholesterol has not been found to have broad benefits for health.
Again, the effect that a foodstuff has on cholesterol levels should not be our focus, but the impact it has on health. What evidence do we have that cholesterol-reducing margarines reduce the risk of heart disease, heart attack or overall risk of death? Not one single study of this nature exists in the scientific literature.
Some cholesterol-reducing margarines contain ‘plant sterols’ that partially block absorption of cholesterol from the gut. However, sterols may make their way into the bloodstream too, and evidence links higher levels of sterols in the blood with increased risk of cardiovascular disease. Perhaps worse still, there are several studies that show sterols have the ability to damage tissue and induce worse health outcomes in animals.
While the British Heart Foundation and many doctors heartily support the use of sterols, the National Institute of Health and Care Excellence (NICE) explicitly advises against their routine use.
In the final analysis, I find it impossible to reconcile margarine’s heart-healthy image with the facts. The fat-phobia that drove our broad switch from butter to margarine in recent decades never did have any meaningful scientific support, and I believe has been a huge retrograde step in terms of our health.
I am a practising doctor and the author of several books on nutrition, and in over 20 years I have not bought a single tub of margarine, nor have consciously limited butter in my diet. There’s little doubt in my mind that butter is better, and not just in terms of how it tastes. To my mind, butter need not be a guilty pleasure at all, but just a pleasure.
More at: My piece in The Times which (I think) settles the butter versus margarine debate once and for all