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Why Is Eating More Smart Fat Good for Your Heart?

By Steven Masley, MD, FAHA, FACN, FAAFP, CNS

For years we have told people to decrease their fat intake to prevent heart disease, but there have been three big problems with this approach.

First, it is hard to do. I spent years telling people to lower their fat intake, and 95% of my own patients couldn’t do it. They weren’t satisfied and they couldn’t stick with it.

Second, I believe the benefits from low fat diets (like Pritikin and Ornish) had little to do with eating low-fat. Sure they got rid of some bad fat, which was good, but the real reason that these eating plans are better than the SAD Standard American Diet is because when they’re done right,,,,, they’re packed with fiber and they’re high in nutrients.

And third, although the low-fat diets did some things right, like when they got rid of bad fats, they also got rid of smart fats – and that was actually pretty dumb. Smart fats have two BIG amazing benefits. They decrease inflammation and they improve hormone levels, in particular blood sugar and insulin. So when we cut out the Smart Fats, we became more inflamed and lost healthy hormone balance, too. And as the leading causes for heart disease are high blood sugar levels and inflammation, cutting out smart fats increased the risk for arterial plaque growth.

This does not mean eating more of any fat is good, (as in, I am not saying that you should eat more ice cream, sausage, and French fries) but only more fat if it is smart fat. So, what do I mean by smart fat?

What is a Smart Fat?

Smart fats have proven clinical benefits from published studies. For example, studies have shown that consuming more olive oil and nuts decrease the risk for cardiovascular disease, and hundreds of other studies suggest nuts and olive oil are good for your heart and help to slow overall aging. Wild salmon and sources of fish oil have proven heart benefits, plus they decrease inflammation and they are good for our brain. Dark chocolate, another smart fat, has been shown to have many benefits for blood pressure, overall cardiovascular health, and is also good for the brain. And monounsaturated food sources, like avocado, have been shown to improve both our cholesterol profile and help with insulin resistance.

So, nuts and nut oils, olive oil, cold water fish, dark chocolate, and avocado are clearly good for your heart and health and can easily be called smart fats. Smart nuts with proven benefits include: almonds, pecans, walnuts, pistachios, hazelnuts, and macadamias.

What is a Bad Fat?

There are also obvious examples of bad fats, such as partially hydrogenated fats (also called trans fats) that worsen cholesterol profiles, blood sugar control, and increase cancer risk. Hydrogenated fats are used by the food industry to extend the shelf life of food, but they shorten your life if you eat them.

Another example of bad fats are fats loaded with pesticides and hormones. Feed lots too often feed cows, pigs, and poultry pesticide-packed grain and those chemicals accumulate in the fat. When we eat the animal fat, we may get a big load of toxic fat. Feed lots may also load animals with growth hormones, and these hormones likely increase your risk for cancer.

So, to avoid bad fats, become a savvy shopper – read labels, and if you purchase meat and dairy, buy it from pasture raised, hormone-free, and grass-fed animals.

What are neutral fats?

The big surprise is that over the last few years, several large, powerful studies have shown that saturated fats are neutral, as in they have not been shown to increase the risk for heart disease. Examples of neutral fats are fats in organic cream, butter, and grass-fed beef. Despite decades of health agencies attacking saturated fats, the most recent evidence suggests they are neutral to our health, not harmful and not beneficial, so we would be much better off focusing on avoiding sugar and flour, which increase blood sugar levels and are strongly associated with heart disease and paying less time to neutral saturated fats.

How does saturated fat impact inflammation? Saturated fat from fatty dairy and fatty meats increases inflammation levels. Multiple scientific articles show this to be the case. Generally speaking, anything that increases inflammation increases aging. The challenge then is you eat fatty dairy or fatty meats with saturated fat is to eat more anti-inflammatory foods, such as vegetables, fruits, beans, nuts, along with olive oil and herbs and spices—all of which decrease inflammation.

The bottom line is that if you eat clean saturated fat along with an abundance of leafy vegetables, fruits, beans, nuts, spices and herbs, then the impact of saturated fat is neutral on your health.

How is coconut fat different from saturated animal fat?

Coconut oil is a bit more controversial. Yes, coconut oil is mostly saturated fat, but its structure is different from saturated fat that comes from dairy and fatty meats, as it is made from lauric acid. In contrast to saturated animal fat, coconut oil has a couple health benefits:

  • It helps boost metabolism in highly active people.
  • The medium chain triglycerides in coconut fat provide a terrific fuel source for prolonged exercise sessions and for athletes.
  • Coconut fats have anti-microbial properties, helping to fight infections.
  • Coconut fat appears beneficial for cognitive function, and for people with neurological disease, as eating more saturated fat may protect the brain from injury.

Despite these benefits, eating more coconut products increases cholesterol levels. Yes, it raises LDL particle size (considered good) and it raises healthy HDL cholesterol levels (also good). The problem is we do not have any clinical outcome studies that show eating coconut is either neutral or beneficial, and at least once clinical study using coconut products showed that it decreased artery function, so there should be some hesitation in recommending coconut oil to people with established heart disease.

So, my recommendation is that if you have established heart disease (meaning you have had a heart attack, stroke, or abnormal cardiovascular testing with your doctor), or you are being treated by your doctor for abnormal cholesterol problems, I’d recommend you stick the many heart-friendly smart fats for now.


There are smart fats that benefit your heart and the latest scientific evidence shows that you do not need to follow a low-fat diet to protect your heart. While clearly some fats should be avoided, you should enjoy eating more nuts, olive oil, cold water fatty fish, dark chocolate, and avocados.


I hope this helps you to make the best choices for your health.

Steven Masley, MD, FAHA, FACN, FAAFP, CNS

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