What Should You Put On Your Toast?

Author: Dr. Stephen Chaney

The Checkered History Of Margarine

Many of you may have seen the recent headlines proclaiming that a recent study has shown that margarine is healthier than butter.

Some of you may be saying, “I don’t believe it.”

Others may be saying, “Of course. Hasn’t that always been true.”

So, to clear up the confusion, let me share a brief history of margarine.

Margarine was invented in 1869 by a French chemist in response to a request from Napoleon III to create a poor man’s butter substitute. Napoleon’s intentions weren’t entirely altruistic. He also wanted a cheaper butter substitute for his armies.

Margarine initially encountered a strong headwind in this country. The dairy lobby influenced congress and state legislatures to pass numerous laws designed to increase the cost and reduce the desirability of margarine.

In the 1950s the ground started to shift. Scientists and the medical community started to recognize that saturated fats were a major contributor to heart disease. Suddenly, butter became a villain, something to avoid.

- But that was a problem. Butter was preferred spread for bread and toast. It was used for cooking. It was ubiquitous. You may even remember the popular “I like bread and butter” song. What was a person to do?

At that time margarine was made by partially hydrogenating vegetable oils (usually corn oil because it was the cheapest). The hydrogenation converted some of the unsaturated fats in vegetable oils to saturated fats so that margarine would not be in liquid form at room temperature. However, the total amount of saturated fat in margarine was less than in butter, and the ratio of polyunsaturated fat to saturated fats was much healthier. Margarine took on a new luster. It was now the healthier alternative to butter.

- Once margarine attained the “healthier” status, most of the anti-margarine laws were quickly abolished, and margarine quickly outpaced butter as the spread of choice.

In the 1980s the ground shifted again. A French study found the margarine increased the risk of heart disease more than butter. Further studies showed that the hydrogenation process created a novel type of fat called trans fats. By the 1990s it was widely accepted that trans fats increased the risk of heart disease even more than saturated fats.

- Margarine became the villain, and butter was considered the more natural, healthier spread. By 2000 sales of butter once more surpassed those of margarine.

In 2018 the ground shifted once again. After almost 20 years of deliberation, the FDA banned trans fats from the American food supply as of 2018. Margarine no longer contained trans fats.

Today’s study (C Weber et al, Public Health Nutrition, doi:10.1017/S1368980021004511) asks whether the reformulated, trans-fat-free margarines are once again a healthier alternative to butter.

Is Margarine Healthier Than Butter?

The study analyzed the fat composition of 53 margarine tub or squeeze products, 18 margarine stick products, 12 margarine-butter blend products and compared them with the fat composition of butter. The results are shown below:

There was no detectable trans fat in any of the margarine products. So, based on saturated fat content and the ratio of unsaturated fats to saturated fats, the margarine products were all healthier than butter. This is what the paper concluded.

	Mean % of Total Fat In:
	Margarine Tub or Tube	Margarine Sticks	Margarine- Butter Blends	Butter
SFA*	29%	38%	38%	60%
MUFA*	36%	34%	43%	26%
PUFA*	33%	29%	13%	4%
*SFA = Saturated fats, MUFA = Monounsaturated fats, PUFA = Polyunsaturated fats

But let’s look a bit deeper. First, we should look at the fat sources.

The saturated fat in the margarine products comes from either palm or coconut oil. There are claims that these plant saturated fats may be healthier than saturated fats from animal sources. But there are no long-term studies to back up those claims, So, I will simply consider them equivalent to any other saturated fat for this review.

Next, we should look at the labels.

The labels of most butter products are simple. Butter is sweet cream and salt. Unsalted butter is sweet cream and natural flavoring (usually lactic acid). This is the way that butter has been made for hundreds of years.

Margarine products are manufactured foods. They didn’t come from a cow. Their labels are significantly longer. And you should read the labels carefully.

- Some margarine products are made with natural ingredients.

- However, many margarine products contain preservatives and artificial flavors.

So, choosing between margarine products and butter is not as simple as looking at saturated fat content alone.

But what if you didn’t have to choose between margarine and butter? What if there were other options to consider?

What Should You Put On Your Toast?

Once you decide to look beyond margarine and butter you will find lots of healthy options. For example:

If you have ever eaten at a fine Italian or Greek restaurant, you may have had your bread served with olive oil to dip it in. Of course, this may be a better option for lunch and dinner than for breakfast. (I don’t think jam would pair well with olive oil.)

Nut butters are an excellent choice any time of day. Peanut and almond butters are the most popular, but there are many other nut butters to choose from.

Avocado is another excellent choice.

This just scratches the surface. There are healthier options for almost every palate.

If you look at the fat composition of my top four suggestions, you can readily see why they are healthier choices than either margarine or butter. They are much lower in saturated fat and high in heart healthy monounsaturated and polyunsaturated fats.

	Mean % of Total Fat In:
	Olive Oil	Almond Butter	Peanut Butter	Avocado
SFA*	14%	9%	22%	16%
MUFA*	74%	64%	53%	71%
PUFA*	12%	27%	25%	13%
*SFA = Saturated fats, MUFA = Monounsaturated fats, PUFA = Polyunsaturated fats

But that is just part of the story:

Nut butters are also a good source of protein. And both nut butters and avocados provide nutrients, phytonutrients, and fiber you don’t find in margarine or butter.

There are also labels to consider:

Avocados are whole foods and don’t require labels. There are no other ingredients. What you see is what you get.

Olive oil is a bit more complicated. It is often blended with cheaper oils to reduce the cost, and that doesn’t always show up on the label. My best advice is to get extra virgin olive oil from a brand you trust.

With nut butters, you should read the label. For example, the ingredient label for almond butter should list almonds as the sole ingredient. Peanut butter should just list peanuts. However, some brands add other oils, sugar, emulsifying agents, etc. These are the brands you should leave on the shelf.

Our “go-to” spread is almond butter. I like it with cinnamon sprinkled on top, although sliced bananas and cinnamon is another excellent choice.

As for butter, we still like it on baked sweet potatoes and corn on the cob. We freeze our butter and cut off a slice whenever we need it. A stick of butter lasts us many months.

The Bottom Line

Now that trans fats have been removed from margarine products a recent study revisited the question as to whether margarine or butter was the healthier choice. On the basis of their saturated fat content, the study concluded that margarine products were healthier than butter.

However, that is just part of the story. When you look at the labels:

The labels of most butter products are simple. Butter is sweet cream and salt. Unsalted butter is sweet cream and natural flavoring (usually lactic acid). This is the way that butter has been made for hundreds of years.

Margarine products are manufactured foods. They didn’t come from a cow. Their labels are significantly longer. And you should read the labels carefully.

So, choosing between margarine products and butter is not as simple as looking at saturated fat content alone. But what if you didn’t have to choose between margarine and butter? What if there were other options to consider?

Once you decide to look beyond margarine and butter you will find lots of healthy options. I discuss my top 4 choices above.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Everything We Thought We Knew About Fats Wrong?

Author: Dr. Stephen Chaney

Bring out the fatted calf! Headlines are proclaiming that saturated fats don’t increase your risk of heart disease – and that they may actually be good for you.

The study (Annals of Internal Medicine, 160: 398-406, 2014) that attracted all the attention in the press was what we scientists call a meta-analysis. Basically, that is a study that combines the data from many clinical trials to improve the statistical power of the effect being studied.

And it was a very large study. It included 81 clinical trials that looked at the effects of various types of fat on heart disease risk.

Are Saturated Fats Good For You?

The answer to this question is a simple No. The headlines suggesting that saturated fats might be good for you were clearly misleading. The study concluded that saturated fats might not increase the risk of heart disease, but it never said that saturated fats were good for you.

In short, the study concluded that:

Saturated fats, monounsaturated fats and long-chain omega-6 polyunsaturated fats did not affect heart disease risk.

Long chain omega-3 polyunsaturated fats decreased heart disease risk [Note: The original version of the paper said that the decrease was non-significant, which is what the headlines have reported. However, after several experts pointed out an error in their analysis of the omega-3 data, the authors corrected their analysis, and the corrected data show that the decrease in risk is significant.]

Trans fats increased heart disease risk

If those conclusions are correct, they would represent a major paradigm shift. We have been told for years that we should limit saturated fats and replace them with unsaturated fats. Has that advice been wrong?

Is Everything We Thought We Knew About Fats Wrong?

Before we bring out the fatted calf and start heaping butter on our12 ounce steaks, perhaps we should look at some of the limitations of this study.

We Eat Foods, Not Fats

When the authors broke the data down into the effects of individual saturated and unsaturated fatty acids on heart disease risk some interesting insights emerge.

For example, with respect to saturated fats:

Both palmitic acid and stearic acid – which are abundant in palm oil and animal fats – increased the risk of heart disease.

On the other hand, margic acid – which is more abundant in dairy products – decreased the risk of heart disease.

So while the net effect of saturated fats on heart disease risk may be zero, these data suggest:

It is still a good idea to avoid fatty meats, especially red meats, if you want to reduce your risk of heart disease. When you focus on foods, rather than fats this fundamental advice has not changed in over 40 years! In next week’s “Health Tips From the Professor” I will share some of the latest research on the dangers of red meat.

With fatty dairy foods the situation is a little more uncertain. I’m not ready to tell you to break out the butter and whipped cream just yet, but recent research does suggest that dairy foods have some beneficial effects that may outweigh their saturated fat content.

With respect to omega-3 fatty acids:

alpha-linolenic acid – which is found in vegetable oils and nuts and is the most abundant omega-3 fatty acids in our diets – had no effect on heart disease risk.

On the other hand, EPA and DHA – which are found primarily in oily fish and omega-3 supplements – decreased heart disease risk by 20-25%.

Once again, while the net effect of omega-3 fatty acids on heart disease risk was very small, that’s primarily because most Americans consume mostly alpha-linolenic acid and very little EPA and DHA. This study shows that fish oil significantly reduces heart disease risk, which is fully consistent with the heart healthy advice of the American Heart Association and National Institutes of Health over the past decade or more.

What We Replace the Fats With Is Important

A major weakness of the current study is that it did not ask what the individual clinical trials were replacing the fatty acids with. Many of them were simply replacing the saturated fats with carbohydrates. To understand why that is important, you have to go back to the research of Dr. Ancel Keys.

The whole concept of saturated fats increasing the risk of heart disease is based on the groundbreaking research of Dr. Ancel Keys in the 50’s and 60’s. But, it is important to understand what his research showed and didn’t show.

His research showed that when you replaced saturated fats with monounsaturated fats and/or polyunsaturated fats the risk of heart disease was significantly reduced. He was the very first advocate of what we now call the Mediterranean diet. (He lived to 101 and his wife lived to 97, so he must have been on to something.)

Unfortunately, his diet advice got corrupted. The mantra became low fat diets, where the saturated fat was replaced with carbohydrates – mostly simple sugars and refined flours. Since diets containing a lot of simple sugars and refined flours also increase the risk of heart disease you completely offset the benefits of getting rid of the saturated fats.

Just in case you think that is outdated dietary advice, Dr. Key’s recommendations were confirmed by a major meta-analysis published in 2009 (American Journal of Clinical Nutrition, 89: 1425-1432, 2009). That study showed once again that replacing saturated fats with carbohydrates had no effect on heart disease risk, while replacing them with polyunsaturated fats significantly reduced risk.

The Bottom Line:

You can put the fatted calf back out to pasture. The headlines telling you that saturated fats don’t increase the risk of heart disease were overstated and misleading. This study does not represent a paradigm shift. In fact, when you analyze the study in depth it simply reaffirms much of the current dietary advice about fats.

1) When you simply replace saturated fats with carbohydrates, as did many of the studies in the meta-analysis that generated all of the headlines, there is little or no effect on heart disease risk. However, other studies have shown that when you replace the saturated fats with monounsaturated and polyunsaturated fats you significantly reduce heart disease risk.

In short, if you are interested in reducing your risk of heart disease, low fat diets may be of relatively little value while Mediterranean diets may be beneficial. No paradigm shift there. That sounds pretty familiar.

2) Fatty meats, especially red meats, appear to increase the risk of heart disease. No surprises there.

3) Alpha-linolenic acid, the short chain omega-3 fatty acid found in nuts, seeds and vegetable oils, does not decrease heart disease risk. However, EPA and DHA, the long chain omega-3 fatty acids found in fatty fish and fish oil supplements significantly decrease heart disease risk. That’s probably because the efficiency of conversion of alpha-linolenic acid to EPA & DHA in our bodies is only around 10%. No surprises there.

4) The study did suggest that dairy foods may decrease heart disease risk. While there are a few other studies supporting that idea, I’m not ready to break out the butter and whipped cream yet. More research is needed.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.