Study · Epidemiology (Cambridge, Mass.) · 2017

Substituting butter and stick margarine with tub margarine

What it found

In a long-term study of women, swapping butter or stick margarine for tub margarine was linked to a lower risk of heart attack.

The findings were strongest in women who used only one type of spread.

What they found

Studies in people

Heart attack risk

Substituting tub margarine for stick margarine was linked to a lower risk of heart attack. Substituting tub margarine for butter showed a similar trend.

Single-source users

Among women who used only one type of spread, the links with lower heart attack risk were stronger.

Other heart outcomes

For total coronary heart disease, ischemic stroke, and related cardiovascular disease, the results pointed in the same direction but the numbers were wide and uncertain.

High fat intake

The link with lower heart attack risk was slightly stronger in women who ate the most total fat.

Butter and stick margarine

Eating more butter or stick margarine was linked to higher risk in some models, but the links weakened after accounting for lifestyle and heart risk factors.

What the authors conclude

“This theoretical dietary substitution analysis suggests that substituting butter and stick margarine with tub margarine when spreadable fats are eaten may be associated with reduced risk of myocardial infarction.”
Liu Q, Rossouw JE, Roberts MB, et al, 2017

Also in their conclusions

  • They say that substituting butter and stick margarine with tub margarine when spreadable fats are eaten may be associated with reduced risk of myocardial infarction.
  • They call for future substitution analyses that use multiple dietary measurements of spreadable fats or other whole foods and measure clinically important outcomes.

How it was done

The authors wanted to test whether replacing animal fat from butter with plant-based fats from different margarines would affect the risk of heart and blood vessel disease.

They followed 71,410 women aged 50 to 79 for an average of 13.2 years. They asked about butter and margarine use at the start and again at year 3, then estimated what would happen if 1 teaspoon a day of margarine replaced the same amount of butter.

What it can’t tell you

  • This study followed women over time, so it can show a link but not prove that one spread causes or prevents heart attacks.
  • The women reported their own butter and margarine use, which can be inaccurate.
  • The results apply to postmenopausal women and may not apply to other groups.

The paper

Title
Theoretical Effects of Substituting Butter with Margarine on Risk of Cardiovascular Disease
Type
Study
Evidence
Studies in people
Summarised from
Full text
Cite
Liu Q, Rossouw JE, Roberts MB, et al (2017). Theoretical Effects of Substituting Butter with Margarine on Risk of Cardiovascular Disease. Epidemiology (Cambridge, Mass.). doi:10.1097/EDE.0000000000000557Free full textPubMed 27648593DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error