The American Heart Association’s woefully outdated dietary guidelines are hurting Americans’ health.
Last December, we told you about the American Heart Association’s (AHA) new new cholesterol guidelines that would make 33 million healthy Americans dependent on statins. These are the most widely prescribed class of drugs in the world—drugs so dangerous that the FDA mandates their side effects be disclosed in labeling.
The AHA’s statin guidelines are based on the outdated, simplistic notion that there are two kinds of cholesterol: “bad” (LDL) and “good” (HDL). Moreover, the AHA’s dietary guidelines are also centered on the notion that “bad” cholesterol causes heart disease, and that since saturated fat may raise “bad” cholesterol levels, it’s the ultimate dietary evildoer.
The problem with AHA’s “logic?” Not only has this bad/good cholesterol dichotomy been solidly debunked by study after study—it was never proven in the first place. According to the Wall Street Journal, the notion that saturated fats and LDL clog our arteries came from a “derailment” of nutrition policy “by a mixture of personal ambition, bad science, politics, and bias.”
Below, in bold, are some other highlights of AHA’s dietary guidelines, accompanied by why they actually are bad for your heart:
- “Reduce saturated fat!” Wrong. In fact, eliminating saturated fat from the modern diet might be harmful, if only because of the alternatives that replace sources of saturated fat. Take butter, for example. Raw, organic butter from grass-fed cows can be extremely healthful: it contains vitamin A in its most bioavailable form, lauric acid, antioxidants, vitamin E, and vitamin K2. But the alternatives to butter—margarine and hydrogenated or processed polyunsaturated oils—are far more detrimental to your health than saturated fat. They are actually a leading cause of heart disease. Recently, the evidence that saturated fat has no connection to heart disease has been snowballing. To give just one example: as reported by LewRockwell.com, a massive meta-analysis by the British Heart Foundation (it examined seventy-two academic studies involving over 600,000 participants) found that saturated fat consumption was not associated with an increased risk of heart disease.
- “Drink low-fat and skim milk!” Wrong. A recent study has shown that children who drink whole milk are slimmer than kids who drink skim! One theory for this is that “full fat foods” promote satiety. Additionally, full-fat dairy can actually reduce your risk of heart disease, as well as diabetes and cancer. (Not surprisingly, the AHA doesn’t even discuss raw milk and its proven benefits.)
- “Avoid ‘bad’ cholesterol!” LDL has some crucial health benefits—it can even provide protection from cancer as well as support aging muscle mass. In addition, studies show that lower levels of LDL don’t necessarily lessen your risk of heart disease.
- “Limit Your Intake of Red Meat!” Wrong again! Unless you have prostate cancer or a propensity to it and want to be extra cautious, there are reasons to view hormone-free, grass-fed beef positively. Red meat is an excellent source of protein and other nutrients. Among other nutrients, it contains L-carnitine, an amino acid that is helpful for heart disease. A large meta-analysis, published in the journal Mayo Clinic Proceedings, found that L-carnitine actually helps heal the heart after a myocardial infarction (heart attack).
- “Don’t smoke tobacco, and avoid secondhand smoke!” Finally—something we can all agree on.
Meanwhile, statin drugs may actually be driving Americans to overeat: a twelve-year study published in JAMA Internal Medicinefound that statin users increased their calorie intake by 9%, and fat consumption by 14.4%, over the study period (those who didn’t take statins didn’t significantly change in either measure).
This study controlled for age, race, education, diabetes, and high cholesterol—which means that researchers isolated statin drugs as the reason participants were overeating. Researchers speculate that the explanation is psychological: those on a “magic pill” feel entitled to take greater liberties with their diet.
I live in the United Kingdom.
What I have found is that doctors are so keen to use drugs, mainly because they simply have no knowledge or training in diet, exercise and other aspects of health.
They only seem to have knowledge of what they call ‘science based’ drugs. They appear not to read the studies that relate to real health and prevention.
In the UK we have a free National Health Service, based on drug-based treatments, approved by NICE, which appears to be very conservative. Despite, or because of this, apparently every few years many drugs are discarded or superseeded. Those that were found to be ‘effective’ are, a few years later to have caused so much disease, pain and death.
As a sufferer of atrial fibrillation, they want to ‘thin’ my blood. They have tried to get me on statins, warfarin and a more recent drug. I was starting to be influenced when my consultant started claiming that warfairin saves 60 from clots, yet this latest drug saves 80, I assumed percentage. No, he corrected me, per 1000. I quickly calculated that meant that his drug would prevent clots in 8% of cases.
I don’t regard that as very scientific, as I have read the % benefits of diet, exercise, supplements and other aspects of health like not smoking and drinking. Doctors seem to expect that most patients will not do much to change these basic habits.
My doctor and the entire staff of doctors at my clinic are insisting that I take a statin, I’m flatly refusing to do so. Even though my cholesterol levels are good they still say I will die sooner if I don’t take the statin since I’m a Type 2 diabetic. I think this is a load of BS! They can keep on quoting their “studys” and trying to cram the pills down my throat, I won’t take them.
Their advice is incredibly ridiculous and not be adhered to by any rational, thinking person capable of doing their own (nutrition) research.
When writing a clinical piece, or even an attempt at a serious article, one should not only put ones name and professional credentials, but also cite the studies to which they refer (ie “study after study” etc). I am not sure what a blog/journalist at WSJ has to do with medicine, nutrition or science, I retrieve my information from accredited professionals whom have actually studied in the pertaining specialized field. Which brings me back to my comment about not knowing who you are, and what your medical and/or scientific credentials are that qualifies you to such a degree, that I should take your word. I am a layperson, there is enough debate within the scientific community regarding the endless perspectives of the human body, the problem is exacerbated by unqualified individuals writing op ed pieces as if they were scientific findings, when in fact they have no idea how to even read a scientific study. Case in point, the research that you refer to regarding saturated fat was retracted:
Excerpt (see link below)
Another study author, Emanuele Di Angelantonio of the University of Cambridge, says the main problem is that the paper was “wrongly interpreted by the media.” “We are not saying the guidelines are wrong and people can eat as much saturated fat as they want.”
Willett says correcting the paper isn’t enough. “It is good that they fixed it for the record, but it has caused massive confusion and the public hasn’t heard about the correction.” The paper should be withdrawn, he argues.
The controversy should serve as a warning about meta-analyses, Willett adds. Such studies compile the data from many individual studies to get a clearer result. “It looks like a sweeping summary of all the data, so it gets a lot of attention,” Willett says. “But these days meta-analyses are often done by people who are not familiar with a field, who don’t have the primary data or don’t make the effort to get it.” And while drug trials are often very similar in design, making it easy to combine their results, nutritional studies vary widely in the way they are set up. “Often the strengths and weaknesses of individual studies get lost,” Willett says. “It’s dangerous.”
http://news.sciencemag.org/health/2014/03/scientists
Diet has limitations. Nothing short of starvation will get those with familial hyper-cholestremia below 300-400 mg TC.
Prophylactic cholesterol reduction below 220 TC does not reduce mortality among the young and healthy. Those with arteries damaged by inflammation, hyperglycemia or hypertension often require remedial reduction below 150 mg TC which does require drug intervention.
Diabetics have similar targets but with higher starting levels as hyperglycemia raises cholesterol synthesis. Those with insulin-dependence or kidney involvement are beyond the realm of exercise and carbohydrate restriction. Preaching diet and lifestyle to them in lieu of appropriate drugs is criminal.
Relegate diet and exercise to primary prevention and as a VOLUNTARY adjunct to more aggressive drug-based secondary prevention.
Finally, statins have effects that stem from reducing inflammation and prenylation of important proteins. Some can slow the progress of Alzheimer’s disease and ARMD. One has cured as many as half of erectile dysfunction cases in one trial. No diet, herb or non-statin lipid drug has achieved those effects.
Diet and life style recommendations are fine for young healthy people but it is unethical to deny drugs to those who are already old or infirm.
Quit making your decisions on Big Pharma false studies and make decisions based on science and facts.
I have a potentially deadly condition, but statins nearly killed me before the disease could. Thankfully my doctor cares enough about his patients to bases his advice on research not, pharmaceutical marketing material.
Now I eat all the fat I want from organic sources and feel better each day. Thanks for the great information. It may save lives.
You say “this bad/good cholesterol dichotomy been solidly debunked by study after study” but you don’t cite even one study which shows this, because such studies do not exist. You do cite a meta-analysis of several studies, but this meta-analysis is deeply flawed and has been partially corrected, as described here:
http://news.sciencemag.org/health/2014/03/scientists-fix-errors-controversial-paper-about-saturated-fats
The American Heart Association recommendations are based on very large epidemiological studies performed over many years (decades, actually). Some of the earliest studies had methodological flaws which would not pass without criticism today, but even ignoring those ones, the fundamental conclusions stand. Saturated fat intake is indeed a major risk factor for developing atherosclerosis, and no studies refute that. Replacing saturated fats in the diet with monounsaturated or polyunsaturated fats reduces cardiovascular risk.
The other questions deserve more research. Replacing saturated fat with carbohydrate may indeed raise risk, but that needs more study. Statins may have harms that are not fully understood, so I wouldn’t take them unless I had seriously elevated cholesterol that can’t be resolved by diet and exercise. There may be risks other than cardiovascular risk which should be taken into account, such as the risk of developing Alzheimer’s disease or other forms of dementia. Also, the stage in life needs to taken into account — there are some studies which seem to indicate that high total cholesterol in old age is associated with reduced risk of dementia. That’s not implausible, because cholesterol is major component of the central nervous system.
What level of cholesterol do you consider “seriously elevated”?
I don’t know what level would get me to take statins, because I’ve never had to consider the question. My cholesterol is very low. I’ve been avoiding saturated fats since I was a teenager. However, current thinking in medical research is that endothelial dysfunction is the initial event in atherosclerosis, which may explain why cholesterol levels and saturated fat intake are only risk factors and do not fully explain why some people get atherosclerosis and others do not.
This study shows the beneficial effect of red wine on endothelial function and blood pressure. After reading this I switched to red wine, even though I’m not very fond of wine.
http://eurheartj.oxfordjournals.org/content/21/1/74.full.pdf
Known causes of endothelial dysfunction include age, obesity, lack of exercise, and oxidative stress (for example, caused by smoking or high blood sugar). In addition to atherosclerosis, endothelial dysfunction is strongly implicated in the development of type 2 diabetes, and an emerging body of evidence implicates endothelial dysfunction in the development of Alzheimer’s Disease. The latter suffers from the burden of overcoming the prevailing Amyloid Cascade Hypothesis, which is the paradigm that has dominated Alzheimer’s Disease research for the last 20 years — to the detriment of all other hypotheses about the cause of AD.
I’ve been using Chinese Herbal Remedies for years. When my doctor analyzes my physical problem, I instruct him that should the prescription include statins, not to even write it. Instead I visit my acupuncturist who keeps a supply of Remedies and take them instead. I have found the Remedies work better than Big Pharma’s prescription “and have no side effects!” I’ve used the BP Remedy and found that, in only 4 1/2 days. my BP was normal. I do not take them regularly but keep track of my BP and take these pills for a few days.
I am 80 years old and quite healthy with the exception of a slightly raised BP. I attribute my good health to my belief that, “if the Creator didn’t create the food, plant, etc., I refuse to use it. Because herbs cannot be patented, Big Pharma extracts the one or two elements they believe will cause a cure while, at the same time, discarding the buffers the Creator placed on this earth. (Chinese Remedies utilize the entire plant.) This is the reason Western drugs have so many side effects. Margarine has never crossed my doorstep! I recall kneading that mess of white stuff with a color bubble in it. That was the initial introduction of margarine.
I’ve also found that exercise reduced my BP so I purchased a tricycle which will allow me to take care of the necessary trips, shopping, laundry, library, etc. and is a lot of fun to use. Cyclists greet each other and have no need to use the finger signs drivers do. With the cycle I receive three benefits: no gas necessary, no insurance and better health.
I take niacin for cholesterol control. It works perfectly. Easy to take and very inexpensive – and why anyone would take statins instead is beyond me. For me personally two grams a day is more than ample to get great cholesterol numbers. Many will have major initial flushing at first. The key is to start at a low dose – and for some this will be 20 or 25mg always with meals. Get a pill cutter if needed. Stay just below the dose that creates a major flush as you build up the amount you take in small increments daily. If too much flush, back off the dose for a day – then start building again. It may take 2 months to get to useful therapeutic dose, but then you are there for the rest of your life. Anyone can do this if I can because I am extremely sensitive to niacin in terms of flushing. Personally I need to take a day off niacin once or twice a week to avoid nausea and throat mucus (seemingly unreported symptom in the literature). And that day off does not really affect the good numbers I am getting. I am totally pleased with the results. All it takes is the will to do it – that is the key. I still get some flushing on occasion but now like the feeling.
Two grams per day is a huge dose of niacin, which carries a risk of liver damage. Note that there is a big difference in toxicity between immediate release (IM), extended release (EM), and sustained release (SR) dosage forms. This paper has a good description of the risks of niacin and other treatments for high cholesterol:
http://www.heartlifetalk.com/Documents/Hepatotoxic%20Effects%20of%20Lipid-altering%20Agents.pdf
If it were me, I’d try exercise and diet first. NO PILL CAN SUBSTITUTE FOR EXERCISE. But if nothing else works, statins and high-dose niacin are clearly options worth considering. Some people have a genetic predisposition toward high cholesterol and cardiovascular disease (due to variations in the genes for the apolipoproteins), and you need to control that somehow.
My huband took Lipitorfor for 6 years and during this time he started having arrthymias ( irregular heart beats) this when on and over time I suggested he see his cardiologist. We did and he ran tests only to suggest more drugs. My husband refused them, the side effect was exhaustion.He could go to work but after that he would need to come home and rest. He was in his mid fortys and choose not to live that life. We were back 1 year later to his Doc his symtoms increased and he was having more and more arrthymias. The doc gave the same answer as before, more drugs. I did research online and found CoEnzymeQ10. My husband started on this vitamin that our bodies make natural. In 6 months he started feeling some relief and in 9 months his arrthymias decreased substancially. If you research the side effects it will state that Lipitor will deplete CoenymeQ 10 which is necessary for the mitacondria (powerhouse of the cell) to work. Henry was so depleted his heart couldn’t fire correctly hense the arrthymias .He stopped the Lipitor and made life changes. 2 years later we heard the 1st commercial about how Lipitor isn’t heart friendly for everyone.
I assure you that every time some thing like this comes out, the nay-sayers are there pointing out the “flaws.” When they said dark chocolate is good for you I heard two idiots on the radio saying, “Yeah sure, go home eat 5 lbs of dark chocolate and you’ll be healthy.” Everything is in moderation. Think “homeostasis,” think “Yin and Yang.” Balance is the key. I lost 35 lbs last year (over 6 months), all I did was cut out dairy (most of it, had to have a little cheese!), cut out most grains, no added sugar. I ate about a dozen eggs a week, and some breakfast sausage (varying types), occasionally some oatmeal, LOTS of VEGGIES, and one to two pieces of fruit a day, and a proper serving of any meat or fish I wanted. I did sometimes overdo the coffee, with cream and stevia, but often drank green tea or herbal tea. And yes, I ate as much as 1 to 2 fair-sized (8 to 12 oz.) dark chocolate bars a month. My cholesterol levels became more perfect. (They were ok to start- below 200 total.)
Oh yes, and cooked everything in olive oil OR REAL butter!!
…Sorry, one final comment,
I also read a well-documented article (probably 2 yrs ago- so, I don’t have a citation, or know in what journal I read it… but, the article said that STATINS commonly are not effective for women. Because women are different than men in certain ways, in which the statins are much less effective. So, you won’t catch me (ALIVE or DEAD) taking statins!!!
If someone had told me that taking statins would destroy my muscles, I would not have taken them. Why isn’t there a huge upswell from the women that’s lives have been ruined by these drugs? Why would they give us a drug that they know will give you more side effects than benefits? My life is ruined. I fight daily to regain my muscles but I am getting worse and worse. Don’t blame those muscle twinges on old age or too much work. It’s statins!!! AND THE HEART IS ONE BIG MUSCLE!!!!!!!!!!!!!!!!!
Christine, have your muscles improved at all? I have been on statins since I was 40. I’m 54 now. I was put on statins because I have been a type 1 diabetic since I was ten. I was told that it was a very safe medication and would prevent heart disease and stroke. I led an active lifestyle and was at a normal weight. Shortly after starting statins, I found it difficult to go for bike rides and walks without getting winded. Dr said “middle age”. Then I began gaining weight and my blood sugar went out of control. Dr said I had insulin resistance from being overweight and not exercising! I went to a different Dr. I told him I didn’t feel well since being on statins. He blamed it on middle age. As the years went by my memory began to go bad and I got depression that wasn’t helped by antidepressants. I kept being told to exercise and lose weight! My depression got to the point of me losing interest in everything and I became emotionally numb. Finally I couldn’t stand it anymore, went to Dr, told her I can’t live like this! She sent me to a muscle specialist who sent a report to my other doctors suggesting that I be off statins. So far I’ve improved greatly but still feel aching in my muscles. Depression and apathy are gone! I’m angry because I feel I’ve lost 14 years.
There is overwhelming scientific evidence that animal products are bad for us. http://www.nutritionfacts.org A plant-based diet will improve the health of most people.
The fact is no real evidence supports the link between saturated fat and heart disease . For a interesting read the WSJ from May 6 2014…”The Questionable Link Between Saturated Fat and Heart Disease
Are butter, cheese and steak really bad for you? The dubious science behind the anti-fat crusade “? which starts
…. “”Saturated fat does not cause heart disease”—or so concluded a big study published in March in the journal Annals of Internal Medicine.” several other large well done studies have concluded precisely the same ……
Yet in response the AHA continues promote the Heart healthy logo on foods based primarily on salt and fat restriction….recently the IOM found no evidence for salt restriction. Yet some of the AHA logo appears on foods loaded with sugar a real cause of disease……and who can forget the advice to use margarine some of which are loaded with trans fat .I wonder how much it cost to use the AHA logo? for an interesting look at statins a very balance piece “Heart of the Matter | The Cholesterol Myth | Part 2 on you tube https://www.youtube.com/watch?v=F0kIC-dbW2g