The widely held belief among doctors and the public that saturated fats clog up arteries, thereby causing coronary heart disease, is just “plain wrong”, contend experts in an editorial published online in the British Journal of Sports Medicine.
It’s time to shift the focus away from lowering blood fats and cutting out dietary saturated fat, they insist, and towards the importance of eating “real food”, taking a brisk daily walk (about 22 minutes) and minimising stress to stave off heart disease.
Coronary heart disease is a chronic inflammatory condition that responds to a Mediterranean-style diet rich in the anti-inflammatory compounds found in nuts, extra-virgin olive oil, vegetables and oily fish, say the experts.
In support of their argument, cardiologists Dr Aseem Malhotra of Lister Hospital, Stevenage, Professor Rita Redberg of UCSF School of Medicine, San Francisco (editor of JAMA Internal Medicine) and Pascal Meier of University Hospital Geneva and University College London (editor of BMJ Open Heart) cite evidence reviews showing no association between consumption of saturated fat and heightened risk of cardiovascular disease, diabetes and death.
Moreover, the limitations of the current ‘plumbing theory’ are writ large in a series of clinical trials showing that inserting a stent (stainless steel mesh) to widen narrowed arteries fails to reduce the risk of heart attack or death.
“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, have been misguided,” the experts contend, suggesting that selective reporting of data may account for these misconceptions.
The piece goes on to examine best prevention methods. A high total-cholesterol to high-density lipoprotein ratio is the best predictor of cardiovascular disease risk, and this ratio can be rapidly reduced with dietary changes such as replacing refined carbohydrates with healthy high-fat foods (such as nuts and olive oil).
A key aspect of coronary heart disease prevention is exercise, and it’s suggested that a little goes a long way. Just 30 minutes of moderate activity a day, three or more times a week, works wonders for reducing biological risk factors for sedentary adults. And the impact of chronic stress should not be overlooked, they say, as it puts the body’s inflammatory response on permanent high alert.
All in all, a healthy diet, regular exercise and stress reduction will not only boost quality of life but will also curb the risk of death from cardiovascular disease.
“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,” they write. “Coronary artery disease is a chronic inflammatory disease, and it can be reduced effectively by walking 22 minutes a day and eating real food.”
But, they point out, “There is no business model or market to help spread this simple yet powerful intervention.”