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From the beginning of our journey, we have wondered what to do when we have to choose between the four things we’re trying to control (those would be sugar, salt, saturated fat and starchy carbs). Given a choice between sugar, sodium, saturated fat, or starchy carbs, which is worse? Which would be the first to avoid, and which the last?

We asked this question of several health professionals at the hospital, and their answers didn’t give us a clear direction:

  • One dietitian was unsure. Another thought for a moment and said that the heart-related issues of avoiding sodium and saturated fat were more of a concern than the diabetes related issues of avoiding sugar and starchy carbs. Of course, this was in the context of being hospitalized for heart disease, not for diabetes, so it makes sense that the heart issues would seem to take precedence.
  • A very young doctor told us to simply swear off all of them — starchy carbs, sodium, sugar and saturated fat for life! When we said “given a choice, which one is worse,” she said “That’s like asking which is worse, cocaine or heroin? Don’t have any of them!” she insisted. This seemed a little unrealistic. In the real world, that’s a noble goal, but our question was how to prioritize when push comes to shove.

In spite of trying to keep our food habits as healthy as possible, we have found that there is at least a little sodium that naturally occurs in many foods, and a little saturated fat in even the leanest meats. It doesn’t help that there is conflicting opinion among professionals on how much sodium and saturated fats are unhealthy. And that’s not even to mention the sharp dichotomy of opinions on the treatment of diabetes: a traditional approach or the low-carb/healthy fat approach. Those are topics for another day!

To put the immediate dilemma in more practical terms, we wondered if it is better to eat a margarine spread, unsalted butter, or ghee (clarified butter, from which milk solids have been removed)? The considerations are for both saturated fat and sodium. Our taste buds wanted us to use the small amount of sodium in margarine as an excuse to pick the butter, but since we’re also watching saturated fats, we took a closer look.

We checked the labels of two olive oil-based trans fat-free margarine products and compared them to unsalted butter and ghee. We knew to avoid stick margarine, which apparently tends to have trans fats (those are a known cardiovascular risk). The unsalted butter and ghee had no sodium, but the butter had 7 grams of saturated fat and the ghee had 9. The margarine products had only 1 to 1.5 grams of saturated fat, but 85-110 mg. of sodium. All were based on a one-tablespoon size serving.

Liquid margarine with no trans fat
Tub margarine with no trans fat
Unsalted butter

All of this is part of the learning process: getting to know which changes are most crucial for your health and which ones are merely playing a support role, based on your specific needs. This is why we keep saying “Talk to your doctor.” It’s complicated, as they say on Facebook, and we’ve learned that patients can have very different needs, depending on their other health issues.

Considering all this, for the time being, we’re leaning more toward using the margarine, when we need that buttery-like flavor. That’s what we use in our All-Purpose Sauce, as well as at other times when we miss the flavor and mouth feel of butter. Of course, you should always follow your doctor’s orders. Some patients have a much higher need for limiting sodium, and that might outweigh the saturated fat concern for some. And if you and your doctor are convinced that the saturated fat in butter is not such a big deal, or that ghee is healthier than butter, then your choice might be different.

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  1. Betty E Adkins on April 28, 2019 at 7:11 pm

    Vital information !

    • Allison Park on May 4, 2019 at 1:58 pm

      Thank you! Glad you found it helpful!

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