Heart-Healthy Fats Explained
By Britni Vincent, RD, LD
February 5, 2024
The truth finally comes out: fats are good for you! But old myths tend to linger, leaving many asking “If I eat more fat, won’t my cholesterol levels go up? And isn’t too much cholesterol bad for my heart? Shouldn't I be worried about my saturated fat intake if I want to lower my LDL cholesterol?”
For years we have been told that the risk of heart disease is caused by fat consumption – specifically foods containing cholesterol and saturated fat –but research of the past decade is telling us the opposite …that dietary fat that comes from real food actually IMPROVES heart health and healthy living.
A meta-analysis of nearly 350,000 individuals found that intake of saturated fat was not associated with an increased risk of congenital heart disease, stroke, or cardiovascular disease (1).
The French are a great example of this. They consume a lot of butter, raw cheese and organ meats and have half the rate of heart disease that Americans do.
Contrary to the low-fat message spread for years, healthy fats should be consumed at every meal and snack throughout the day. And there are several wonderful, natural fats that are heart-healthy to choose from. Are you eating them? Plus, do you know how to shop properly for these good fats? Let me break down good and bad fats for you.
What Are Good Fats For Heart Health?
Good fats are those that exist in nature. They are not highly processed. These include:
- olive oil and olives
- coconut oil
- avocado and avocado oil
- lard and tallow
- butter and cream
- ghee (clarified butter)
- nuts and seeds
- nut butters
Some other foods we consider as a protein macronutrient, also contain healthy fat. Those foods would be:
- cold-water fatty fish
- grass-fed meats
- full-fat dairy, if tolerated
For the healthy animal fats, like the lard and tallow, it's best if you can get them from organic grass-fed or pasture raised animals.
According to Sally Fallon Morell in her book Nourishing Fats Why We Need Animal Fats for Health and Happiness (2), one of the most important reasons we should be eating these natural fats is that they provide important vitamins like vitamin K, which helps protect our arteries and heart against cardiovascular disease.
Another good reason to be eating healthy fats is that you absorb more nutrients from your food when you add a good fat. The fat helps carry nutrients from your vegetables into your cells. So, go ahead and add yummy butter to your broccoli!
How can you tell if it is a good fat option and not unhealthy fats? When you are at the store look for dark bottles and words like unrefined, extra virgin, expeller pressed, cold pressed, and first pressed. Let’s break it down even further to help you with your grocery lists:
Look For These Heart-Healthy Fats And Proteins
Eggs (yolks, too):
You don’t have to worry anymore about eating eggs on a regular basis, and please ditch the liquid egg white products. They only contain the egg whites and have many other additives.
Dietary cholesterol from eggs does not have a significant effect on raising your body’s cholesterol level. Egg yolks contain 13 important nutrients, plus they are delicious. Look for “organic” and “pasture-raised” eggs. They are the best option because they contain the most nutrients. For more information on eggs, check out our Ask The Nutritionist podcast episode, Egg Essentials.
Gone are the days of only eating dried out chicken breast to be healthy. Chicken thighs, ground beef, steak are delicious cuts of meat that give you the protein you need for a healthy heart and body. Animal products are good sources of saturated fats, but it's important to look for “100% grass-fed,” “free-range,” and “organic” to find the healthiest options.
Fatty fish, such as sardines, salmon and mackerel, are the best source of omega-3 essential fatty acids.
A review of omega-3s and cardiovascular disease from the Harvard School of Public Health, concluded that omega-3 consumption “lowers plasma triglycerides, resting heart rate, and blood pressure and might also improve myocardial filling and efficiency, lower inflammation and improve vascular function.” Put into simple terms, the review is saying omega-3 essential fatty acids help the heart to function more efficiently while helping lower inflammation. Omega-3s are an amazing fat and have many other benefits other than heart health.
When shopping for fish, purchase “wild-caught” fish. Most canned salmon is wild-caught and can be an economical way to get your delicious salmon and healthy omega-3 fatty acids.
If it doesn’t say "wild-caught" on the label that means it’s farm-raised, meaning pumped with antibiotics and hormones, which are then stored in our bodies after we consume the fish. As a result of their poor living conditions, farm-raised fish lose a lot of their nutrient value and many contain additives as well. For one example, to make the grayish-white farmed salmon color look more appealing, artificial colors are added to give the fish its “salmon” pink color.
Butter and cream:
Choose organic brands and look for “grass-fed.”
Another healthy source of saturated fat, look for “cold-pressed” and organic brands. Here’s a great in-depth post about exactly what to shop for in coconut oil.
Olive oil and olives:
Olives are a source of monounsaturated fats and contain polyphenols, which are anti-inflammatory and also act as powerful antioxidants. Look for “extra virgin,” “cold-pressed” or “first-pressed,” which means it’s the least processed and contains the most nutrients. After that just choose whatever kind you like best!
Arginine is an amino acid found in nuts that protects the inner lining of the arterial walls (endothelium), making the arterial walls less susceptible to plaque build-up. Nuts are also plentiful in phytonutrients, which have powerful health benefits and have been linked to the prevention of coronary heart disease. Each nut has different nutrients to offer so choose a variety, but make sure they are raw or dry roasted so they don’t contain damaged oils. The fiber found in nuts also provides heart health benefits.
These are an excellent source of heart-healthy monounsaturated fats and contain close to 20 health boosting nutrients. Like nuts, they are also a great source of fiber. Research also suggests they can lower LDL cholesterol levels.
How Much Healthy Fat Should You Eat?
If you are used to a low-fat diet, you might be wondering how much fat is ideal for a healthy diet? We recommend eating healthy fat every time you eat. How much? Examples include 1/4 cup nuts, ½ avocado, 1 tablespoon butter or olive oil, 1/4 cup of nuts, 14 green olives, 3 tablespoons cream, or 1 -2 tablespoons nut butter.
Not to get too in the weeds with types of fat, but eating a collection of the natural foods listed above will give you a good mix of saturated fat, monounsaturated and polyunsaturated fats. Healthy eating is all about variety, so a mix of more healthy fats will be beneficial to a balanced diet that reduces the blood cholesterol levels and the risk of heart disease. You don't have to worry about all the types of dietary fat intake - instead focus on real food in variety.
What About Cholesterol?
Dietary cholesterol doesn’t have much impact on our blood cholesterol levels. I wanted to bold that so it’s loud and clear. Even so, some clients are still concerned about their cholesterol after I tell them to include more eggs in their diet.
In 2013 new cholesterol guidelines (3) were released, and in 2015 the Dietary Guidelines stated “available evidence shows no appreciable relationship between consumption of dietary cholesterol and [blood] cholesterol ... Cholesterol is not a nutrient of concern for overconsumption (4)."
Only 25% of the cholesterol our body has each day comes from diet; the remaining 75% is made in our bodies by our liver. Some of the cholesterol found in food can’t even be absorbed by our bodies. I have seen it countless times that when people start to consume more eggs and other healthy fats, their cholesterol either doesn’t change or actually improves.
Dr. Aseem Malhotra, an interventional cardiology specialist at Croydon University Hospital in London, said “the avoidance of saturated fat actually promotes poor health in a number of ways, compounding the health risks of following this completely outdated and dangerous advice.”
According to Dr. Bowden and Dr. Sinatra, authors of The Great Cholesterol Myth, saturated fat raises HDL cholesterol (which has a protective effect) and tends to make a beneficial change to the pattern of your LDL cholesterol. Not all LDL is unhealthy, read our article Understanding Cholesterol to learn more about LDL.
What Fats Should You Avoid For Heart Health?
Unhealthy fats to avoid are highly processed and refined. These might include:
- canola oil
- grapeseed oil
- soybean oil
- corn oil
- cottonseed oil
- vegetable oil
These oils are made using intensive mechanical and chemical processes to get the oil from the seeds. The process for partially hydrogenated vegetable oils removes all the natural nutrients, and they oxidize easily. This causes your cells and blood vessels to get stiff and damaged. Unhealthy fats can cause an increase in inflammation in the blood vessels and this inflammation can be the root cause of coronary artery disease.
Avoid These Bad Fats
Like we did above with the healthy fats, let’s break down what to watch out for when looking at labels in the store:
New products no longer contain trans fats and rarely are older products from before the June 2018 trans fat ban still lurking on some fridge or pantry shelves, but I want to make you aware of the history of trans fat. These damaging fats were found in margarine, non-dairy creamers, cake mixes, soup cups, most packaged baked goods, chips, and fast food (especially fried foods!).
You can identify trans fats and refined oils in the ingredient list by looking for “partially hydrogenated oils” or “hydrogenated oil.” Toss any expired products and any products containing trans fats; we don’t recommend consuming anything with trans fats.
Trans fats were found to increase your (“bad”) LDL cholesterol and decrease your (“good”) HDL cholesterol. As a result, the FDA banned their use, but it’s best to still beware of lingering products.
Refined oils (corn, canola, soybean and cottonseed oil):
Historically, vegetable oils, such as canola oil, have been promoted as being “heart healthy” but that’s simply not true. Again recent research has found these kinds of fats to be inflammatory by nature, but the processing makes them even worse.
Think about what happens when you squeeze a kernel of corn or a soybean …oil doesn’t actually come out. The oils are extracted and refined using very high heat and petroleum solvents, like hexane. Then it goes through another process of refining, degumming, bleaching, and even deodorization (because they stink).
Researchers from “Dietary Fats, Carbohydrate, and the Progression of Coronary Atherosclerosis in Post-menopausal Women” found that when they were replacing saturated fat (like butter or coconut oil) with processed polyunsaturated fat (vegetable oils described above) it led to an increase in the progression of coronary atherosclerosis, or plaque build-up. These kinds of fats are found in many fried foods and packaged snack foods, even roasted nuts, so always read the ingredient list!
Heart-Healthy Recipes & Next Steps
So, how do you make the transition from bad fats to good fats in your diet? The good news is healthy fats are delicious and they will add a satiety to your meals and decadent mouth feel to your food, so it won’t be hard!
Step 1: Start swapping processed foods for real foods
By eating foods found in nature, you’ll naturally start eating more of the good healthy fats since most processed foods contain refined oils and damaged fats. For example, instead of using a powdered creamer in your coffee, use a full fat heavy cream or coconut milk from the can. Instead of cereal or a bagel for breakfast, have some scrambled eggs with spinach cooked in butter with some berries on the side. Swap your fast food fries for homecooked sweet potato wedges tossed in avocado or coconut oil.
Step 2: When you are run out of something in your fridge or pantry, replace it with the healthy fat option
This might look like finding an avocado-based mayo or salad dressing with healthy oils. Tossing out your vegetable oil or margarine for baking and upgrade to coconut oil, avocado oil, or butter. When you have nuts or nut butters on your grocery list, pick up the ones that are dry roasted with no added ingredients (except for salt) on the label.
You certainly can go through your fridge and pantry in one fell swoop and get rid of all the old sauces and products that have those refined oils at once, but you can also take it one step at a time if that feels more manageable.
Step 3: When planning your meals, always think PFC (protein, fat, carb) to make sure you are getting healthy fat in your diet
The balance of animal protein, healthy fats, and vegetable carbohydrates balances blood sugar, which prevents or reduces insulin resistance. Insulin resistance is a large contributing factor to heart disease (5).
An example day of eating healthy fat – in collaboration with animal protein and healthy carbs – might look like this:
Breakfast: Egg Bake recipe, which has your protein, veggies, healthy fat all in one!
Lunch: leftover taco meat on a bed of salad greens topped with salsa and sour cream (F) or guacamole (F)
Afternoon snack: meat stick with a handful of dry roasted nuts (F) and sunflower seeds (F) and a clementine (they don't have to be unsalted nuts!)
Dinner: Sheet Pan Asian Salmon with Brussels Sprouts and Red Pepper, cooked with avocado oil or melted butter (F) *salmon is a great source of omega-3 fatty acids for heart health
Bedtime snack: ½ cup berries with 2-3 Tbsp. heavy cream (F)
Get Support With Heart Healthy Eating
If you’re struggling with cholesterol levels or other heart health issues that could lead to heart disease, I’d highly encourage you to sign up for a nutrition consultation with me or one of my fellow nutritionists and dietitians here at Nutritional Weight & Wellness. We’ve helped hundreds of people get their cholesterol levels and heart health under control, Jim and Mary Lou are great examples of that!
For more information on heart disease and heart health, check out these resources:
Listen to the Dishing Up Nutrition Podcast Episode: All About Fat
(2) Fallon, Sally. Nourishing fats: why we need animal fats for health and happiness. 1st ed. New York: Grand Central Life & Style, 2017.
(3) Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-934.
(4) U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Part D. Chapter 1. Question 2.