This video analyzes hundreds of research papers to deeply examine butter's impact on cardiovascular disease, mortality, diabetes, and fatty liver. The conclusion: butter raises cardiovascular disease risk and mortality compared to other fats and dairy products, and increases LDL cholesterol the most. Therefore, reducing butter intake and replacing it with unsaturated fats like olive oil is the most sensible choice for health.
1. Introduction: Is Butter Actually Healthy?
Dr. Dingyo begins by addressing 'butter,' the most requested topic since the previous saltwater video. Unlike salt, butter is a very tricky subject to explain. While there's a risk of elevated LDL cholesterol from butter consumption, there are also mixed positive aspects like weight loss and improved diabetes and fatty liver numbers (primarily as a result of resolving obesity).
However, Dr. Dingyo emphasizes that we should focus on core outcomes — cardiovascular disease and mortality — rather than secondary effects like constipation relief or skin improvement.
It's like buying a new apartment and moving in, and the walls are crumbling but the wallpaper is really pretty. You need to know what's important. If constipation improves and skin gets better but you die from heart attack, stroke, dementia, or cancer, none of it matters.
Both low-carb high-fat and high-carb low-fat diets have been shown by multiple studies to increase mortality. The key question of this video is, setting aside the carbohydrate debate, "How does butter rank among other fats in terms of health?" Hundreds of papers were reviewed, and the results were shocking.
2. Non-Meal Butter Consumption and Bulletproof Coffee
First, studies on consuming butter itself apart from meals, most notably bulletproof coffee, were analyzed. According to a 2023 systematic review from Australia's University of Wollongong, bulletproof coffee showed no difference in cognitive performance or alertness compared to black coffee.
Satiety increased slightly but equalized with black coffee after 4 hours. Rather, gastrointestinal issues (abdominal pain, nausea, diarrhea) increased overwhelmingly. Additionally, the only clinical controlled study on butter itself (Cambridge University, 2018) showed:
- LDL cholesterol: Butter raised it overwhelmingly more than coconut oil or olive oil.
- Weight and blood sugar: No significant difference among the three groups.
Some claim butter's butyric acid component is good for gut health, but butyric acid consumed through butter gets absorbed in the small intestine and doesn't reach the colon. To get butyric acid effects in the colon, you need to eat dietary fiber.
If someone emphasizes the butyric acid benefits of butter, they should also be advocating for eating dietary fiber.
3. Butter Consumption During Meals and Cardiovascular/Mortality Impact
The second area is butter consumption during meals — the most common way we encounter it. The 2016 Tufts University large-scale meta-analysis showed:
- Mortality: For every additional 14g of butter consumed daily, mortality increased by 1% (statistically significant).
- Diabetes: Conversely, diabetes risk decreased by 4%.
In other words, eating more butter may slightly help prevent diabetes, but overall mortality slightly increases.
4. Butter vs. Other Dairy Products and Fats (Key Findings)
This is the highlight of the video. To precisely determine butter's health position, it was compared with other dairy products and other fats.
4.1. Comparison Within Dairy Products
Synthesizing the 2023 University of Bergen study (stable angina patients) and the 2018 Lancet paper, the differences among dairy products were clear:
- Cheese/Yogurt: Tended to reduce heart attacks and mortality.
- Butter: Increased heart attacks and overall mortality.
- Cancer association: In prostate and breast cancer studies, yogurt and cheese were either protective or neutral, but butter increased cancer risk.
Cheese has fat enclosed in special membranes or bound to calcium for excretion, while butter's fat is directly exposed and absorbed.
4.2. Comparison with Other Fats
A 2021 NIH 16-year follow-up study (520,000 subjects) compared butter, margarine, corn oil, canola oil, and olive oil. The results were striking:
- #1 in total mortality & cardiovascular mortality: Butter (most harmful)
- Then margarine, corn oil, canola oil, and olive oil was the healthiest.
You'd think how can it be worse than margarine... Current margarine has trans fat below 0.2g. When looking at research on mixed margarines, butter was more harmful.
A 2025 Harvard study also found that replacing butter with plant oils reduced mortality by 17%.
4.3. Cholesterol and Low-Carb High-Fat Comparisons
In a network meta-analysis comparing 13 types of oil, butter was #1 in raising LDL cholesterol the most. Even within low-carb high-fat diets, when compared to palm stearin (the solid component of palm oil), butter raised LDL far more.
Dr. Dingyo even asked AI tools (ChatGPT, etc.) but couldn't find a fat definitively more harmful than butter — only 1960s-era high-trans-fat margarine and refined carbohydrates (bread, jam, soda) were found to be worse.
5. Butter and Fatty Liver, and Diabetes
5.1. Fatty Liver
While carbohydrates are the primary cause of non-alcoholic fatty liver, butter's saturated fat transports the gut bacterial toxin LPS (endotoxin) to the liver, causing inflammation. This risks progressing simple fatty liver into steatohepatitis. Olive oil, on the other hand, doesn't have this side effect.
Butter increases LPS endotoxemia, so there's a higher probability of progressing to steatohepatitis, while olive oil doesn't have that issue.
5.2. Diabetes
- Prevention: For non-diabetics, there's a slight diabetes prevention effect (4%).
- Blood sugar control: Switching from ghee or butter to canola oil or olive oil lowered both fasting and postprandial blood sugar. Even in Type 1 diabetes patients, olive oil was more favorable for blood sugar management.
- Mortality in diabetic patients: When diabetic patients replaced animal saturated fat (including butter) with unsaturated fat (plant oils), cardiovascular mortality decreased by 13%. Conversely, mortality increased as butter consumption rose.
6. Conclusion
After examining hundreds of papers, all the data pointed to a single conclusion. Even setting aside LDL cholesterol levels, butter showed unfavorable outcomes in terms of cardiovascular disease and mortality compared to other fats.
The single message that all the papers' results point to is: as much as possible, replace butter with other fats. That is today's... final conclusion.
Dr. Dingyo notes that butter isn't a poison that kills you immediately upon consumption, but it deserves the same caution as refined carbohydrates. He closes by recommending substituting healthy fats like olive oil, avocado oil, and perilla oil wherever possible.
When someone says something is good for health, patients can't help but buy it. I'd like to ask those who produce and present such content to conduct more thorough research before making their claims.