- Is butter really that bad for you? We've all heard that swapping out saturated fat for unsaturated fat may be helpful, but a new study is making ways by directly comparing butter to plant-based oils. Which fat should you be adding to your shopping cart? That's exactly what we're gonna break down today. We'll dive into the science, separate fact from fiction, and give you a clear takeaway you can use in your kitchen. Welcome back, everybody, to the Building Life on Anthese podcast. Thanks so much for stopping by. We haven't met yet. My name is Jordan Wernicke. I'm a dual board certified physician in family and sports medicine. And the goal of this podcast is to help keep you active and healthy for life through actionable and in support of education. Today we're looking at a study that's diving into the topic of butter versus plant oils. No controversy here, I'm sure. Let's get started. So first, what is the study in the background here? Well, the article's looking at a study that was reviewed in 2025 in GM Internal Medicine, so a big one, and examines the link between dietary fats and mortality risk. And for a little bit of historical context, people say that replacing saturated fats in your diet with unsaturated fats is generally accepted as heart healthy. And this study compares specifically looking at butter versus other plant-based oils. So previous butter research has been inconsistent. A lot of times we have associate associative ones, meaning, hey, we look at longitudinal studies, people who ate butter tend to have more outcomes, but we really looking at comparators, right? They weren't really comparing to healthier options. So this study directly compares butter to various plant-based oils over a long period focusing on mortality outcomes. And what's going on in study design? Well, this was still a cohort, right? So I do wanna step back. This is not intervention. So this is not saying, hey, we're gonna take butter here and swap it out there. So this was still a cohort-based study. So hang with me here. They did look at multiple cohorts though. They're all healthcare practitioners, whether they're nurses or whatnot, that's a big one. There were over 221,000 health professionals. And if you had a preexisting medical condition, you were excluded. So that's the big thing. You couldn't have preexisting condition, which is nice. So we're looking at once again, a healthy population and the follow-up was awesome. It was like over 98%. And for a dietary assessment, they did use food frequency questionnaires, everyone's favorite food frequency questionnaires. And they gave them every four years in the study. So every four years they were saying, yeah, this is how I ate for the past four years. So like spoiler alert, that's a huge limitation to this study, but that's what they did. That's how they did it. So they looked at and they collected this food frequency questionnaires over looking at 130 food items, including specific fats and oils. For butter intake, they looked at butter or margarine blends, which once again, they kind of didn't separate those, which could be an issue, immediate limitation there. I looked at spreadable butter, butter used in baking, serving size of butter was like five grams. And for plant-based oil intake, they looked at things like corn oil, safflower, soybean, canola, and olive oil. And they estimated a lot of times based on brand, cooking type and salad dressings. And yeah, that's kind of what they did is kind of how they looked at that. And they also had a, overall, they assessed the quality of the diet using the alternative healthy eating index, which calculated the overall diet quality. And then from a mortality assessment, they just looked to see how many people died, looking at state records, national death index, all that stuff. And when they were doing the stats, they adjusted for a lot of things. So here are a non-exhaustive, looked at age, total energy intake, adjustment for butter, plant-based oil intake, mayonnaise consumption, menopausal status, hormone use, race, BMI, alcohol intake, smoking, physical activity, lots and lots of things. So that's kind of a lot of factors they're trying to make sure that they're isolating for and making sure that they didn't confound. And the funding, this study was primarily founded by the NHI or NH, I'm sorry, National Institute of Health. And so pretty much a government funding, although there was one person on the Dried Nut and Fruit Council, but they reiterated that their lack of involvement in the study's design and execution. So the Dried Fruit and Nut Council didn't know it was a thing, but there we go. Overall, government funded by the NH. So looking at the butter and mortality, what did we find? Well, this study found that participants with the highest intake of total butter had a 15% higher risk from dying from any cause. So total mortality, compared to those people who had the lowest intake of butter. And this association was statistically significant with a hazard ratio of 1.15. And once again, these are relative risks. So relative versus absolute, they are a little different in terms of the magnitude. So these are 15% relative risk, which the way I explain relative versus absolute is, relative can sometimes make it seem like the huge number without actually being clinically important versus absolute actually is. So relative, you could say, hey, like if we have a certain amount of people, only five people in this study and something happens to them, then like, you know, let's say five people get something and then also another person does, like, well, shoot, that's almost like a 20% increase in what's going on. Whereas in reality, it's like, okay, these five people had this out of thousands and the absolute goes from five to six, it may not worry. So long story short, relative risk, I don't worry too much about that, but it is what they use here to market. So it's worth mentioning. There was also associations with specific causes of death. So higher butter intake was specifically linked to an increased risk of cancer mortality. For every 10 grams increased intake of butter, there was a 12% high risk of dying from cancer, which is interesting, but interestingly enough, the study did not find any statistically significant link between higher butter intake and cardiovascular disease in mortality, which is fascinating, right? That's the big thing is butter increases saturated fat and that increases LDL and that increases cardiovascular disease. Well, they didn't see necessarily in this paper that that's the reason people were dying. They did look for a dose response relationship as well, though, and they found that the association between butter intake and total mortality showed a statistically significant trend, meaning that as butter consumption increased, the risk of death also progressively increased. So the more butter you ate, the risk of dying also increased as well. And what about the different ways to consume butter, right? Butter, there's many ways to consume butter. If you're like me, fat Jordan back in the day when I was a kid, I literally would see butter off the stick of butter. I'd just go in the cabinet, which my parents kept it in the cabinet, which is interesting, and I'd just go there and I'd just eat it. So, you know, hey, we all gotta start somewhere, right? That was my health journey, but there's many ways to consume butter. I'm an expert in knowing that, but it could affect how the outcomes are actually. So butter added directly to food or bread, excluding cooking, was associated with 4% high risk of mortality for every five grams per day increase. And these findings remain consistent even after adjusting for white bread intake and glycemic load. So pretty much saying like, it's only from the butter is what they were saying. However, in contrast, butter used at home in baking and frying did not show a statistically significant association with total mortality. And the authors said, ah, we're not sure. Maybe this is due to the fact that you use much less butter in cooking or variable amounts. They weren't entirely sure, but they found that if you were cooking with it or baking with it, not as a big deal. Whereas if you're eating it straight up, like young Jordan, turns out probably not that great for you. So that's one finding that they had there. Next, looking at the plant-based oils now in mortality. So what they found is that participants with the highest intake of total plant-based oils had a 16% lower risk of total mortality compared to those with the lowest intake. So once again, this is not necessarily straight up butter comparison yet. We'll talk about that. They're saying if you ate more plant oils, you tend to be better than if you ate fewer of them. Looking at plant or specific plant-based oils, the study identified statistically significant inverse association between the intake of specific plant-based oils and mortality. So once again, the more you ate of the oil, the lower chance you had of mortality. So canola oil, they did look at each five grams per day was shown with a 15% lower risk of death. Soybean oil, once again, each five gram per day increase was associated with a 6% lower risk. Olive oil, each five gram increase per day was an estimated 8% lower risk of total mortality. However, interesting enough, the study did not find statistically significant association between corn oil or safflower or in the total mortality. Maybe there's just lower consumption. They're not as common. Who knows, but they didn't see that. And from a dose-response relationship perspective, similar to butter, the relationship between total plant-based oil intake and total mortality was statistically significant trend, but in the opposite direction, meaning as intake increased, the risk of death decreased. So that's kind of what it is. And they also looked at some benefits of plant-based oils, excluding olive oil, right? So even when excluding olive oil from their analysis of total plant-based oils, a higher intake of remaining oils still led to a low risk of total mortality. Comparing the highest and lowest intake, there was a 8% lower mortality risk. And this is kind of nice. I think this is a cool way of doing that 'cause everyone talks about olive oil, right? It's like the magic Mediterranean diet. People are just like guzzling down olive oil, who knows? You know, that's not necessarily the case, but even taking that out seems to be that, hey, other oils did not show this huge increase in death and actually had a little benefit as well. And looking at cost-specific mortality in these oils, higher intake of total plant-based oils was associated with a lower risk for both cancer and cardiovascular disease and mortality. So for every 10 gram per day increase in total plant-based oils, there was an 11% lower risk of dying from cancer. For every 10 gram per day increase, there was a 6% lower chance of dying from cardiovascular disease. And specifically olive oil, canola oil, and soybean oil were linked to lower risks of cancer mortality and olive oil was also linked to lower risk of cardiovascular mortality. So once again here, they tended to show that the more oil you consumed in your diet, that you had a lower chance of dying is what it came down to. And once again, remember where this came from. This is food frequency questionnaires. People saying, "Hey, I ate this and this is a typically at least salad." So like how much they're actually eating, I don't know. That's a good question, but we'll kind of go from there. But that's what they found so far. So next let's talk about the power of substitution, right? So butter versus plant-based oil. So this is a big one. The substitution analysis, this is where we're looking directly like, hey, if we were to swap out this for that, what happens? And the substitution analysis revealed that replacing just 10 grams, approximately two teaspoons or about two five gram pats of butter, if you replace 10 grams per day with the same amount of total plant-based oil, it was associated with a substantial 17% reduction in the risk of mortality. Once again, relative risk, but reduction there nonetheless. And similarly, replacing 10 grams of butter daily with total plant-based oil was linked to 17% reduction in the risk of cancer mortality. And while there was observed a 6% reduction in cardiovascular disease mortality associated with the same substitution, the finding was not statistically significant. So once again, we saw an overall in cancer, but not necessarily in cardiovascular disease mortality, which is interesting, right? A lot of people think, hey, if I'm replacing butter, why wouldn't that necessarily improve my cardiovascular health? Great question, not sure, but that's what they found here. And they did this study also examined the impact of replacing a butter with specific types of plant-based oils. So substituting 10 grams of butter per day with plant oils, excluding olive oil, so not looking at olive oil, results in an estimated 17% reduction in total mortality and 18% reduction in cancer mortality. So looking at those, so once again, 17 down in mortality and 17 down in cancer, that's great. Soybean oil results in an estimated 15% reduction in total mortality and 17 in cancer. Olive oil results in an estimated 19% reduction in total mortality and a 16% reduction in cancer mortality. So overall substituting butter with specific plant-based oils showed a trend towards lowering cardiovascular disease as well, but they were not significant. So overall though, replacing pretty much butter with any of the plant oils seem to improve your chances of dying from cancer or overall just dying. That seems to be the general results here, which I thought was really, really interesting. And what do we make of this, right? How, what does this mean? Who knows what, but the findings do support the dietary guidelines recommending replacing saturated fats with unsaturated fats. What's the mechanism? No idea, no idea though, you know, could there be something going on when you eat and treat increased saturated fats that's linked to inflammation, who knows? No idea, once again, it's an associative study. Everyone's just kind of getting there. Some interesting things as well is that the lack of association between butter and baking and frying in mortality might be due to lower or less, you know, more variable amounts, meaning they're not quite sure how much you put in there. People underestimate it, not necessarily sure. Why is it though that when we see this swap out, we have a benefit? Also not sure on that. Maybe it's due to the unsaturated fat intake, you know, the monounsaturated fats in olive oil, linoleic acid, or omega-6 in soybean and canola oil. Study emphasizes though that we're not sure, but overall it seems that they tend to have an improvement there. And daily small substitutions of butter with plant-based oil could have a potentially significant long-term positive impact for people. That's like what we're looking at. But before we jump into that, let's talk about some limitations, right? So everyone's gonna say this study's garbage, it doesn't count. And then once again, I'm just reporting what the study shows. And I think all that is helpful. It's just the lens you look at, right? So first and foremost, reliance on self-reported dietary data. As with any study using food frequency questionnaires, there's a lot of potential for measurement error in the reported dietary intake, right? So participants may not accurately recall or even like report the amount of butter or plant-based oils they're eating. They may get it grossly wrong. And yeah, the authors do acknowledge that such errors tend to underestimate associations. However, yeah, they tried their best to control that, but food frequency questionnaires, once every four years, like every four years, like, oh, hey, the way I eat now compared to four years ago, like that's so different. And even now way now compared to last year is different. So to kind of have just like four year aliquots of me and just like time, like, okay, this is how I eat, that's a huge problem to me. But once again, I don't know how you measure it over the huge time like this. So I'm props to the people who did this, but that's a definitely an issue one. Anytime you see these studies as well, there's also potential for reverse causation, right? Although the researchers try their best and took steps to kind of exclude participants with chronic diseases or anything like that, it's really, really hard that there could be individuals who might have altered their diets in the years before some sort of diagnosis, which could affect the observed association. So yeah, reverse causation, meaning, hey, is this diet causing that or vice versa? It's very, very hard to tell with an observational study and kind of a cohort one. Also, as I mentioned before, possibly misreporting. Yeah, it could easily have misreported the intake on butter, what they're doing there. Also, we see confounding is gonna always happen, right? We try our best to limit for this and they've done a great job. They tried to literally everything. They tried to adjust as much as we can for a pretty comprehensive list of potential confounders, but there's always a chance that there's some unmeasured or unknown factor that could influence both diet and mortality risk leading to residual confounding, meaning, hey, it's not the dietary changes that led to their improvement, it was something else. Also, there's limited generalizability with this. It was health professionals who tend to have, we think, a little higher literacy. So does that affect things as well in terms of the substitutions they make, making other healthy eating patterns or healthy decisions in life? Who knows? Also, it's predominantly white health professionals, so that's hard to extrapolate to other people. Also, the challenge in assessing the specific uses of butter, right? So the study found different associations with mortality on how butter is used, meaning adding it to food or bread versus using it in baking. And the lack of statistically significant association of mortality for butter used in baking and frying might be due to relatively small quantities and less frequent use, but we're not sure. It could just be because we misreported it, lots to know. So that's just a couple of them. I kind of go through that. There's a lot of issues and it's not to have, once again, take away from the study, but just, hey, these are the limitations we have when we don't have an interventional thing. So once again, they did not say, hey, we are looking at you at time point A, following you and going there. That's not what happened. So I do wanna talk about putting it all together. So what does this mean from a clinical perspective? You're saying, Jordan, cool, this is another study that makes me more confused. What does it actually mean? Well, first things first, this doesn't prove anything, right? This is an associative study. It can't prove anything. It's not, can't prove anything's causal here. You can't prove that. Swapping out butter for some plant oil is definitely gonna make your heart healthier. But I think the biggest thing I wanted to talk about this today specifically is 'cause the internet goes bananas, right? Anytime you mention a plant oil, olive oil, avocado oil, seed oil, canola oil, it's just like, literally you're telling, it's like you're consuming poison for some people. It's like, oh my gosh, you are literally poisoning yourself. And I view this as more of a piece of evidence that maybe plant and seed oils aren't poison like people will have you believe, right? Like we have these people who made these swaps out and they didn't magically die. And the studies show that actually maybe they had a little bit better in terms of mortality. So who knows what. But lots and lots of limitations with the self-reported studies. So I take everything with a grain of salt. Once again, I think this is a helpful study 'cause a lot of people are saying, I don't know what to eat, man. Like I get the comments on YouTube channel, like, oh cool, it's another study. I don't know what to eat. I'm telling you like, you probably can eat a lot of things, a wide variety of things and still be okay. Everyone's gonna be different too. So what you may respond worse to better than other people. You may respond better to olive oil than other people. I don't know. And we won't know until we check and everything can be personalized. But I just wanted to get this out there to say, hey, this is another one I saw and I see that and people aren't just dropping dead. When they ate like these crazy, you know, crazy bad canola or safflower oil or things that are apparently literally liquid poison and they didn't die and actually may have had some improved outcomes. To me that's saying, okay, maybe we can include those in our diet. Like maybe you're not gonna just like spontaneously combust if you have a tablespoon of that on something. And that's more of, I just wanted to give you permission to like, hey, it's okay. Like you're gonna be okay as long as once again, you know, the overall health promoting diet, I think that's gonna be the biggest thing. And so you may ask, well, Jordan, what are you changing from this specific study? And nothing really. As always one study really shouldn't change your mind. You know, there are definitely groundbreaking and practice changing articles and this is not one of them. Yeah, I think it's a cool article and talked about it, but it does fall in line with a lot of the previous research. So it kind of confirms things saying, okay, yeah, like, you know, when we swap out saturated fat for something else, we may have some benefits from it. And at this point, I'm even just willing to say, we may have benefit from it, but we don't just magically die. You know, it's not like it's automatically the worst thing in the world for you like some people have you believe. But that's gonna be it for today. Thank you so much for stopping by. If you did like this though, it would mean the world to me. If you either liked the video on YouTube, subscribe on your podcast feed of choice, or if you share with a friend, that would really, really mean the world to me. But we are done now. Now get off your phone and get outside, have a great rest of your day. We'll see you next time.
