The real association between butter and heart disease in Sweden


The outdated fear-mongering propaganda claiming that a dramatically increased butter consumption in Sweden has also increased the incidence of heart disease is once again crushed by reality.

New statistics from The Swedish National Board of Health and Welfare show the exact opposite. The incidence of heart attacks in Sweden keeps plummeting, for both men and women, just as they have done since 2005. We are becoming healthier, despite eating more and more butter.

The Swedish National Board of Health and Welfare: Fewer people suffer heart attacks (statistics 1988-2012, Google translated)

As modern science time and time again has shown that a low-fat diet doesn’t do anything good for heart health, nobody should be surprised. But there are definitely people that need to update their knowledge.

Above is the butter consumption in Sweden (yellow line) in relation to statistics on heart disease (blue + purple). The axis for butter consumption is to the right.

The Swedish butter consumption just keeps going up, while the incidence of heart attacks keeps going down.

So, what’s the correlation between butter consumption and heart disease? None. There is no correlation.

That the old theory on saturated fat and heart disease has been a mistake has already been proven in high quality studies (RCT). This is just a telling illustration.

Fear of butter is as scientifically well-founded as fear of monsters under the bed.


The Real Cause of Heart Disease

The Death of the Low-Fat Diet

Heart Doctor: Time to Bust the Myth about Saturated Fat and Heart Disease

Chief Physician: Forget About the MyPlate Guidelines

“Fat Trims Your Waistline”


  1. sten
    The association goes the "wrong way", "against the grain", so to speak.
    Is it time to do another Sidney Heart Study, or is it a new case for Inspector Clueso ?
  2. Wade Henderson
    It should be noted that the chart begins with the year 1988, which just happens to be when the first use of statins began.

    Regardless of diet, the trend was downward, and not just in Sweden.

    I might also add there is often a lag time between dietary changes and death from heart attacks.

    Reply: #11
  3. laza
    Hmm, from that figure, butter consumption is the same in 2013 as it was in late 80ies, yet heart disease rates and continually lowered. So it suggests other factors are important, and not that increased butter consumption alone makes people healthier.

    Or, if you are mathematically inclined, you might claim that the first derivative of butter consumption curve is what is making people healthier. This particular correlation seems very strong: the more upward-tilted the curve, the healthier the people.

    So for Swedes to eradicate heart disease, they need an ever-increasing butter consumption inflation.
    (just joking)

  4. Steven

    Firstly, it's an association... so cause is not deterimined. However, the association suggests, rather, that increased butter consumption is not unhealthy, not necessarily that increasing butter consumption is 'healthy'.

    Make sense?

  5. Zepp
    Its mostly smoking that gone down from the 80ies.. and smoking is a dumb thing to do!

    And on top of that.. smart people dont eat margarine.. as it is a butter substitute!

    Soo.. there are a dubble corelation of swedes being smarter and healtyer! ;)

  6. greensleeves
    The new scare tactic however is that sat fat like butter is the true cause of diabetes, by causing insulin spikes and insulin resistance. You see this asserted all the time by dieticians in the USA now. And apparently it is true - sat fat is not metabolically neutral, but does create a long slow rise in insulin over many hours after the meal by affecting cell membranes.

    "Certain dietary fats, such as trans fats and some saturated fats, may alter the structures of cell membranes to inhibit insulin binding and lead to increased insulin levels, according to Leszek Szablewski, author of the book "Glucose Homeostasis and Insulin Resistance."

    Please Andreas show us the plot of Swedish butter eating & diabetes diagnosis. I suspect you see the increase.

    Replies: #7, #12
  7. robert
    That is only an issue if there are a lot of carbs in the diet. High fat + high carb is a no no (basically junk food).

    This fat-induced insulin resistance may also take place if people eat a very high carb diet. I've read somewhere (can't remember) that the fat created in the liver signals the muscles to become I-resistant. Not a good thing if there is a lot of glucose in the blood.


    BTW, a strict very low-carb diet also increases muscle insulin resistance, which is perfectly normal. If glucose is scarce, the muscles are prohibited from metabolizing it (they use fat + ketones), so the brain and nervous system can have all the glucose. Not a problem if you don't eat a lot of carbs.

    This induced (fully reversible) insulin resistance is also the reason why low-carb aficionados usually fail oral glucose tolerance tests if they don't increase their carbs for about a week before it.

    I've experienced this effect myself. I try to stay well below 20g of carbs per day. After taking some supplements (fizzy tablets) I measured elevated blood glucose (25mg/dl above baseline) and was quite surprised. It turns out that those pills have about 3-4g of glucose in them.

  8. Jay Wortman MD
    Jeff Volek did an RCT in which the low-carb group ate 3 times as much saturated fat as the control diet yet had lower saturates in all the serum fractions tested. If saturates are implicated in any kind of pathology it would appear that a low-carb high sat fat diet would result in fewer circulating saturates so you would expect an improvement in those pathologies.
  9. Kevin O'Connell
    Per capita butter consumption is still below what it was in the mid-late 80s - Swedish population has increased by about 12% over the period.

    So, still a way to go for LCHF to get the country back to a healthy level of butter consumption.

  10. Dina
    Maybe it's not the butter being heart-healthy and there are certainly other things causing and effecting these trends BUT ...

    Swedish heart-health "experts" claim that Swedes now more then ever get heart attacks and they usually claim so in order to trash LCHF and other similar diets. What can be seen in the above statistics is the opposite, which means that either these "experts" don't know their facts or they are lying.
    Either way is bad and one wonders what else these "experts" may not know or lie about ...

  11. FrankG

    It should be noted that the chart begins with the year 1988, which just happens to be when the first use of statins began.

    Regardless of diet, the trend was downward, and not just in Sweden.

    I might also add there is often a lag time between dietary changes and death from heart attacks.

    Are you suggesting that the trend was already downward _before_ the first use of statins?

    Are you suggesting that: unlike diet where "there is often a lag time between dietary changes and death", statins could have an _immediate_ effect? Stopping already pending deaths from heart-attack in its tracks, as it were?

    Reply: #13
  12. FrankG

    The new scare tactic however is that sat fat like butter is the true cause of diabetes, by causing insulin spikes and insulin resistance. You see this asserted all the time by dieticians in the USA now. And apparently it is true - sat fat is not metabolically neutral, but does create a long slow rise in insulin over many hours after the meal by affecting cell membranes.

    Is your intent to _warn_ us against this new "scare tactic" or to try and _use_ this new scare tactic in an attempt to get others to avoid in the use of saturated fats?

    Can you give us examples of where this is "asserted all the time by dieticians ... now"

    I'm not clear how you equate "insulin spikes" and "long slow rise in insulin over many hours"... these do not mean the same thing to me.

    IF this is true then it clearly needs to be looked at in greater detail than a news-media article, including (as Robert astutely points out) the role of carbohydrates (chiefly sugar and refined starches) in the meal, alongside (or even without) the saturated fats. Are the fats which lead to these proposed metabolic changes, directly derived from a diet high in saturated fats?

  13. Wade Henderson
    Two things were happening in Sweden from 1980 forward.

    Smoking was in a decline from well over 25% to well under 10%

    At the same time, beginning in 1988, statins began to be used.

    Both items can have a somewhat "immediate" effect on rates of acute myocardial infarctions.

    Of course they also have a long term effect.

    The combination of the two would outweigh and even possibly hide any possible negative effect of any shorter term rise in butter consumption.

  14. FrankG

    The combination of the two would outweigh and even possibly hide any possible negative effect of any shorter term rise in butter consumption.

    "would outweight" or "could outweight"?

    You recently made a lengthy comment that I read as a desire for unbiased science-based discussion; so I can't help wonder if you are being somewhat presumptive here? What evidence is there for your statement?

    Reply: #15
  15. Wade Henderson
    Well, we both know there is no study looking at the three items.
    Smoking, statins, and butter. As such no definitive proof is available.

    However given the combo of non-smoking and statins combined, I'd think it 'would' outweigh the damage of butter ..... IF....IF one were to assume butter was damaging.

    Smoking is simply huge. There is no dispute in that. By most doctor's opinion, and some studies, statins seem to also play a significant role.

    Yes, I'd say those two combined 'would' overcome, and possibly mask, any potential danger from increased butter usage.

    Me, I don't smoke, I don't take statins, and I don't buy butter (although I happily eat it when out or over at friends homes). I don't see any medicinal value in slathering it on.
    On the other hand I don't think a little is harmful.

    I do push-ups and biking instead of butter, statins, and cigarettes.
    Trying to avoid sarcopenia and hippocampus shrinkage.

    Reply: #19
  16. FrankG
    So just your opinion then... I see
  17. Maki
    @Wade Henderson

    You do push ups instead of eating?

    "Yes, I'd say those two combined 'would' overcome, and possibly mask, any potential danger from increased butter usage."

    That would make the dangers of butter pretty insignificant, and you can see if that is the case by comparing sweden to other countries since almost every country had reduced smoking, and prescribe statins.

  18. Alan
    I don't think that there is an improving trend in heart attacks from 1988 to ~2008--it is pretty flat with some stochastic wiggle (bit up and bit down); 10 years of statin use does not look protective.

    A single focus on total cholesterol for heart disease prevention is not terribly effective. There are dozens of other risk factors for heart disease that are not improved by taking statins. LCHF does seem to improve these risk factors in a meta-analysis (Santos et al. 2012).

    It seems that the increasing butter intake (2006-2012) is associated with the downturn in heart attacks and it precedes it by a couple of years (I wonder how long it would take?).

  19. murray
    Wade, perhaps I am doing something else to compensate, but I do buy lots of butter (lots), have bulletproof tea or coffee every morning, and cook most vegetables with butter and make butter sauces. It is high quality butter from grass-fed, organically raised cows and made by a friend who runs a small dairy, so perhaps the fatty acid profile (including CLA) and micro-nutrients (K2, retinol, etc.) are different.

    But the effect of this has been to lower my HbA1c to 4.7 and my ketones measure above 1.0 mmol almost every morning, so I doubt either my blood sugar or insulin is high. In fact, I have yet to measure blood sugar above 5.6 mmol/L even after dinners or snacks. I am almost always 4.5 mmol/L blood sugar or below in the mornings when I get up. Based on the studies I have seen correlating blood sugar and brain mass, avoiding sugar and starch is beneficial and increasing fat content in diet is beneficial.

    I do some exercise, like you. Mostly walking and jogging the dog in the morning, sprinting up 10 flights of stairs from time to time (I work in an office tower) and cutting, hauling and chopping wood (like this weekend). Most certainly do not have sarcopenia, in fact I have six pack abs at 54 without going to the gym. My 14 year old son and I did over seven hours of strenuous cutting, hauling, chopping and stacking firewood for the winter on the weekend. (I confess, we both had a nap Sunday afternoon. It was a grind in the early snowfall followed by cold rain.) Ironically, I find it is the chainsawing that tires me most and not the hauling of the cut logs up the hill. I suppose it is because I do stairs regularly and the chainsawing is a different mix of muscle. The chainsaw is heavy and you have to maintain total focus and good positioning (amidst the brush and branches in the woods), for obvious reasons.

  20. nancy
    My total cholesterol has been over 250 since I started having it checked, probably 20 (mostly vegetarian) years. On the 15th day of HFLC I had fasting lipid profile done.

    (Honestly, I was going for other labs and did not realize the Dr Rx a lipid profile also or I would have waited a few months)

    Anyway, my total cholesterol was 202! HDL has always been higher than normal, but it was 107!
    Can it be that these values change that much in just 2 weeks????

    Reply: #21
  21. Zepp
    Strange values!

    HDL 107 is very high.. its cald hyperHDL.. and it seems to be protective against CVD.. female gender is altso protective!

    Did your HDL rise or go down?

  22. nancy
    My HDL went up, from 71 to 107. Honestly, I haven't even been exercising lately and zero alcohol for past 2 weeks. My job as an ER nurse keeps me more active than a desk job, but not that much. My triglycerides were 38, down from 80, but I was not so surprised at that.

    My LDL was 88 and don't remember what it was last year, but it was not elevated.

    I was just so shocked my total cholesterol would go from 256 to 202 in two weeks. I have tried no meat, no dairy, mostly vegan, lots of fruit, diet for 6 months prior to labs and my ratios are always good, but it bugged me to have cholesterol so high.

  23. Zepp
    Even 71 is a god value!

    I think your body do some adjustments and relocate fats to different places.. more conform to your new homeostasis.

    Many report shrinking bellys but the same weight.

    If its abdominal fat thats going away.. its good!

  24. Jerry Atkinson
    I do not think that any one food stuff can be the cause of a heart condition since it is usually a combination of factors either genetic or else. There is therefore no sufficient ground for the said assumption.
  25. Lonneke
    This conflict is the only thing I'm not loving about the whole change in diet. I think I will take the same advice that my doctor always used to tell me when he wanted me to go on more medications for T2D with the associated "side effects". He would say "weigh the risks". So weight loss, more energy and consistently lower BGLs ..... as opposed to [from re Januvia]

    For Healthcare Professionals
    Applies to sitagliptin: oral tablet

    Common (1% to 10%): Hypoglycemia (when used in combination with insulin or sulfonylurea)[Ref]

    In a pooled analysis of 19 trials (sitagliptin (the active ingredient contained in Januvia) 100 mg/day, n=5429; active control or placebo, n=4817), the incidence of acute pancreatitis was in 0.1 per 100 patient-years in each group (4 patients in each group)[Ref]

    Common (1% to 10%): Abdominal pain, nausea, diarrhea, constipation, gastroenteritis
    Postmarketing reports: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, vomiting[Ref]

    Common (1% to 10%): Nasopharyngitis, upper respiratory infection, pharyngitis,
    Postmarketing reports: Interstitial lung disease[Ref]

    Nervous system
    Common (1% to 10%): Headache
    Uncommon (0.1% to 1%): Dizziness[Ref]

    There have been postmarketing reports of serious hypersensitivity reactions in patients treated with this drug. Reactions have occurred within the first 3 months of therapy initiation, with some reports occurring after the first dose.[Ref]

    Postmarketing reports: Serious hypersensitivity reactions including anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, and exfoliative skin conditions including Stevens-Johnson syndrome[Ref]

    Postmarketing reports: Hepatic enzyme elevations

    There have been postmarketing reports of worsening renal function, including acute renal failure, sometime requiring dialysis. A subset of these reports involved patients with renal insufficiency, some who were prescribed inappropriate doses of this drug. With drug discontinuation, supportive treatment and discontinuation of potentially causative agents, a return to baseline levels of renal insufficiency occurred.[Ref]

    Postmarketing reports: Worsening renal function[Ref]

    Postmarketing reports: Arthralgia, myalgia, extremity pain, back pain, osteoarthritis[Ref]

    Between October 2006 and December 2013, thirty-three cases of severe arthralgia have been reported to the FDA Adverse Event Reporting System Database. Each case involved the use of 1 or more dipeptidyl peptidase-4 (DPP-4) inhibitors. In all cases, substantial reduction in prior activity level was reported, 10 patients were hospitalized due to disabling joint pain. In 22 cases, symptoms appeared within 1 month of starting therapy. In 23 cases symptoms resolved less than 1 month after discontinuation. A positive rechallenge was reported in 8 cases, with 6 cases involving use of a different DPP-4 inhibitor. Sitagliptin had the greatest number of cases reported (n=28) followed by saxagliptin (n=5), linagliptin (n=2), alogliptin (n=1), and vildagliptin (n=2).[Ref]

    Common (1% to 10%): Hypertension[Ref]

    Postmarketing reports: Pruritu

    I think no meds and LCHF is my safest option at this stage.

  26. 1 comment removed
  27. mikke
    I have a question. Which is worse, millions of Africans starving to death or Millions of Americans Eating them selves to death ?...Americans eating to death are worse, because they actually "can make a "choice" not to eat too much. They're lacking of self control , discipline . Those Africans do not have choices but to starve.The biggest problem with controlling diabetes and weight through diet is the lazy human variable. You can lead a horse to water but cant force
    them to drink. Most people rather eat fast food , factory frozen food ,protein powder made in china full of casein ,
    pills or shoot insulin than to change their shitty eating habits. We live in an "instant gratification"
    society full of people with 0 discipline or work ethic.
    Sad but true .....
    "Fasting" and "intermediate fasting" is the cure (controlling insulin)....... for those people who are over weight
    and UN-healthy , you should get
    this book by Dr. Jason Fung from Toronto Canada his book will cure
    obesity and type two diabetes the book is called ; The Obesity Code: Unlocking the Secrets of Weight Loss , go to Amazon and check the reviews ;

    if you want to lose weight watch your intake of carbs, but be careful since the equivalent of 12
    of sugar happens very quickly.
    For example:
    • 1 cup of milk equals = 2 teaspoons of sugar
    • 1 cup of rice (cooked) equals = 9 teaspoons of sugar
    • 1 banana equals equals = 5 teaspoons of sugar
    • 1 baked potato equals = 7 teaspoons of sugar
    • 1 sweet potato = 8 teaspoons of sugar
    • 1 cup of strawberries equals = 2.5 teaspoons of sugar (low sugar)
    • 1/2grapefruit = 2 teaspoons of sugar
    - Coca cola (one can) - 8.25 teaspoons of sugar
    - Raisin Bran cereal - 7.75 teaspoons of sugar (per 100grams)
    - Grapes fruit - 4 teaspoons of sugar (per 100grams)
    - Tomatoes - 0.7 teaspoons of sugar (per 100grams)
    - 1 Muffin (one chocolate chip muffin) - 4.75 teaspoons of sugar
    - Special K cereal - 3 teaspoons of sugar (per 100grams)
    - Corn Flakes - 2.4 teaspoons of sugar (per 100grams)
    - Alpen cereal - 5.75 teaspoons of sugar (per 100grams)
    - Mangos fruit - 3.2 teaspoons of sugar (per 100grams)
    - A cup of seedless prunes has, in effect, 25 teaspoons of sugar !

    Scientists find in comparing the sugar levels in the blood after the
    consumption of a snickers bar that has 8.5 teaspoons of sugar the same
    as two bread slices ! . The sugar equivalent is of 1 large bagel a
    whopping 12 teaspoons of sugar !
    Lastly, it is worth noting that there are many breads that a single
    slice of which will raise your blood sugar more than a US Snickers bar
    (which has a GI of 68/97)…if the Glycemic Index can be believed. You
    can browse the table yourself to see. I’ve included some of the more
    interesting ones below.

    Breads that have a higher Glycemic Index than a Snickers bar:

    Bagel, white, frozen (Lender’s Bakery, Montreal, Canada)
    Baguette, white, plain (France)
    Kaiser rolls (Loblaw’s, Canada)
    Melba toast, Old London (Best Foods Canada Inc, Etobicoke, Canada)
    White flour (Canada)
    White flour (USA)
    White flour (Sunblest; Tip Top Bakeries, Australia)
    White flour (Dempster’s Corporate Foods Ltd, Canada)
    White flour (South Africa)
    Wonder, enriched white bread
    Stay Trim, whole-grain bread (Natural Ovens, USA)

    In contrast, strawberries give you a big carbohydrate
    “bang for the buck” meaning you can eat lots of them with minimal sugar.
    Strawberries have lots of water in them. 1 cup of strawberries = 2.5 teaspoons of
    sugar make sure the strawberries you are organic .

    If you have heart disease or you're over weight watch this video by Dr. Caldwell Esselstyn MD
    the more meat and dairy you eat the more fat you eat and alcohol you
    drink ; The more weight you gain . Fat and alcohol creates more Estrogen
    in your body ...more Estrogen in the body more weight you gain ...and
    The more hormone-cancers like breast cancer and prostate cancer.The
    solution is to eat a plant base organic diet (Vegetarian ) coffee ,
    sweets, beer , junk food , red meat dairy raises your estrogen in the
    body . Vegetarian diet and exercise will bring down estrogen . life is
    about the choice you make in life ! alcohol , red meat ,
    dairy & fat equals = estrogen------------more estrogen in your body
    equals = lots of weight gain Vegetarian plant base diet , no sugar, no wheat , no
    alcohol , no coffee , and exercise every day is the solution to lose
    weight and bring down estrogen . if you're not
    born with the skinny gene ! than you have only one solution eating low
    fat healthy diet and exercise .and sleep 9 hours at least , go to bed
    early so your hormones are not out of control . I you don't get good
    sleep you will not lose weight . you must fast , and not eat every hour
    .control your insulin ! You must not use any type of sweetners , no
    Stevia either , Stevia also raises your insulin and you gain weight !
    no sugar no sweeteners .Insulin resistance comes primarily from the fat we eat... whole food plant based diets are very low in fat and the fat we wear.. being over fat causes fats to be put into the blood and recirculated back to fat cells. Although a bit over simplified this characterization of the problem helps persons understand why by cutting fats out of their diet their serum glucoses improve quickly. As they lose fat off their body and get down to normal weight and they continue to improve but more gradually .
    "Chicken poultry" ; contains a "virus" that cause "obesity" "google chicken virus causes obesity : don't eat chicken , red meat or any dairy . Eat organic and only eat two meals a day . Intermediate fasting will shrink your stomach naturally ; when you're hungry eat "resistant starches" like half green banana , Artichokes , "barley" is great it will make you full and is so healthy, Use Barley instead of rice or cereals .Eat barley every day make sure its organic and sleep 10 hours a night .
    . and last Walk 12 thousand steps a day
    Show less
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  28. Nicolas
    Why is there no source for the data on butter consumption?

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