Among doctors and the public alike, there is a popular belief
that dietary saturated fat clogs up the arteries and results in coronary heart
disease. A new editorial published in
the British Journal of Sports Medicine says that this notion of saturated fat
clogging a pipe is "just plain wrong."
According to researchers, 'the conceptual model of dietary
saturated fat clogging a pipe is just plain wrong.'
The article is the result of a collaboration between a team
of cardiologists, including: Dr. Aseem Malhotra, of Lister Hospital in
Stevenage, in the United Kingdom; Prof. Rita Redberg, of the University of
California-San Francisco School of Medicine and editor of JAMA Internal
Medicine; and Pascal Meier, of University Hospital Geneva in Switzerland and
University College London, who is also the editor of BMJ Open Heart.
The team cited reviews that show no association between
intake of saturated fat and a greater risk of heart disease, in order to
support their argument against the existence of artery-clogging saturated fat.
"It is time to shift the public health message in the
prevention and treatment of coronary artery disease away from measuring serum
lipids and reducing dietary saturated fat," say the authors. Instead of
focusing on lowering blood fats and cutting out dietary saturated fats, the
importance of eating "real food," partaking in regular physical
activity, and minimizing stress, should all be emphasized.
According to Malhotra, Redberg, and Meier, the current
approach to managing heart disease echoes the practice of plumbing, but the
notion of improving the condition by "unclogging a pipe" has been
invalidated by a series of clinical trials. The trials found that when a stent was
inserted to widen narrowed arteries, the risk of heart attack or death was not
lessened.
"Decades of emphasis on the primacy of lowering plasma
cholesterol, as if this was an end in itself and driving a market of 'proven to
lower cholesterol' and 'low fat' foods and medications, has been
misguided," the panel contends. These misconceptions may stem from
"selective reporting of data," they suggest.
Coronary artery heart disease is the most common type of
heart disease and the leading cause of death for men and women in the United
States. The chronic inflammatory condition responds positively to a
Mediterranean-style diet, rich in the anti-inflammatory compounds often found
in extra virgin olive oil, vegetables, oily fish, and nuts, the researchers note.
The best predictor of heart disease risk involves a high
total cholesterol (TC) to high-density lipoprotein (HDL) ratio, not low-density
lipoprotein. Dietary changes, such as substituting refined carbohydrates with
healthful high-fat foods including olive oil and nuts, can significantly reduce
the high TC to HDL ratio, the experts explain.
Exercise plays an essential role in preventing heart disease
and may increase life expectancy by 3.4 to 4.5 years. Just 30 minutes of
moderate activity per day on more than three occasions each week has been shown
to make a difference to risk factors for inactive adults. Furthermore, the
researchers point out that regular brisk walking may be more effective at
preventing coronary disease than running.
Chronic stress is a risk factor for coronary heart disease
that "should not be overlooked," the team underline. Chronic stress
puts the body's inflammatory response on a continuous state of high alert.
Research has shown that environmental stress, such as childhood trauma, can
decrease life expectancy by up to 20 years.
The authors write:
"Combining a complete lifestyle approach of a healthful
diet, regular movement, and stress reduction will improve quality of life,
reduce cardiovascular, and all-cause mortality."
The researchers add that spending just 22 minutes per day
walking and eating healthful food can prevent coronary artery disease. However,
"there is no business model or market to help spread this simple yet
powerful intervention," the authors conclude.
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