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  • Taylor Leahy - Dietitian

A Better Butter? Alternative Options for Individuals with POTS .

I’m going to be the first one to admit it… I LOVE butter. Adding butter to toast, pasta and baked potatoes is what I live for (don’t judge). I think we can all admit that it’s pretty tasty, but even so, for someone with Postural Orthostatic Tachycardic Syndrome (POTS) or similar symptoms, you may need other options.

Excess saturated fat consumption from butter may be a trigger for someone with POTS and can worsen symptoms if they have gastroparesis. Butter also has very little protein (0.1g per Tbsp), vitamins and nutrients which makes it high in energy density but low in nutrient density. When someone has chronic fatigue and lacks the energy to eat and do much meal prep, nutrient dense foods that are also energy dense are generally recommended. That way you get the biggest bang for your buck!

Let’s take a look at some of the alternative options to butter:

Hummus- Hummus is one of those foods that can really be a substitute for a lot of things, but in this case let’s look at how it stacks up to butter. Hummus is a traditional Middle Eastern spread and dip that is primarily made out of pureed chickpeas (also called garbanzo beans), tahini (ground sesame), oil, lemon and salt. SO simple, yet SO tasty. Hummus has about a third of the fat per serving compared to butter, and also contains protein (1.2g per Tbsp), fiber and sodium. According to Dysautonomia International, a high sodium diet is recommended for individuals suffering with POTS as it helps to replenish electrolytes and increase blood volume.

Avocado- This green goddess may be known for being a staple in many Mexican dishes, but did you know it can be an alternative to butter? It still provides that creamy mouthfeel that butter does, but instead of saturated fat, its green meat contains heart healthy monounsaturated fat. Avocado also has a higher nutrient density compared to butter, meaning when you sub avocado for butter you’re also getting- fiber, potassium, vitamin c, a small amount of protein (2.9 g per cup), and lots of antioxidants! Fiber can help reduce diarrhea in some individuals. Avocado can also be used as a replacement for some butter in baking and can be spread on toast. Avocados are naturally dairy free and sodium free, however it does pair well with a nice sprinkle of table salt if a higher sodium intake is what you’re looking for.

Margarine and Oil Blends- Olive oil margarine and avocado oil spread, yes folks, let’s talk about this never ending list of margarine. Original margarine had a bad reputation for high saturated fat however, there have been a lot of improvement in the nutrient composition of margarine and now there’s a seemingly never ending array of margarine and oil spreads that can fit your every need. There are so many options, from a more traditional light margarine, to yogurt butter (which is quite delicious in my opinion). These spreads generally contain more heart healthy monounsaturated fat and significantly less cholesterol compared to butter. Most of these spreads are dairy free and low fat, which may be beneficial for someone who may be dairy free or have gastroparesis.

Nut and Seed Butters- Nut and seed butters are a great example of getting more “bang for your buck”. These types of butters have everything- protein, calories, healthy fat, fiber and sodium. They can make a great substitution for butter on toast, and can be a great way of adding calories for someone with a low appetite or severe fatigue. There are endless options of nut and seed butters on the market, so even if you’re peanut or tree nut free -- don’t worry, there are still options for you! The best choices for nut and seed butter are those with the fewest ingredients. If there are more than 2 or 3 ingredients, it may be best to go with a different option.

Olive Oil- Olive oil can easily be a substitute for butter in many instances, including: frying or sautéing, grilling, marinating, spreading it on bread, the list can go on. What I love about olive oil is the unique taste it offers, the heart healthy fats it provides, and oh so many antioxidants! Olive oil can also be added to foods to not only improve nutrient density but also energy density. Oils generally contain more calories than butter per serving (119 kcal/Tbsp vs 102 kcal/Tbsp) so oils can easily be added to foods if additional calories are needed. Try using olive oil as a salad dressing, or blend up a quick pesto with oil and basil for a calorically dense sauce!

Applesauce- Applesauce isn’t a super traditional butter alternative when talking about using it as a spread on toast or adding it to a baked potato. However, it comes in handy as a substitute for butter in baking. Butter is notorious for giving baked goods their moisture and helps bind ingredients together, and applesauce can do the same thing. In some instances, baked goods may come out slightly sweeter and softer with applesauce, so starting small and subbing only half the butter may be a good way to start. If you’re confident in your subbing abilities most sources recommend a 1:1 swap, meaning if a recipe calls for 1 cup of butter, you’d use 1 cup of applesauce instead. Applesauce is naturally low in fat so may benefit individuals who are struggling with gastroparesis or may need a heart healthy option.

Ghee- Ghee has been around for a long time and is a common staple in Indian cuisine, but it’s recently gained popularity in other circles. For those who aren’t familiar, ghee is clarified butter, which means that it has been melted and strained to remove the milk solids. Ghee and butter have very similar nutrient and calorie profiles, meaning Ghee still contains saturated fat, however for individuals with a dairy sensitivity it may be a better option than butter because it contains less lactose than traditional butter.

We talked about a lot of things in this article, so here is a quick summary:

  • Butter contains saturated fat and dairy, which may exacerbate dysautonomia/POTS symptoms especially if one has gastroparesis or if dairy is a food sensitivity.

  • Replacements for butter as a spread on toast: avocado, heart healthy based margarine, hummus, nut butter and ghee.

  • Replacements for butter in baking: applesauce, avocado and ghee.

  • Most of these replacements contain a healthier source of fat and more antioxidants compared to butter.

  • Hummus and nut butters also contain sodium, a crucial nutrient for individuals with POTS.

Check out the black bean and avocado brownies on Instagram that all of my coworkers loved! They are a great example of swapping out butter for an alternative. Try it and you’ll be the hit of the next get together!

You can always find more food and nutrition inspiration and fast facts on Dysautonomia if you follow Leahy Nutrition on Facebook and @dysautonomia.dietitian on Instagram.


1. Butter vs. Margarine. (n.d.). Harvard Health. Retrieved July 27, 2020, from

2. The truth about fats: The good, the bad, and the in-between—Harvard Health. (n.d.). Retrieved July 27, 2020, from

3. Dysautonomia International: Postural Orthostatic Tachycardia Syndrome. (n.d.). Retrieved July 30, 2020, from

4. Avocado Nutrition Facts and Nutritional Information. (n.d.). Retrieved July 26, 2020, from

5. Living with Dysautonomia. (n.d.). Cleveland Clinic. Retrieved July 30, 2020, from

6. Margarine or Butter: The Heart-Healthiest Spreads. (2014, January 28). Health Essentials from Cleveland Clinic.

7. California Olive Oil Council. (n.d.). Retrieved July 27, 2020, from

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