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New Insights or Confusion—Is Butter Really Back?

Myers, Esther F. PhD, RDN, FAND

doi: 10.1097/NT.0000000000000071
Nutrition Policy

Controversial systematic reviews such as “Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk” by Chowdhury et al cause confusion for the public and health professionals alike. However, a closer look at the question being addressed as well as the methodology lends insights into why the these results may differ from other systematic reviews on fatty acids and heart disease. Evaluating research to independently connect individual fatty acids (either dietary or lipid levels) directly to coronary heart outcomes instead of connecting meal patterns with varying macronutrient content to cardiovascular risk factors such as circulating lipid levels will give quite different answers. Significant challenges common to nutrition systematic reviews are identified that cause us to question the systematic review conclusions. However, at the same time, it does raise questions about our assumptions that reducing cardiovascular risk factors will always lead to changes in coronary heart disease outcomes.

Esther F. Myers, PhD, RDN, FAND, is chief executive officer at EFMyers Consulting, Inc, Trenton, Illinois. She is an internationally recognized author and speaker on evidence-based dietetics practice. She served as the chief science officer for the Academy of Nutrition and Dietetics, Chicago, Illinois, where she led the development of the Academy’s Evidence Analysis Library until July 2012. She was the chief military consultant to the US Air Force surgeon general on nutrition and dietetics before her retirement from the US Air Force in 2000.

The author has no conflicts of interest to disclose.

Correspondence: Esther F. Myers, PhD, RDN, FAND, 600 N Oak St, Trenton, IL 62293 (

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