“I think one of the terrible things today is that people have this deathly fear of food: fear of eggs, say, or fear of butter. Most doctors feel that you can have a little bit of everything.” — Julia Child

So, butter is back.

Does that mean we now have carte blanche to eat as much as we want?

Not exactly.

Real butter is “all natural” and not as processed as trans fat-filled margarines, but a tablespoon of butter still contains 100 calories, 30 milligrams of dietary cholesterol and 11 grams of fat — and 7 grams of it is saturated fat. And too much saturated fat is still considered dangerous, says Dr. Jon Eddinger, a cardiologist with Mercy Cardiology and a spokesman for the American Heart Association.

The most recent overview of the data suggests that higher intakes of saturated fat can lead to higher cholesterol levels, more bad cholesterol and a higher risk of heart disease, Eddinger said.

“You definitely want to minimize the saturated fat,” he said. “It’s not that we want to eliminate it, but we definitely want to minimize it.”

But switching to margarine only, which is made with vegetable fats and contains no dietary cholesterol, isn’t necessarily the right answer either.

Eddinger calls margarine a “waste-basket term” that includes lots of products containing varying levels of hydrogenated oils and trans-fatty acids, the bad stuff that causes heart disease.

“Margarine has a lot of variability in the amount of trans-fatty acids,” Eddinger said. “It doesn’t increase cholesterol by itself, but it can worsen the cholesterol profile — it can lower the good cholesterol and also raise the bad cholesterol.”

Eddinger tells his patients to try to minimize or eliminate trans-fatty acids from their diets. If you’re going to choose margarine, get rid of the solid spreads and sticks, and go toward the tubs or liquids that are based on “good fats” — vegetable oils and olive oils. Stay away from partially hydrogenated oils found in the solid spreads and things like cakes, pies and muffins.

“Soft, trans fat-free spreads are the way to go,” Eddinger said. “They tend to have less hydrogenated oils and less trans-fatty acids.”

But using real butter is also OK, if you are otherwise eating healthy and use it in moderation. “If you’re minimizing your (fat) intake in general,” Eddinger said, “and you’re looking at labels, it’s quite possible that butters that you choose are better than margarines because margarine itself is so variable as to what’s in it.”

Eddinger added one big caveat, though: Most people don’t have healthy diets and don’t routinely get their four or five servings of fruits and vegetables in a day — and they aren’t being honest with themselves about it.

What does a cardiologist do? For daily use, Eddinger turns to the plant stanol-based spreads, such as Benecol or Take Control, that are proven to lower cholesterol. But he also eats butter in moderation. He considers it an occasional treat.

Susan Quimby, a registered dietitian in Portland who specializes in weight management and in helping clients lower their risk for heart disease, said she tries to get her clients to avoid both butter and margarine. She tells them to spread nut butters on toast, and to roast vegetables with olive oil.

“Neither butter nor margarine have much to add to someone’s diet,” Quimby said. “While we do need to have some fat every day to absorb fat-soluble vitamins, I usually suggest healthy fats such as olive oil, nuts, nut butters or avocados. However, if I do need a spreadable fat, I would personally use butter — sparingly.”

— Meredith Goad