I am concerned with heart health (I am on a statin), so am I better off with grass-fed butter (paying attention to portion control) or a "Smart Balance" type, trans-fat-free margarine? -- Greg (last name withheld)
(city withheld), IA
In your case, I highly recommend using a trans-fat-free margarine (or a vegetable oil-based spread, like Smart Balance) fortified with phytosterols.
Clinical trials have shown that adding 2 grams of phytosterols a day to the diets of patients on statins results in lower total cholesterol levels than statins alone.
Each tablespoon of Smart Balance provides 80 calories and 0.5 grams of phytosterols. This means it takes 320 calories to get your suggested phytosterol intake.
I mention this because it is important to remember that waist circumference is the best predictor of heart disease risk.
Bottom line -- you still need to be mindful of calories, no matter what type of fat you are spreading on your toast.
I have come across a fair number of people who inaccurately think the 20 or 30 extra pounds they are carrying on them are no longer a threat to their health since they are on statins. Not so!
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My dad has heart disease, and his nutritionist said he should not use Earth Balance because it contains palm fruit (i.e., palm oil). She instead recommends those spray bottles of fake butter. Seems to me like that's recommending a bunch of fake chemicals instead of a naturally derived product with modest amounts of saturated fat (and no trans fat).
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