- Saturated fats American Heart Association
- Siri-Tarino PW et al, 2010, Saturated Fatty Acids and Risk of Coronary Heart Disease: Modulation by Replacement Nutrients PubMed Central
- Grundy SM, 1994, Influence of stearic acid on cholesterol metabolism relative to other long-chain fatty acids The American Journal of Clinical Nutrition
- Hunter JE et al, 2010, Cardiovascular disease risk of dietary stearic acid compared with trans, other saturated, and unsaturated fatty acids: a systematic review The American Journal of Clinical Nutrition
- Mensink RP et al, 2003, Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials The American Journal of Clinical Nutrition
- Denke MA et al, 1992, Comparison of effects of lauric acid and palmitic acid on plasma lipids and lipoproteins The American Journal of Clinical Nutrition
- Ascherio A et al, 1996, Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States PubMed Central
- Chu-Sing K, Comments on draft document: Diet, nutrition and the prevention of chronic diseases World Health Organization
- Kabagambe EK et al, 2005, The Type of Oil Used for Cooking Is Associated with the Risk of Nonfatal Acute Myocardial Infarction in Costa Rica The Journal of Nutrition
- Mozaffarian D et al, 2010, Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials PubMed Central
- What is the effect of saturated fat intake on increased risk of cardiovascular disease or type 2 diabetes? USDA Nutrition Evidence Library
- Crupkin M et al, 2008, Detrimental Impact of Trans Fats on Human Health: Stearic Acid-Rich Fats as Possible Substitutes Wiley Online Library
- Calcium Linus Pauling Institute
- What Is the DASH Eating Plan? National Heart Lung and Blood Institute
- Hooper L et al, 2012, Cutting down or changing the fat we eat may reduce our risk of heart disease Cochrane Summaries
- Ness A et al, 2001, Milk, coronary heart disease and mortality PubMed Central
- Elwood PC et al, 2004, Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies PubMed
- Elwood PC et al, 2005, Milk consumption, stroke, and heart attack risk: evidence from the Caerphilly cohort of older men PubMed Central
- Tavani A et al, 2002, Milk, dairy products, and coronary heart disease PubMed Central
- Cardiovascular disease and diet Cancer & Diet
- Holmberg S et al, 2009, Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up International Journal of Environmental Research and Public Health
- What is the relationship between the intake of milk and milk products and cardiovascular disease? USDA Nutrition Evidence Library
- De Biase SG et al, 2007, Vegetarian diet and cholesterol and triglycerides levels Scientific Electronic Library Online
- Tokede OA et al, 2011, Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis PubMed
- Rees K et al, 2013, Mediterranean diet for the prevention of cardiovascular disease Cochrane Summaries
- Micha R et al, 2010, Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence PubMed Central
- What is the effect of saturated fat intake on increased risk of cardiovascular disease or type 2 diabetes? USDA Nutrition Evidence Library
- What are the effects of dietary stearic acid on LDL cholesterol? USDA Nutrition Evidence Library
- Hooper L et al, 2001, Dietary fat intake and prevention of cardiovascular disease: systematic review The BMJ
- 2002, Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Circulation
- Dietary fats: Total Fat and Fatty Acids US Department of Agriculture
- Evidence Analysis Library Division, Center for Nutrition Policy and Promotion, US Department of Agriculture, 2014, A Series of Systematic Reviews on the Relationship Between Dietary Patterns and Health Outcomes USDA Nutrition Evidence Library
- Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease PubMed
- Chowdhury R et al, 2014, Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis Annals of Internal Medicine
- Hoenselaar R, 2011, Saturated fat and cardiovascular disease: The discrepancy between the scientific literature and dietary advice Nutrition
- Huth PJ et al, 2012, Influence of Dairy Product and Milk Fat Consumption on Cardiovascular Disease Risk: A Review of the Evidence Advances in Nutrition
- Ding EL et al, 2006, Chocolate and Prevention of Cardiovascular Disease: A Systematic Review Nutrition & Metabolism
- Elwood PC et al, 2010, The Consumption of Milk and Dairy Foods and the Incidence of Vascular Disease and Diabetes: An Overview of the Evidence PubMed Central
- Palazhy S et al, 2012, Composition of plasma and atheromatous plaque among coronary artery disease subjects consuming coconut oil or sunflower oil as the cooking medium PubMed
- Kumar PD, 1997, The role of coconut and coconut oil in coronary heart disease in Kerala, south India PubMed
- Chen BK et al, 2011, Multi-Country analysis of palm oil consumption and cardiovascular disease mortality for countries at different stages of economic development: 1980-1997 PubMed Central
- Schwab U et al, 2014, Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review PubMed Central
- Risérus U et al, 2009, Dietary fats and prevention of type 2 diabetes PubMed Central
- Fattore E et al, 2014, Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials PubMed
- Micha R et al, 2013, Processing of meats and cardiovascular risk: time to focus on preservatives PubMed Central
- Kaluza J et al, 2014, Processed and Unprocessed Red Meat Consumption and Risk of Heart Failure Circulation: Heart Failure
- Okullo JBL et al, 2010, Physico-chemical characteristics of shea butter (Vitellaria paradoxa C.F. Gaertn) oil from the shea districts of Uganda African Journal of Food, Agriculture, Nutrition and Development
- Takata Y et al, 2013, Red Meat and Poultry Intakes and Risk of Total and Cause-Specific Mortality: Results from Cohort Studies of Chinese Adults in Shanghai PubMed Central
- List of foods high in saturated fat US Department of Agriculture
- Brunzell JD, 2005, Increased ApoB in Small Dense LDL Particles Predicts Premature Coronary Artery Disease Atherosclerosis, Thrombosis and Vascular Biology
- Lamarche B et al, 1999, The small, dense LDL phenotype and the risk of coronary heart disease: epidemiology, patho-physiology and therapeutic aspects PubMed
- Hoogeveen RC et al, 2014, Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study PubMed
- Ya-Ching Huang et al, 2013, Association of Small Dense Low-density Lipoprotein Cholesterol in Type 2 Diabetics with Coronary Artery Disease Biomedical Journal
- Siri PW et al, 2005, Influence of dietary carbohydrate and fat on LDL and HDL particle distributions PubMed
- Meyer BJ et al, 2013, Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinaemia in the third trimester PubMed Central
- Tchernof A et al, 1996, The dense LDL phenotype. Association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men PubMed
- Faghihnia N et al, 2012, Effects of dietary saturated fat on LDL subclasses and apolipoprotein CIII in men PubMed Central
- Williams PT et al, 2003, Smallest LDL Particles Are Most Strongly Related to Coronary Disease Progression in Men Atherosclerosis, Thrombosis and Vascular Biology
- Campos H et al, 1994, LDL particle size distribution, results from the Framingham offspring study Atherosclerosis, Thrombosis and Vascular Biology
- Siri-Tarino P et al, 2009, Reversal of Small, Dense LDL Subclass Phenotype by Normalization of Adiposity PubMed Central
- Dreon DM et al, 1998, Change in dietary saturated fat intake is correlated with change in mass of large low-density-lipoprotein particles in men The American Journal of Clinical Nutrition
Saturated Fatty Acids
What are saturated fatty acids?
Saturated fatty acids (SFA) have all carbon atoms saturated with hydrogen atoms, so they contain no double bonds.
Examples of saturated fatty acids (with a number of carbon atoms):
- Short-chain fatty acids: acetic (C2), propionic (C3), butyric (C4) and valeric acid (C5)
- Medium-chain fatty acids: caproic (C6), caprylic (C8), capric (C10) and lauric acid (C12)
- Long-chain fatty acids: myristic (C14), palmitic (C16), stearic (C18), arachidic (C20) and behenic acid (C22)
Saturated fatty acids in combination with glycerol form saturated fats (triglycerides).
Chart 1. Foods High in Saturated Fats
Saturated Fats (grams)
|Cheeseburger (250 g)||20|
|Pizza, pepperoni (430 g)||20|
|Beef (3 oz, 85 g): rib, brisket naval, ground meet||10-12|
|Cheese (2 oz, 57 g): brick, cheddar, colby, edam, gouda, monterey, muenster, pimento, provolone, Swiss||10-12|
|Hamburger (250 g)||11|
|Lamb (3 oz, 85 g)||11|
|Milk: sheep, Indian buffalo (1 cup, 237 mL)||11|
|Ice cream, vanilla (1/2 cup, 107 g)||11|
|Blood sausage (3 oz, 85 g)||11|
|Bacon (2 oz, 57 g)||8|
|Cheese: American, feta, mozzarella (2 oz, 57 g)||8|
|Duck, domesticated, meat and skin (3 oz, 85 g)||8|
|Cream, fluid, heavy whipping (1 oz, 30 mL)||7|
|Butter, regular and clarified (ghee) (1 tbsp, 14 g)||7|
|Beef, tenderloin, top sirloin, chuck under blade (3 oz, 85 g)||7|
|Pork, shoulder, ham ( 3 oz, 85 g)||6|
|Salami, pork (50 g)||6|
|Goose, domesticated, meat and skin (3 oz, 85 g)||6|
|Milk, cow, whole, 3.25% fat (1 cup, 237 mL)||5|
|Chocolate, milk (1 oz, 28 g)||5|
|Lard, beef tallow (1 tbsp, 13 g)||5|
|Sausage, berliner (3 oz, 85 g)||5|
|Oil (1 tbsp, 14 g): fish oil, menhaden||4|
|Oil (1 tbsp, 14 g): babassu, coconut, palm kernel||11-12|
|Coconut meat (1 oz, 28 g)||8|
|Palm oil (1 tbsp, 14 g)||7|
|Coconut milk (1 fl oz, 30 mL)||6|
|Brazilnuts (1 oz, 28 g)||5|
|Doughnut (85 g)||5|
Chart 1 source: USDA.gov 
Meats Low in Saturated Fat
Meats low in saturated fat (<2 g/85 g) include turkey and chicken breast without skin, kangaroo, ostrich, goat, bison (buffalo) and certain beef cuts, like top sirloin and round, and and pork cuts, like sirloin .
Most fish and other seafood, eggs, nuts, seeds and vegetable oils (except coconut, palm and palm-kernel oil) contain less than 2 grams of saturated fat per serving (3 oz meat or fish, 1 oz nuts, 1 tbsp oil or margarine) . Most fruits, vegetables and legumes are low in fat and saturated fat .
The Effect of Specific Saturated Fatty Acids on Blood Lipids
Excessive intake of saturated fats may raise the blood levels of total and LDL (“bad”) cholesterol and triglycerides and thus increase the risk of coronary heart disease and stroke [1,11,31]. Diet high in saturated fats can result in very different blood lipid changes in different individuals, though . Weight loss of even few pounds reduces LDL cholesterol levels regardless of the diet composition [31-V8].
Bellow are common saturated fatty acids arranged by their cholesterol-raising effect (from lowest to highest):
- Stearic acid (the main saturated fatty acid in shea butter , cocoa butter and dark chocolate , also abundant in beef tallow, lard and milk fat) intake results in a lower raise of total and LDL cholesterol than other saturated fatty acids; its effect on blood cholesterol levels is comparable with unsaturated fats; it decreases total/HDL cholesterol ratio [3,4,5,12,29] and less likely causes the formation of blood clots than other saturated fatty acids .
- Lauric acid (in coconut milk, meat and oil, and palm-kernel oil) raises total, HDL and LDL cholesterol but increases HDL more than LDL, so it decreases total/HDL cholesterol ratio [3,5,6].
- Myristic acid (in butter, coconut oil, palm-kernel oil) raises total and LDL cholesterol [3,5].
- Palmitic acid, the most abundant saturated fatty acid in the human diet (in meats, dairy, palm oil) raises total, LDL and HDL cholesterol and slightly raises total/HDL cholesterol ratio [3,5].
- In one study, palmitic acid increased blood cholesterol levels only in individuals who already had increased total cholesterol levels (>225 mg/dL) and who consumed more than 400 mg of cholesterol per day, but not in individuals with normal blood cholesterol levels who consumed less than 300 mg of cholesterol per day .
- On the World Health Organization (WHO) website, Dr. Chu-Sing lists various studies in which the intake of palm oil, which is high in palmitic acid, did not raise the total and LDL cholesterol, but raised HDL cholesterol levels .
High blood levels of small, dense LDL particles (LDL IV) [51,52,53,54,59] have been associated with increased risk of coronary heart disease.
Factors that increase blood levels of small, dense LDL particles [55,56,57]:
- Genetic factors
- Obesity and insulin resistance
- Diet low in saturated fats and cholesterol was associated with small dense LDL particles in some individuals .
Factors that decrease blood levels of small, dense LDL particles:
- Weight loss 
- Diet high in fat and saturated fat increases blood levels of apolipoprotein III, which is a risk factor for cardiovascular disease  but decreases the levels of small dense LDL particles .
The Effect of Replacing Saturated Fats with Other Macronutrients
- Replacing some of the saturated fats in the diet with polyunsaturated or monounsaturated fats decreases blood levels of total and LDL cholesterol [2,43].
- Replacing saturated fats with carbohydrates decreases both LDL (especially small-size LDL) and HDL cholesterol, and increases triglyceride levels and does not lower the risk of coronary heart disease .
The Effects of Various Foods or Dietary Pattern on Blood Lipid Levels
- In one study, vegans and ovo-lacto vegetarians had lower blood levels of total and LDL cholesterol and triglycerides than meat eaters .
- According to one 2011 meta analysis, dark chocolate and cocoa in amounts that do not exceed the recommended daily calorie intake reduce total and LDL cholesterol and do not affect HDL cholesterol and triglyceride levels .
- In one 2014 systematic review, palm oil, which is high in saturated palmitic acid, was associated with higher total and LDL cholesterol levels than mono- and polyunsaturated fats, but not in young adults and in those with relatively low-fat diets .
The Effect of Saturated Fats on Heart Disease and Stroke
According to several systematic reviews of studies, high intake of saturated fats is associated with increased risk of coronary heart disease [11; 31-V8; 32-p.485], and replacing some of saturated fats with either polyunsaturated fats [2,27,43] or both mono- and poly-unsaturated fats is associated with decreased risk [10,15,26,28]. Replacing saturated fats with carbohydrates does not seem to be associated with a decreased risk of coronary heart disease [2,15].
American Heart Association recommends limiting saturated fats intake to 7% of total calorie intake (up to 16 g saturated fats a day in a 2,000 calorie diet) .
However, according to other systematic reviews, there is insufficient evidence about saturated fats as a risk factor for coronary heart disease [2,30,34,35,36] or stroke .
In the Health Professional Follow-Up Study (1986-1992), high saturated fat intake was associated with increased risk of heart disease only when it was combined with low dietary fiber intake; high saturated fat intake alone was not associated with heart disease .
The Effects of FOODS High in Saturated Fats on Heart Disease
- According to a 2013 Cochrane review of randomized clinical trials, there is a limited evidence that a Mediterranean diet (a diet with a high monounsaturated/saturated fat ratio, high amount of legumes, cereals, fruit and vegetables, moderate consumption of red wine and dairy products, low consumption of red meat and increased consumption of fish) reduces some of the risk factors of cardiovascular disease .
- There is a limited evidence that vegetarian diet, which is usually low in saturated fats, is associated with lower risk of ischemic heart disease [33-p.4].
- There is conflicting evidence about the effect of red meat (beef, pork) intake on heart disease: from inconsistent evidence [33-p.4] to increased risk associated only with processed but not unprocessed red meat [46,47] and increased risk of death from heart disease only in men .
- There seems to be no significant correlation between dairy products [37,39] or, specifically, milk [16,17,18], cheese  or butter  consumption and chronic heart disease. A study running in Sweden for 14 years has revealed that rural men whose diets were high in both fruits/vegetables and milk products had less coronary heart disease than those who ate a lot of fruit/vegetables but few milk products . Another review of studies has shown an association between high dairy consumption and decreased incidence of heart attack and stroke . The DASH (Dietary Approaches to Stop Hypertension) eating plan, which includes diet low in saturated and trans fats and high in potassium, calcium and magnesium, was associated with decreased risk of high blood pressure; the drop of blood pressure was greater when dairy was added to the diet [13,14].
- Chocolate intake may not increase the risk of cardiovascular disease .
- In one 2005 study in Costa Rica, consumption of palm oil was associated with increased risk of heart attack . In one multi-country study, consumption of palm oil was associated with increased mortality due to coronary heart disease . Note that association does not already mean a cause-effect relationship.
- In one 2012 study in individuals from Kerala/India who underwent coronary artery bypass surgery, consuming coconut oil, high in saturated myristic acid, or sunflower oil, high in polyunsaturated linoleic acid did not result in different plaque composition . In another small study in Kerala/India, consumption of coconut oil was not associated with coronary heart disease .
The Effect of Saturated Fats on Blood Glucose and Diabetes Mellitus Type 2
There is a CONFLICTING EVIDENCE about the association of saturated fats intake and diabetes mellitus type 2:
- According to a 2010 systematic review published in USDA Nutrition Evidence Library, there is a strong evidence about association between the intake of saturated fats and increased risk of diabetes type 2 . Replacing as little as 5% energy from saturated fatty acids by monounsaturated (MUFA) or polyunsaturated fatty acids (PUFA) may decrease insulin resistance and the risk of diabetes mellitus type 2 .
- According to one 2009 review of clinical trials, replacement of saturated fats with mono- or polyunsaturated fats increases insulin sensitivity .
- According to the US Department of Agriculture, there is a mixed evidence about the association between saturated fat intake and diabetes 2 [32-p.484].
- FATTY ACIDS
- Alpha-linolenic acid (ALA)
- Eicosapentaenoic (EPA) and Docosahexaenoic acid (DHA)
- Arachidonic acid (AA)
- Linoleic acid
- Conjugated linoleic acid (CLA)
- Short-chain fatty acids (SCFAs)
- Medium-chain fatty acids (MCFAs)
- Long-chain fatty acids (LCFAs)
- Very long-chain fatty acids (VLCFAs)
- Hydrogenated starch hydrolysates (HSH)
- Fructo-oligosaccharides (FOS)
- Galacto-oligosaccharides (GOS)
- Human milk oligosaccharides (HMO)
- Isomalto-oligosaccharides (IMO)
- Mannan oligosaccharides (MOS)
- Raffinose, stachyose, verbascose
- SOLUBLE FIBER:
- Acacia (arabic) gum
- Beta mannan
- Carageenan gum
- Carob or locust bean gum
- Fenugreek gum
- Gellan gum
- Glucomannan or konjac gum
- Guar gum
- Karaya gum
- Psyllium husk mucilage
- Resistant starches
- Tara gum
- Tragacanth gum
- Xanthan gum
- INSOLUBLE FIBER:
- Chitin and chitosan
- Aspartic acid
- Glutamic acid
- Vitamin A - Retinol and retinal
- Vitamin B1 - Thiamine
- Vitamin B2 - Riboflavin
- Vitamin B3 - Niacin
- Vitamin B5 - Pantothenic acid
- Vitamin B6 - Pyridoxine
- Vitamin B7 - Biotin
- Vitamin B9 - Folic acid
- Vitamin B12 - Cobalamin
- Vitamin C - Ascorbic acid
- Vitamin D - Ergocalciferol and cholecalciferol
- Vitamin E - Tocopherol
- Vitamin K - Phylloquinone
- Flavanols: Proanthocyanidins
- Flavanones: Hesperidin
- Flavonols: Quercetin
- Flavones: Diosmin, Luteolin
- Isoflavones: daidzein, genistein
- Caffeic acid
- Chlorogenic acid
- Tannic acid
- Alcohol chemical and physical properties
- Alcoholic beverages types (beer, wine, spirits)
- Denatured alcohol
- Alcohol absorption, metabolism, elimination
- Alcohol and body temperature
- Alcohol and the skin
- Alcohol, appetite and digestion
- Neurological effects of alcohol
- Alcohol, hormones and neurotransmitters
- Alcohol and pain
- Alcohol, blood pressure, heart disease and stroke
- Women, pregnancy, children and alcohol
- Alcohol tolerance
- Alcohol, blood glucose and diabetes
- Alcohol intolerance, allergy and headache
- Alcohol and psychological disorders
- Alcohol and vitamin, mineral and protein deficiency
- Alcohol-drug interactions
- Moderate, heavy, binge drinking
- Alcohol intoxication
- Alcohol poisoning
- Alcohol and gastrointestinal tract
- Alcoholic liver disease
- Long-term effects of excessive alcohol drinking
- Alcohol craving and alcoholism
- Alcohol withdrawal