Butter Vs Olive Oil For Cholesterol: Why The Heart Evidence Is Weaker Than You Think

Butter or olive oil? A butter stick and olive oil bottle on a balance scale beside a man in glasses, with the text: the heart proof is thinner than you think.

What the research really shows about cooking oils, butter, and your LDL

Are you swapping butter for olive oil and still wondering if it is working? I have spent 36 years in a cardiac cath lab and assisted on more than 25,000 angiograms, so I take this question seriously. Butter versus olive oil has real trial data behind it. But most cooking oil research is far weaker than the headlines suggest. This post separates what is proven from what is hype so you can choose with confidence.

What does the biggest review of cooking oils actually show?

A 2024 review in Advances in Nutrition (Voon et al.) pooled 48 reviews and checked 206 separate findings on cooking oils. Only 2 of those findings were rated high certainty, and about 67.5% were very low certainty.

Here is how that breaks down:

206 findings were analyzed across oils including olive, canola, rice bran, sesame, flaxseed, peanut, coconut, and palm
47 findings (about 23%) were statistically significant
2 findings were high certainty
20 were moderate certainty, 45 were low, and 139 were very low
Most trials ran 6 months or less, so long-term heart outcomes are still missing

Very low certainty means a better study could easily flip the result. That does not make the findings useless. It means treat them as direction, not proof.

Infographic showing the certainty of evidence across 206 clinical findings, with 2 high-certainty, 18 moderate-certainty, 46 low-certainty, and 140 very-low-certainty findings. The very-low-certainty category is highlighted in red on a dark Healthy Rant clinical-research design.

Which cooking oils lowered LDL, and which raised it?

Virgin olive oil, canola oil, and rice bran oil lowered total cholesterol and LDL in the review. Coconut oil and palm oil raised LDL and also raised HDL.

LDL is the cholesterol that can build up in your artery walls. Lower is generally the goal. Here is the pattern:

Virgin olive oil lowered total cholesterol, with extra benefits linked to its polyphenols
Canola oil lowered LDL and ApoB, a count of the artery-clogging particles
Rice bran oil lowered LDL
Coconut oil raised LDL and HDL
Palm oil raised LDL and HDL, while palm olein, the liquid cooking fraction, had minimal impact

One surprise: regular olive oil did not match virgin olive oil. In some comparisons it raised LDL, and it was the only oil linked to higher triglycerides. If you buy olive oil for your heart, the label matters. Look for extra virgin.

Also note that every result compares one oil to another oil, not to a baseline of no oil.

Is butter worse than olive oil for cholesterol?

In the best head-to-head trial I found, yes. Butter raised LDL more than olive oil or coconut oil. Butter was not in the oil review as a main exposure, only as a comparison in 7 of the included reviews, so this evidence comes from separate studies.

Khaw et al., BMJ Open (2018): about 90 adults ate 50 grams a day of butter, coconut oil, or olive oil for 4 weeks
LDL rose significantly more on butter than on either of the others
That gap is roughly 15 mg/dL on a US lab report (converted from the trial's mmol/L)
Coconut oil and olive oil did not differ on LDL in that trial
Neelakantan et al., Circulation (2020): across 16 trials, coconut oil raised LDL by about 10 mg/dL and HDL by about 4 mg/dL versus non-tropical oils

Notice the dose. 50 grams is about 3.5 tablespoons of butter a day. That is far more than a pat on toast. Treat the result as a direction, not a verdict.

Does lowering cholesterol mean you live longer?

Not necessarily. Lower LDL is a marker, not the finish line. The strongest evidence shows fewer heart events, while proof of living longer is thinner.

Hooper et al., Cochrane (2020): cutting saturated fat reduced combined heart events by about 21% but made little to no difference in deaths
American Heart Association advisory (Sacks et al., 2017): replacing saturated fat with polyunsaturated vegetable oil was linked to about 30% lower cardiovascular disease, while swapping it for refined carbs showed no benefit
Recovered data from the Minnesota and Sydney trials (Ramsden et al.): cholesterol fell with corn oil and margarine, but deaths did not drop, and critics note those trials used captive populations
A December 2025 systematic review of 17 trials in Annals of Internal Medicine found cutting saturated fat helped high-risk people over 5 years, but the benefit was less clear for low and moderate risk people

So the honest summary is this. The cholesterol-lowering part is consistent. The "you will live longer" part is where certainty drops.

Is cheese different from butter?

Possibly. Food structure may matter, not just fat grams. That is early evidence, but it is a reason to stop treating all dairy fat the same.

Hjerpsted et al. (2011), a Danish trial: LDL was about 7% higher on butter than on cheese with the same fat
Feeney et al. (2018), an Irish trial of 164 people: LDL was lowest when all the fat came inside full-fat cheese, compared with butter plus supplements

How much saturated fat is okay each day?

The 2025 to 2030 Dietary Guidelines for Americans, released in January 2026, kept the limit at 10% of calories from saturated fat. That is roughly 20 to 22 grams a day on a 2,000 calorie diet.

The same guidelines place more emphasis on full-fat dairy and other whole food fat sources. The cap itself did not change. A practical way to use it: let olive oil carry most of your cooking, and use butter as a flavor fat.

What should you do this week?

Start with these 5 steps. They hold up whether you believe the headlines or not.

1
Make extra virgin olive oil your default daily fat.
2
Keep butter as a flavor fat. A pat, not a scoop.
3
Do not swap butter for refined carbs. That swap shows no benefit.
4
Ask for a lipid panel that includes ApoB, then change your fats for 6 to 8 weeks and retest.
5
Watch portions. Any oil adds calories, and the benefits assume normal amounts.

People respond differently to the same fat. Your retest numbers are the real answer for your body.

Key Takeaways

Only 2 of 206 findings in the biggest cooking oil review were high certainty.
Virgin olive oil, canola, and rice bran oil lowered LDL. Coconut and palm raised it.
Butter raised LDL more than olive oil in a 4-week trial, at a high dose.
Regular olive oil is not the same as extra virgin. The label matters.
Lower LDL is a marker. Long-term proof of living longer is thinner.
Test with ApoB, change fats for 6 to 8 weeks, then retest.

FAQ: 8 Questions About Butter, Olive Oil, And Cholesterol

Does butter raise cholesterol more than olive oil?
In a 4-week trial of about 90 adults, yes. Butter raised LDL significantly more than olive oil, but the dose was 50 grams a day.

Is coconut oil healthier than butter?
On LDL, coconut oil raised it less than butter in the same trial. Across 16 trials, though, coconut oil still raised LDL by about 10 mg/dL versus non-tropical oils.

Is extra virgin olive oil better than regular olive oil?
For cholesterol, the review points that way. Virgin olive oil lowered total cholesterol, while regular olive oil raised it in some comparisons.

Do eggs raise LDL more than saturated fat?
No. In a 2025 crossover trial of 61 adults, saturated fat intake predicted higher LDL and ApoB, while dietary cholesterol did not.

Is cheese better than butter for cholesterol?
It may be. In a Danish trial, LDL was about 7% higher on butter than on cheese with the same fat.

What is ApoB and why test it?
ApoB is a count of the artery-clogging particles in your blood. It can tell a fuller story than LDL alone.

How long before my cholesterol changes after switching fats?
Trials in this area often show changes within 4 weeks. Retest after 6 to 8 weeks to see your own response.

Does butter increase the risk of dying earlier?
A large Harvard study of 221,054 people linked the highest butter intake to 15% higher total mortality than the lowest. It was observational, so it shows an association, not proof.
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Educational information only, not medical advice. Talk to your doctor before changing your diet or medications.