Heart Risk Evaluations Dietary Philosophy

(Low Fat or Low Carbohydrate?)

Which Diet Does Heart Risk Evaluations Recommend?

There are many diets commonly recommended for good general health and specifically to lower cholesterol and the risk of heart disease.  And today, early in the 21st century, there is a huge debate raging over two popular but very different dietary programs.  One is the high-carbohydrate, low-fat approach, which has been popular for the last 10 or 15 years.  These diets are recommended by such prominent figures as Dr. Dean Ornish, Dr. John McDougall, Nathan Pritiken, Dr. Terry Shintani and a host of others.  Furthermore, the medical industry as a whole has favored this approach for a number of years.  The other popular dietary regimen is low carbohydrate, with moderate to even high levels of fat and protein recommended.  Proponents of these diets include Dr. Robert Atkins and the authors of Sugar Busters, Protein Power and the Carbohydrate Addict's series.

Which of these two groups is correct, is it possible that they could both be correct, or could there be some middle ground between these two extremes?  Have scientific studies proven anything in this regard?

Actually, there has been such a "scientific" study in effect for many years and tested on millions, even billions of "subjects."  The testing ground is Japan and China and the South Seas and Hunza and the United States and Finland and Germany.  In these lands and others the general populace follows certain dietary patterns.  By examining medical data from these locations it can readily be discerned which dietary traits offer the most heart-health protection.  The answer?

In lands such as Japan, China, the South Seas and the Hunza, where diets are traditionally lower in fat and high in plant-based foods, occurrence of heart disease is very low, even rare.  In places such as the United States, Finland and Germany, where diets tend to be heavy in fats, and particularly saturated fats, the occurrence of heart disease is very high, even common.  (The incidence of heart disease in other lands where much fat is consumed but where it is in a more healthful, monounsaturated form such as olive oil, such as Italy, falls somewhere in between these two groups.)

Furthermore, studies have shown that a very low saturated-fat, low-cholesterol diet, such as that of Dean Ornish's "Prevention Diet," actually reverses arterial plaque buildup.  It is so successful at doing this that over 150 insurance companies support his dietary program for heart patients.

What, Then, Accounts for the Low Carbohydrate Craze?

If the low-fat diet is superior, what accounts for the recent higher fat, low-carbohydrate craze?  There are probably three reasons, and they all exploit "weaknesses" in the low-fat plan, as follows:

1.  While many people on low-fat diets faithfully follow the principles of healthy eating, others do not.  They get sidetracked, or obsessed, with keeping their fat intake below a certain level, such as 10% of all dietary calories consumed.  In doing so, they may lose sight of the big picture, and become careless with the other 90% of their calories.  These may more and more be eaten in the form of simple carbohydrates—soda (even health food sodas), candies (even health food candies), pretzels (even health food pretzels), juices (even health food juices) sweet fruits, low-fat ice creams and so on.   This sets the stage for and can become carbohydrate addiction, also known as insulin resistance syndrome or Syndrome X.  Even on a low-fat diet, but in the presence of high insulin levels, body weight may rise (especially in the form of upper-body weight, the spare-tire syndrome) and cholesterol levels may rise.  This diet can also put one on the fast-track to adult-onset diabetes and heart disease.

2.  Some people like their ears tickled (and their bellies filled with fat).  In other words, many have grown up in the culture of "the more meat and dairy products the better."  They thus consume a steady diet of these products, often supplied by fast food establishments.  When they realize they have serious health problems and need to make changes, they are shocked by the scope of change necessary to move to a truly healthy lower fat, plant-based diet.  (By plant-based diet we are referring to the bulk, or majority of the diet being plant foods.  This is not necessarily implying completely eliminating animal products from the diet.)  So to avoid what they believe will be a traumatic change, they are very easily convinced that as long as they avoid carbohydrates, they can eat whatever they want, grease, chemicals and all.

3.  They sell a lot of products.  Dietary books have always been huge sellers, often planting themselves at the very top of bestseller lists.  Furthermore, it is interesting to note that there is a huge difference in the amount of food products sold between the low-fat and the low-carbohydrate camps.  Dr. Atkins of the latter, for instance, has a huge line of products that produces tasty, even sweet-tasting manufactured foods that are low in carbohydrates.  You can, though, barely find a store bought product by the low-fat experts.  Why is this?  Because those who propose the low-carbohydrate diets are always coming up with some sweet-tasting man-made candy bar or cookie that has a bonus, they are indeed low in carbohydrates.  On the other hand, what Drs. Ornish and McDougall and Shintani and others are telling us is to eat the healthful, nutrient-packed foods that come right out of the ground.  They know that these foods are perfectly designed, and they can't be improved upon.  (These facts may also bring into question the motivation behind the dietary structure of those pushing an ever-increasing line of expensive diet foods.)

Are Some Low-Carbohydrate Diets Better Than Others?

We think so.  The diets recommend in the books Sugar Busters, Pure Protein, and the Carbohydrate Addicts series are all reasonably sound in principal and may indeed be a better alternative to those who tend to keep fats low but are damaging their bodies with an overabundance of simple, refined carbohydrates.  On the other hand, diets such as the Atkins Diet, where the bulk of food choices are products low in carbohydrates but dripping with saturated fat, such as sausages and fatty marbled red-meats and large quantities of eggs, have been called by many medical experts dangerous and irresponsible.  Heart Risk Evaluations shares this view.  It could be asked, in fact, is this not essentially the diet that got us into so much trouble in the first place?

The Heart Risk Evaluations Recommended Diet

Expert sources such as Dr. Dean Ornish, Dr. William Castelli and Stanford University's Life Plan all suggest two different dietary programs—one for those with good heart-health and another more stringent one for those with a history of plaque buildup or heart disease.  We agree with this sound approach.

In general, a healthy diet should have the following characteristics.  It should: 

1.      Be low in saturated fats.  Because the body uses saturated fats to produce cholesterol, saturated fats contribute most to our levels of serum cholesterol, even more so than dietary cholesterol.  For those without heart disease we recommend a limit of 25 grams a day.  For those with heart disease we recommend a limit of 10-15 grams.  (These limits are best implemented on a weekly basis by average.  This allows for the occasional—and perhaps necessary—splurge.)

2.      Reduce dietary cholesterol.   Dietary cholesterol will contribute to an increase in serum cholesterol.  And for those of you who may have wondered, there is no way of consuming HDL "good cholesterol" to increase your bodies level of that substance. Dietary cholesterol increases serum LDL cholesterol.  Heart Risk Evaluations recommends that those without heart disease limit their cholesterol intake to under 200 mg. a day.  Those with heart disease should not exceed 10-50 mg. a day.

3.      Control total fats.  Even unsaturated fats, such as those found in olive, canola and flax seed oil, are healthy only in small or moderate amounts.  We recommend a total fat intake of between 15-25 percent of all dietary calories, concentrating on such healthful sources as the three oils mentioned above and those occurring naturally in avocados, nuts and seeds.  For those with heart disease, we suggest reducing this to 10-20 percent.

4.      Limit consumption of animal products, while concentrating on leaner cuts of meat, such as chicken, fish and turkey, and low-fat or non-fat dairy products.  Egg yolks are very high in cholesterol, and two egg whites often provides a suitable substitute for one egg yolk in cooking.

5.      Limits other substances that are harmful in large amounts, such as refined dietary sugar and alcohol.  Remember, you can wipe out all of the good effects of a lower-fat diet by pushing past reasonable limits in these areas.

6.      Rule out overeating.  While it is very difficult to track precise caloric intake, and calorie requirements vary from person to person and even from day to day, it is taken for granted that a healthful diet would exclude overeating, especially so on a regular basis.

7.      Include moderate to generous amounts of supplementation.  For some a simple, low potency multi-vitamin-mineral tablet may suffice.  Others will achieve better results with higher doses, especially of specific cardiovascular protective nutrients.  Some of the more recognized supplements are vitamins E and C, niacin, flax seed oil, psyllium, garlic (including deodorized), co-enzyme Q-10, and others.

8.   An abundance of water.  The benefits of proper hydration are many.  A good rule of thumb is to drink eight glasses of water each day.  To tailor a program more closely to your needs, consider the following formula:  Drink one half of your total pounds of body weight in ounces.  Thus, a person weighing 150 pounds should drink 75 ounces of water a day.  We recommended drinking the majority of this away from the main meals. Some meet this requirement by sipping on water through a "sports bottle" throughout the day.

9.   Not be an oppressively overbearing.  Learn to enjoy eating healthful foods, but don't become a fanatic (those with heart disease or who are at high risk need to be more stringent than the rest of the population, though).  Don't ruin the benefits of  your whole tropical vacation because of being inflexible with your eating habits.  An occasional splurge, or eating small amounts of less than ideal foods, probably won't hurt you.  One famous health practitioner recommends that if you are going to splurge, do it with quality foods.  You'll probably be more satisfied with a smaller amount if you do this, she claims.

May you enjoy eating such a healthful diet and may your heart beat soundly for a long, long time.  Good health to you!

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