Can a Diet Higher in Fat Still Be Heart Healthy?

Can a diet higher in fat like the dash diet still be heart healthy?

If the trends are on target, this may be the year of the full-fat diet. A number of nutritionists predict in 2016 more people will be putting full-fat dairy products, including cream, in their coffee, and fewer will lighten their coffee with skim milk. While it was once trendy to buy fat-free yogurt and dairy items, the infatuation with low-fat and fat-free has ebbed, thanks to recent studies showing that refined carbohydrates may be worse for your health than saturated fat.

What does the research show? A study published in the European Journal of Nutrition showed people who ate diets that contained full-fat dairy were no more likely to develop type 2 diabetes and heart disease than those who ate low-fat dairy products. Likewise, studies don’t support the idea that consuming moderate amounts of full-fat dairy leads to weight gain. In fact, some studies show the opposite. Eating more dairy foods, even ones high in fat, helps with weight control.

In reality, sugar may be the real villain. Recently, researchers at Albert Einstein College of Medicine looked at evidence that saturated fat and another dietary component, sugar, are linked with heart disease. Their conclusion? Refined sugar is a stronger contributor to heart disease than saturated fat. Now, a new study further supports the idea that adding a little fat to your diet may not be so bad after all.

Dash Diet: The World’s Healthiest Diet Fattened Up

For the sixth year in a row, nutritionists awarded the DASH diet the distinction of being the healthiest diet. If you’re not familiar with the DASH diet, it’s a favorite among cardiologists and health care practitioners. Aptly named, DASH stands for Dietary Approaches to Stop Hypertension, so you can see why it’s the darling of the health care profession. Unlike more controversial diets, the DASH diet has withstood the test of time.

So what is the DASH diet?  It’s an eating plan centered around fruits, vegetables, whole grains, fish, poultry, nuts, and low-fat dairy. What it doesn’t typically emphasize are full-fat dairy products like whole milk and cream. However, in a recent study, researchers modified the DASH diet, adding more fat, to see if the heart-healthy benefits stayed the same.

In the study, participants ate three different diets. Each participant ate each diet for three weeks followed by a 2-week washout period. The three diets were:

.   A typical DASH diet

.   A control diet

.   A DASH diet with added fat (including meat and dairy)

After comparing the diets, researchers found the DASH diet WITH added fat lowered blood triglycerides and low-density lipid particles more than the standard DASH diet while there were no significant differences in how each diet impacted LDL-cholesterol, the type most closely associated with heart disease. In addition, both the high-fat DASH diet and the standard DASH diet lowered blood pressure to a similar degree.

What does this mean? Even if you modify a DASH diet by adding more saturated fat, it’s still a heart-healthy diet.  Despite older studies showing saturated fat increases LDL-cholesterol, participants in this study experienced no rise in their “bad” cholesterol. In fact, their lipid panel was more favorable on the high-fat DASH diet.

Refined Carbohydrates Versus Fat

One thing to remember is the participants, while on the high-fat DASH diet, ate fewer carbohydrates compared to the standard DASH diet group, mostly by consuming less fruit and fruit juice. The reduction in carbs may have been why their triglyceride level dropped. Elevated triglycerides are associated with a greater risk for heart disease, and triglycerides are sensitive to dietary carbohydrates, especially refined carbs and added sugar. Drinking lots of fruit juice and natural sugars can raise triglycerides as well.

Why modify the fat content of the DASH diet? As the researchers in this study point out, being more liberal with the fat means people will find this type of diet easier to follow since it’s not so restrictive.

Fat and Heart Health

The Mediterranean diet is also higher in fat relative to the standard DASH diet, but the emphasis is on monounsaturated fats, a type abundant in nuts, olive oil, sesame seeds, and avocados. Monounsaturated fats are structurally different from saturated fats. Unlike saturated fats that have no double bonds, meaning all of the carbons are bound to hydrogen, monounsaturated fats have a single double bond. Studies have linked monounsaturated fats with protection against cardiovascular disease, as evidenced by the Mediterranean diet being one of the healthiest in the world.

Yet, you still have to consider the impact of refined carbohydrates. As you increase the amount of fat in your diet, you’ll likely eat fewer carbohydrates and added sugar. As one study showed, when you replace saturated fat with unrefined, fiber-rich carbs, your risk for heart disease drops, however when you replace them with refined carbs, you do nothing to help your heart.

In other words, taking some of the refined carbs and sugar out of your diet and replacing it with saturated fat may be better for your health than sticking with a sugary, processed diet. Even better would be to replace refined carbs with more monounsaturated fats, especially nuts and olive oil, two foods researchers have linked with a reduction in mortality.

The Bottom Line

You can’t take everything out of your diet. When you cut back on processed carbs, you’ll probably consume more fat. You have to eat something! Although monounsaturated fats are likely a healthier option compared to saturated fat, both are likely better for you than sticking to a diet built around refined carbs. These days, many experts believe sugar and processed carbohydrates are more harmful to heart health than saturated fat but it would be nice to have more evidence to confirm this. Until then, you can’t go wrong building your diet around whole foods and limiting the amount of sugar and packaged foods you eat.



Science Daily. “Higher fat variation of DASH diet lowers blood pressure, triglycerides, study shows”

WebMD. “DASH Diet and High Blood Pressure”

Time Magazine. “Why Full-Fat Dairy May Be Healthier Than Low-Fat”

Eurekalert.org. “The evidence for saturated fat and sugar related to coronary heart disease”

Science Daily. “Unsaturated fats, high-quality carbs lower risk of heart disease”

Journal of the American College of Cardiology, 2015; 66 (14): 1615 DOI: 10.1016/j.jacc.2015.08.025.

Int. J. Epidemiol. (2015) doi: 10.1093/ije/dyv039.

BMC Med. 2014 May 13;12:78. doi: 10.1186/1741-7015-12-78.


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