Season 1 Episode 3: Fatty Acids

We tell patients to “eat more healthy fats” — but what does that actually mean?
Why is coconut oil villainized while olive oil gets the heart-healthy halo — even though both come from plants?
Why does cheese get a pass on the charcuterie board, but butter gets the side-eye — even though both are saturated fats?

The truth is, fatty acids aren’t just a diet label. They’re central players in inflammation, lipid metabolism, insulin resistance, and even gene expression.

In this episode of LipidCurious, we go beyond the good-vs-bad debate and unpack what clinicians really need to know about fatty acids — from molecular structure to bedside application.

 What You’ll Learn in This Episode 

1.     What are fatty acids?

2.     The major types of fatty acids

3.     How they show up in clinical practice

Bonus: The Visual Guide for this episode is waiting for you — click here. For the full collection of visuals across episodes, visit the Podcast page.

Download the Free LipidCurious Starter Kit here

Questions or feedback? Reach out at hello@lipidcurious.com

Disclaimer: This podcast is for educational purposes only. It is NOT medical advice.

Transcript

Every week, we tell patients to “eat more healthy fats.”
But what does that actually mean? 
Did you ever wonder why coconut oil is labeled “bad” while olive oil gets the heart-healthy stamp — even though both are plant-based?
Why does cheese get a place on the charcuterie board, but butter gets the side-eye— even though both are saturated fats? 

Now, here’s the thing: fatty acids aren’t just a dietary label. They’re key players in inflammation, lipid metabolism, insulin resistance, and even gene expression.

Today, we’re going past “good vs. bad” and breaking down what clinicians really need to know — from molecular structure to the clinical impact of fatty acids.

Welcome to LipidCurious — the podcast dedicated to demystifying lipids for medical boards and real-world clinical practice.
I’m your host, Dr. Vishnu Priya Pulipati — a board-certified Endocrinologist and Lipidologist.

This is Season 1, Episode 3: Fatty Acids
Here’s what we’re unpacking today:

1.     What are fatty acids?

2.     The major types of fatty acids

3.     How they show up in clinical practice

If you’re just joining us — welcome!
This season builds step by step, so if you want the full foundation, I recommend starting at Episode 1.

A quick reminder: this podcast is for educational purposes only and is not medical advice.

And if you haven’t already, I invite you to grab the LipidCurious Starter Kit — it’s a free download at www.lipidcurious.com. Designed for busy clinicians like you, it includes quick-reference guides on lipid panels, treatment targets, and common clinical pitfalls.

Alright — let’s get started.

What Are Fatty Acids?

At their core, fatty acids are long chains of carbon atoms — like a zigzag string — with a water-loving carboxyl “head” and a neutral methyl “tail.”

This chain can be anywhere from 4 to 24 carbons long.
 Now, here’s a fun fact: Omega-3 and omega-6 get their names from where the first double bond sits, counting from that methyl or omega tail. Three carbons in? Omega-3. Six carbons in? Omega-6. Same naming rule — totally different biological effects.

Functionally, fatty acids are building blocks for a broad range of lipids such as triglycerides, phospholipids, cholesterol esters, etc. 

For instance, triglycerides — the body’s primary form of stored fat — I imagine them as happy little jellyfish with three fatty acid tentacles attached to a glycerol body through ester linkages. That’s why we call them esterified fatty acids. 

During fasting, exercise, or stress — your body taps into stored fat, releasing free fatty acids into the bloodstream as an alternate fuel source.

Major Types of Fatty Acids

We can classify fatty acids in two ways — by how long the carbon chain is, or by how “saturated” that chain is with hydrogen atoms. 

For clinical purposes, degree of saturation — the number of double bonds — is the biggest driver of health effects. 

I suggest you picture this as a simple flowchart: Start with a box labeled Fatty Acids. From there, three branches: Saturated, Unsaturated, and Trans fats.

1. Saturated fatty acids

• No double bonds — straight chains that pack tightly. Solid at room temperature: butter, coconut oil, ghee.
• Tend to raise LDL cholesterol and, depending on the source, may promote inflammation.
• U.S. guidelines: keep under 10% of daily calories starting at age 2.

2. Unsaturated fatty acids — at least one double bond, which creates a “kink” and keeps them liquid at room temperature. Two categories:

• Monounsaturated (MUFA) — one double bond. Olive oil, avocados, nuts. Linked to lower LDL, better insulin sensitivity, and cardiovascular protection.
• Polyunsaturated (PUFA) — two or more double bonds. Two subtypes
   
  • Omega-3s: found in flaxseed, chia, walnuts, and fatty fish. Anti-inflammatory and cardioprotective 
  • Omega-6s: found in vegetable oils like sunflower and safflower. Essential too, but in excess — especially without enough omega-3s — may tip toward inflammation.
  • Includes essential fatty acids — polyunsaturated fats the body can’t make due to missing enzymes for certain double bonds, so they must come from the diet. The two main EFAs are alpha-linolenic acid (ALA), an omega-3, and linoleic acid (LA), an omega-6. 

3. Trans fats — These are the villains. 

In trans fats, the hydrogen atoms are on opposite sides of the double bond, straightening the chain, which acts as saturated fat. Raise LDL, lower HDL, drive inflammation. Banned in the U.S., but trace amounts can still appear in imports or old packaged foods.

How This Shows Up in Clinic

Let’s bring this to life with a quick case.

Mr. J, a 52-year-old with type 2 diabetes mellitus, comes in with fasting triglycerides of 280 mg/dL. He says he’s “cutting carbs” but proudly tells you he’s putting butter in his coffee and eating more steak because “it’s keto.”
 A look at his diet reveals lots of saturated fat, very little omega-3, and almost no fiber.

What’s happening?

• His triglycerides are essentially carrying saturated fatty acids — shaping his lipid profile in a more atherogenic direction.
• His diet is skewed toward pro-inflammatory fats, with no counterbalance from omega-3s.
• In fasting, his free fatty acids are likely high — a sign of insulin resistance.

Adjustment strategy:
 Instead of telling him to “go low fat,” the focus is on being fat-smart:

• Favor: fatty fish, olive oil, flax, chia, avocados, walnuts
• Limit: red meats, butter, palm oil
• Avoid: trans fats 

The Mediterranean diet gets this right: healthy fats, low processed fats, better heart and brain outcomes.

Here’s what I want you to take away from this

The type of Fatty acid matters — for labs, for inflammation, and cardiometabolic risk. Helping patients spot and balance the right fats is where lipid science turns into real medicine.

Next episode in 2 weeks — we’re talking Cholesterol: Friend or Foe? Understanding Its Role in Health and Disease 

Thanks for joining me on LipidCurious. If you found today helpful, I’d love to hear your feedback, suggestions — or even if you just want to connect.
You can reach me at hello@lipidcurious.com

Be sure to subscribe or follow, so you don’t miss what’s next.

Until next time — stay curious, and stay confident.
Signing off, Dr. Pulipati.

Bonus: The Visual Guide for this episode is waiting for you — click here. For the full collection of visuals across episodes, visit the Podcast page.

Download the Free LipidCurious Starter Kit here

Questions or feedback? Reach out at hello@lipidcurious.com