Fat: It’s Not What Makes You Fat

Guest Article by Mark Hyman, MD

If you’re feeling completely confused about whether you should cut fat from your diet, you are not alone. But here’s the bottom line: fat does not make you fat or sick. So, why do so many people believe that fat is bad for you and causes heart attacks?

This all started in the Dr. Key’s Seven Countries Study decades ago that examined heart risk based on lifestyle and dietary habits. He found that in the countries where people ate more fat—especially saturated fat—there were more cases of heart disease, and he concluded that the fat caused the disease. But here’s the problem with this study: correlation is not causation. Just because both fat intake and heart disease were higher among the same population doesn’t mean the heart disease was caused by the fat consumption. Here’s another way to look at it: Every day, you wake up and the sun comes up, but although these events happen at the same time, you waking up doesn’t cause the sun to come up.

A study that observed this would show a 100% correlation between these two events, but it would be wrong to conclude that you caused the sun to rise. Because of studies like this, we became sidetracked into believing that saturated fat causes heart disease. But in fact, we are now learning that sugar is the true culprit, not fat. A review of all the research on saturated fat published in the American Journal of Clinical Nutrition found there was no correlation between saturated fat and heart disease. And a recent editorial in the British Journal of Medicine hammers home the same point and shatters the myth that fat causes obesity and heart disease. Researchers have found that, while it’s true that lowering saturated fat in the diet may lower total cholesterol, it’s actually lowering the good kind of cholesterol, the light, fluffy, buoyant LDL that’s not a problem.

When people eat less fat, they tend to eat more starch or sugar instead, and this actually increases their levels of dangerous cholesterol, the small, dense cholesterol that causes heart attacks. In fact, studies show that 75% of people who end up in the emergency room with a heart attack have normal overall cholesterol levels. What they do have is pre-diabetes or type 2 diabetes.

So, what’s the conclusion here? Eating a diet with good quality fat and protein prevents and even reverses diabetes and pre-diabetes (diabesity). And eating sugar and refined carbs cause diabesity.

So, I encourage you to look at the issue of fat and sugar in a totally different way. Don’t cut out the fat; enjoy it! Eat good fats. Here are my favorite sources of fat:

  • Avocados
  • Nuts—walnuts, almonds, pecans, macadamia nuts, but not peanuts (one recent study showed a handful of nuts a day reduced death from all causes by 20 percent)
  • Seeds—pumpkin, sesame, chia, hemp
  • Fatty fish, including sardines, mackerel, herring, and wild salmon that are rich in omega-3 fats
  • Extra virgin olive oil (a large study showed that those who consumed 1 liter a week reduced heart attacks by 30 percent)
  • Enjoy grass-fed or sustainably raised animal products (I recommend the Environmental Working Group’s Meat Eater’s Guide to eating good quality animal products that are good for you and good for the planet).
  • You can even eat saturated fat like extra virgin coconut butter, which is a great plant-based source of saturated fat that has many benefits. It fuels your mitochondria, is anti-inflammatory, and it doesn’t cause problems with your cholesterol. In fact, it may help resolve them. I have many diabetic patients whose health improves when I get them on diet that’s higher in fat.

I was just talking to researchers from the Joslin Diabetes Center who told me that the low fat recommendations for diabetics promoted by the American Diabetic Association has in fact been harmful, bad advice making diabetes worse! Their new research shows that diabetics should be switching to a diet that’s about 30% fat, 30% protein, and about 40% low starch vegetables and fruits (carbohydrates). That turns their previous advice on its head.

So here’s the take-home message: Fat doesn’t make you fat. Sugar makes you fat. Eating good fats can actually help you stay healthy. So, eat good quality fats and real, whole, fresh food, and don’t worry about it.

Now, I’d like to hear from you. Send in your comments and share your experiences. How have you noticed fat and sugar affecting you? What happened with your cholesterol when you changed your diet? I encourage you to share this newsletter with your friends and family on Facebook and Twitter. And submit your questions so that, next week, I may make a House Call to you.


Mark Hyman, MD
Dr. Hyman is dedicated to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach called Functional Medicine. He is a family physician, a four-time New York Times bestselling author, and an international leader in his field.

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  • Roslyn O'Grady says:

    how does this work with calorie intake when trying to reduce weight?

  • Jim Cahill says:

    The other problem with the 7 country study was that it omitted 15 countries that didn’t fit the hypothesis ( http://books.google.com/books?id=Gkq4DpK3Uo0C&lpg=PA56&ots=wsS9j80j2p&dq=ancel%20keys%207%2022%20countries%20omission&pg=PA56#v=onepage&q=ancel%20keys%207%2022%20countries%20omission&f=false ). If he included all 22 countries in the data set, the correlation wasn’t even there.

  • ann-maree kotynia says:

    hi, i have been on a paleo eating plan for two months now, i have lost 4 kilos and i feel great. i have not exercised, so if i was walking like i should be my weight loss would be more significant. who would have thought eating fat would aid in losing weight. i am now a believer in eating fat and a nonbeliever in no fat diets, this is just a myth.

  • jolice hamilton says:

    I just bought a ton of organic macadamia nuts, walnuts, pecans. Brazil nuts, almonds, hemp, sprouted pumpkin seeds, chia seeds, sesame seeds , and more. I eat more avocado than you can imagine. Organ cold-press olive oil, and hemp seed oil for salad. I make my own coconut oil because im from the Caribbean. I dont eat anything that was cooked and storage by someone else (junk, refined, processed, not whole) I make my own salas dressings, cheese, ice cream. I’m a anti. GMO, I read labels like its crazy. ..anything that I can’t pronounced stays on the shelves. It it not certified organic, I dont want it. I don’t jjoke with my foods, hair products, skin care products, household items. I love fermented foods, so I do my own.

  • jolice hamilton says:

    I heard peanut butter is ok and not ok. What’s your take? What about organic peanut butter? I buy the raw almond butter. I also eat organic cashews. I make sute I spend time with weights and cardio at the gym. . I drink a good amount of teas, more so green tea. I dont eat after 6pm. I’m 51 almost and people believe I’m in my 30s… I have a 24 and a 22 year old children. .. I sleep very well at nights. ..I vegan, so im very mindful of my iron and B12. My doctor, is Aww of my lifestyle. I do a lot of teach when it come to my wellbeing. I’m happy to say my children and hubby is not doing too bad.

  • Jack Cain says:

    You’re saying that LDL is the good cholesterol and HDL is the bad cholesterol??? What’s up with that.

  • Frid Fastbø says:

    I just wonder…why are peanuts not to be included in this diet?

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