If you have heart disease or conditions like atrial fibrillation, you may have been told that a diet low in saturated fats will help. For heart health, you may have believed that a low-fat diet would protect you. But now that some studies report links between saturated fats and heart disease may not be that strong, what should you do?
A 2014 review, published in the Annals of Internal Medicine, looked at 32 different studies on dietary fats and heart health published over the years. The review concluded that when it comes to heart health benefits, there is not enough evidence to support a diet low in saturated fats or high in healthy fats.
“Saturated fat may not be as bad as we thought, but don’t order a bacon cheeseburger yet. The data on all these trials is confusing because there are many different variables related to dietary fat intake. There is still plenty of evidence linking saturated fats to heart disease,” says Seth J. Baum, MD, director of Women’s Preventive Cardiology at the Christine E. Lynn Women’s Health and Wellness Institute at Boca Raton Regional Hospital in Florida.
Get the facts about fats.
Fact: All dietary fats are not alike.
“We are still learning more about saturated fats and their impact on heart health. I still recommend limiting saturated fats from animal sources, like whole fat dairy products, as well as higher fat cuts of beef, pork, and poultry,” says Alison Massey MS, RD, dietitian and diabetes educator at The Center for Endocrinology at Mercy Medical Center in Baltimore, Md.
Unsaturated fats in your diet can actually improve your blood cholesterol levels. These fats are liquids at room temperature and come from vegetable oils, fish, nuts, and seeds. One of the main reasons why the Mediterranean diet is thought to be better for heart health is preference for olive oil, an unsaturated fat.
“Trans fats are worse than saturated fats. They make all your cholesterol numbers worse,” says Dr. Baum. Overall, trans fats are the worst fats for your heart, according to the American Heart Association. Margarine made with trans fats is even worse for you than butter. Most trans fats have been removed from packaged foods, but always check your labels. You want to see zero for trans fats.
Fact: Not all cholesterol is the same.
There is good cholesterol and bad cholesterol in your blood. Good dietary fats are those that raise your level of “good” cholesterol, which protects against heart attack and stroke. Saturated fats raise your level of “bad” cholesterol, which increases the risk of heart attack and stroke. The difference is in how these fats and cholesterol move through your blood.


Low-density lipoproteins (LDL) carry bad cholesterol and allow formation of plaques inside arteries. These plaques lead to heart disease. High-density lipoproteins (HDL) on the other hand, carry cholesterol out of the blood and return it to the liver. In this way, HDL cholesterol helps to keep arteries clean.
Myth: The guidelines for saturated fat allowance have changed greatly.
The guidelines are really quite similar. Previous guidelines said you can get 30 percent of your daily calories from fats and you should limit saturated fats to 7 percent of your calories. The latest guidelines from the American Heart Association say you can get 35 percent of your calories from fats, and you should still limit your saturated fats to less than 7 percent.

 Fact: Refined sugars are as bad as saturated fats for your heart.
Refined sugars are found in foods like white bread, mashed potatoes, white rice, white noodles, and sugary drinks. Refined sugars lower both good and bad cholesterol levels in the blood, making them a net negative for heart health.
“Cutting back on saturated fats only works if you replace those calories with healthy foods. Healthy foods are healthy fats, nuts, vegetable oils, fruits, and vegetables. Too much refined sugar in your diet could be as bad as saturated fats,” says Baum.
Myth: People should eat by following guidelines.
“We are drowning in guidelines. Luckily people eat foods, not guidelines. The bottom line is choosing a balanced diet,” says Baum.
Here are your tips for fats:
  • Eliminate trans fats
  • Limit red meat and full-fat dairy foods
  • Limit refined sugars
  • Use liquid vegetable oils in place of butter
  • Get frequent servings of heart-healthy foods like fish, nuts, plant oils, and avocado
“We have received confusing information regarding the types of fat to exclude or include in our diets over the past few years. I encourage my clients to focus on incorporating more unsaturated fats in their diet along with avoiding trans fats,” says Massey.
Fact: Cholesterol numbers are still important.
If you are age 20 or older, you should have your cholesterol numbers checked every four to six years. Your total cholesterol and good cholesterol (HDL) numbers can predict your future risk of heart attack or stroke. Aim for total cholesterol of less than 180 milligrams per deciliter (mg/dL), recommends the American Heart Association.
Talk to your doctor about how frequently you should get your cholesterol checked and what your numbers mean, and what your individual goals should be. And don’t get carried away by headlines that say saturated fats are off the hook.