Butter is back! Or is it?

Let’s take a balanced look at the latest science:

First, the bad news for butter:

In controlled substitution trials comparing butter to plant-based oils, butter consistently sends markers of cardiovascular risk in the wrong direction (i.e. LDL & HDL cholesterol, and triglycerides). This is even true of butter vs coconut oil (also a highly saturated fat).

These data make a compelling choice for swapping butter out with plant-based options.

*Caveat: Most substitution trials don’t last long enough to look at cardiovascular events. Thus, their utility hinges on the (imperfect) blood-based markers of cardiovascular health. 

Now, the good news for butter:

1) For heart health, butter beats industrial oils loaded with trans fats, which are clearly linked to poor heart health. They USED to be found in high amounts in margerine. Nowadays, trans fats been virtually eliminated from margerines and many countries regulate levels to keep them out of our food supply.

2) Butter is also a lesser evil than refined (white) carbs. Replacing your buttery toast with jam or honey on toast is unlikely to be a win for heart health.

3) Butter will not make or break your heart health. Observational trials, those that simply ask people how much butter they eat, and look for a link to heart attack rates, DO NOT find a clear link. This lack of link is the big reason why we see a lot of “Butter is Back” headlines. To me, this says that butter alone is not going to make or break your heart health, and that other factors are just as important. Perhaps people who choose butter tend to avoid sugary, processed foods or trans fats? Such confounders would outweigh the harms and explain the lack of association.

Note: butter contains ruminant trans fats, the health profile of which are uncertain. I believe that caution is warranted (hear my tboughts  on ruminant trans fats in this video).

The choice is yours!

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