From red meat to 'big and fluffy' LDL, a lipid expert unpacks fat and cholesterol misconceptions that persist among patients and clinicians.
In an interview with Pharmacy Times for the National Lipid Association’s (NLA) 2026 Fall Clinical Lipid Update, Carol F. Kirkpatrick, PhD, MPH, RDN, FNLA, director of the Idaho State University (ISU) Wellness Center and a clinical associate professor in the Kasiska Division of Health Sciences (KDHS), discussed common misconceptions about dietary fats and cholesterol. The discussion centers on her presentation at the NLA Clinical Lipid Update, which focused on the
Kirkpatrick noted that misinformation is widespread, fueled in part by influencers sending mixed messages. One of the biggest misconceptions, she said, is that red meat raises low-density lipoprotein (LDL) cholesterol more than poultry or fish, a belief held by many patients and even health care professionals. According to Kirkpatrick, randomized controlled trials comparing red meats, including beef, pork, and lamb, with poultry and fish have found no difference in their effects on cholesterol levels. She added that a 12-week crossover trial her organization helped conduct found that LDL cholesterol did not change with either red meat or white meat. Kirkpatrick acknowledged that the relationship between saturated fat, dietary cholesterol, and blood cholesterol is complicated and often misunderstood by patients and clinicians alike. She emphasized that red meat can be part of a healthful dietary pattern but should not be overconsumed and that plant-based proteins consistently have a more favorable effect on blood cholesterol than red meat, poultry, or fish.2
A second misconception gaining traction is that large LDL particles are big, fluffy, and benign. Kirkpatrick stressed that large LDL particles can still cross the endothelial lining and contribute to the development of atherosclerosis. Although small LDL particles appear more atherogenic, she explained that they are associated with other risk factors, such as inflammation, prediabetes, and insulin resistance, which may make them seem more harmful. She also pushed back on the related narrative that high LDL cholesterol levels do not matter. The core message for patients, Kirkpatrick said, is that LDL particles in general are atherogenic.
