By Sandee LaMotte, CNN
(CNN) — Heart disease is the No. 1 killer of American women and men — and has been for over 100 years. In fact, cardiovascular diseases are the top cause of adult deaths everywhere, responsible for 1 in 3 deaths worldwide.
Cardiologists say physical inactivity, smoking, high blood pressure, high cholesterol and diabetes are all to blame — as is an unhealthy diet full of refined grains, added sugars and the artery-clogging saturated fats found in red and processed meats and full-fat dairy.
The recently released 2025-2030 Dietary Guidelines for Americans restrict refined grains, added sugars and ultraprocessed foods (known as UPFs) — a move applauded by medical organizations.
However, the revised food pyramid — which flips prior pyramids on their heads — also puts red meat and other foods full of protein and saturated fat in a starring role in the top tier, alongside fresh vegetables and fruits known to protect health.
Leading cardiologists tell CNN this is upside-down thinking.
“Promoting saturated fat and increasing the amount of protein goes against all nutrition and cardiology science,” said Dr. Kim Williams, chair of the department of medicine at the University of Louisville in Kentucky.
“We’ve been researching this for decades, and we definitively know saturated fat — such as butter fat, beef tallow, red and processed meat — are all closely associated with more deaths from cardiovascular disease,” said Williams, a past president of the American College of Cardiology. “This does not fall in line with President Trump’s executive order 14303, which mandates that all federal policies use the best scientific evidence available.”
That executive order, signed by Trump on May 23, 2025, called for a return to “a gold standard for science” to ensure “that Federal decisions are informed by the most credible, reliable, and impartial scientific evidence available.”
Yet it’s exactly the impartial, verified and credible science that the new guidelines ignore, according to cardiologists. In fact, randomized controlled clinical trials — the current gold standard of research — have found replacing saturated fats with vegetable and seed oils reduced cardiovascular disease by some 30%, similar to the benefits of statin medications.
“There’s no question that when we remove saturated fat from the diet and add in polyunsaturated and monounsaturated fats from fish, seed and plant sources, we save lives by improving cardiovascular health,” said Dr. Monica Aggarwal, an adjunct clinical associate professor of cardiovascular medicine at the University of Florida in Gainesville.
“People are going to look at the new pyramid and think ‘Oh, I can eat as much steak as I like.’ Social media is already full of headlines like: ‘Beef is back on top,’ or ‘Butter is back,’ or ‘Beef tallow is the way to go,” Aggarwal said. “Yet there is no debate that the saturated fat in those foods is linked to heart disease.”
Discarding decades of science
In a January 8 press conference on the new guidelines, federal officials spoke of their disdain for past nutritional guidance.
“For decades, we’ve been fed a corrupt food pyramid that has had a myopic focus on demonizing natural, healthy saturated fats, telling you not to eat eggs and steak and ignoring a giant blind spot — refined carbohydrates, added sugars and ultraprocessed food,” US Food and Drug Administration Commissioner Dr. Marty Makary said at the briefing.
The new dietary guidelines call for less than 10% of total daily calories to come from saturated fats, not terribly far from AHA recommendations to keep unhealthy fats to less than 6%.
However, 10% or less is an impossible goal, experts say, if the major emphasis of the Make America Healthy Again movement is on eating more proteins with saturated fats.
The Nutrition Source, an online resource from the Harvard T.H. Chan School of Public Health, recently put the new dietary guidelines, which recommend three servings of dairy a day, to the test.
If all three of those dairy servings were full fat: whole milk with about 5 grams of saturated fat and nearly a cup of full-fat Greek yogurt with a single ounce of cheddar cheese — each of which have 6 grams of saturated fat — that’s a total of 17 grams.
According to the Harvard calculations, for a person on a 2,000-calorie a day diet with a limit of 22 grams of saturated fat, that leaves only 5 grams for the rest of the day. Add a single tablespoon of butter (7 grams) or beef tallow (6 grams), and the person has surpassed their daily 10% limit of saturated fat.
Add a standard burger patty cooked at home (over 13 grams), or a 7×7 Steakburger from Steak ’n Shake (66 grams of saturated fat and 7 grams of trans fats) and a large order of their “RFK’d” beef tallow french fries (24 grams of saturated fat and 2.5 grams of trans fats), and levels of dangerous fats zoom.
CNN reached out to Biglari Holdings, which owns Steak ’n Shake, for comment but did not receive a response before publication.
Role of trans fats in heart health
The trans fats found in the Steak ’n Shake foods are considered the worst type of saturated fat, experts say. This type of fat is banned in the United States except in tiny amounts due to its strong connection to heart attacks and stroke. Made from an industrial process in which hydrogen is added to liquid vegetable oils to make those oils more solid, trans fats are cheap to make and increase the shelf life of foods.
Natural sources of trans fats are found in meat, milk, butter and cheese from ruminant animals — cows, sheep, goats — and are considered by some in the MAHA movement to be healthy.
Cardiologists disagree. Natural trans fats found in foods from ruminant animals, and to a lesser degree in pork and poultry, are “actively pro-inflammatory” and lead to atherosclerosis or hardening of the arteries, Williams said.
“Beef tallow contains ruminant trans fats in levels far above what’s considered safe. When paired with high saturated fat, as in deep-fried foods or fatty burgers, the combined risk is substantial,” he said.
Long-standing science
Warnings about the dangers of saturated fat aren’t new. The American Heart Association recommended a switch from disease-causing saturated fat to healthy options in 1961, acting on data-based recommendations from its nutrition committee, first established in 1954.
Updates over the years to the American College of Cardiology and American Heart Association’s guidelines have reiterated that advice, citing hundreds of gold-standard studies on the role of fats in heart disease.
“It’s never been no- or low-fat,” said preventive cardiologist Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
“All types of fat can play a role in a healthy diet, but the emphasis is on polyunsaturated and monounsaturated fats,” Freeman said. “That’s what the Mediterranean diet and other plant-predominant diets have shown.”
Studies have found the award-winning Mediterranean diet can reduce the risk of diabetes, dementia, memory loss, depression and breast cancer. Research has also linked the diet to stronger bones, lower cholesterol, a healthier heart and longer life.
The Mediterranean diet’s pyramid focuses on fresh fruits and vegetables, whole grains, seeds, some fish and heart-healthy olive oil, with an emphasis on meals with family and friends and daily exercise. Red meat and sweets are extremely limited, designed to be served only on special occasions.
Not enough protein?
FDA Commissioner Makary also focused on the need for more protein in the American diet, especially for children.
“The old guidelines had such a low protein recommendation that we are increasing that by 50% to 100% — kids need protein,” Makary said. “The old protein guidelines were to prevent starvation and withering away. These new protein guidelines are designed for American kids to thrive, and they’re based on science, not on dogma.”
However, most Americans today, including children, eat much more protein than they typically need, experts say.
“Except for the very sick or old, protein deficiency almost does not exist in the United States,” Freeman said. “We also know that protein excess taxes the kidneys and is linked to certain cancers.
“If you look at what MAHA stands for, it’s exactly opposite what Trump is doing with this guidance. It doesn’t add up,” he said. “We need our politicians to focus on changing unhealthy behaviors, not promoting them. Increasing the saturated fat that often comes bundled with the proteins the new pyramid recommends is in nobody’s best interest.”
The-CNN-Wire
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