Suck Carrots, High Protein Diet Advocates
Promoters of high protein
diets discount the importance of traditional risk factors, such as
elevated blood cholesterol, because they do not fit well into their
backwards theories on diet, health, and weight loss. Support for their
diatribe is also provided by papers written in scientific journals
suggesting that half of the people suffering from coronary heart disease
do not have the conventional risk factors. Instead they propose risk
factors that fit better with the teachings found in their diet books, such
as elevated insulin levels, to be the most relevant predictor of heart
disease. The Zone diet is a good example of this kind of diversion.
This
week�s issue of the Journal of the American Medical Association,
with three lead articles and an accompanying editorial, clearly shows that
consumption of the standard American diet, and the resulting elevation of
traditional risk factors, accounts for the vast majority of heart disease.1-4
Two separate articles examined data from 122,458 people in 14 randomized
clinical trials and 386,915 people in 3 observational studies to challenge
the claims that 50% of heart patients lack the conventional risk factors.1,2
Six Conventional Risk Factors
1)
Elevated Blood Cholesterol (> 200 mg/dl)
2)
Elevated Blood Pressure (> 140/90 mm/Hg)
3)
Diabetes
4)
Obesity
5)
Adverse Dietary Habits
6)
Cigarette Smoking
The solution is much less
confusing than having to worry about 6 separate problems (risk factors).
The first four risk factors are a direct consequence of the fifth (adverse
dietary habits). The risk factor of cigarette smoking also reflects an
unhealthy diet. Smokers have a higher intake of total fat, saturated fat,
and cholesterol, and a lower intake of folate, vitamin C, beta-carotene,
and fiber than nonsmokers.5,6 In other words, smokers consume
significantly more meat, dairy products, and processed foods; and fewer
fruits and vegetables, than nonsmokers. As a result, smokers have a much
less healthy diet than nonsmokers and this may be the most important
reason why they have more heart disease, rather than the direct toxic
effects from cigarette smoke. (Of course, smoking is bad for you too.)
Between 89% and 100% of the time, fatal heart disease was found to be
associated with at least one of the above risk factors. In 75% of cases
of non-fatal heart disease, total cholesterol was equal to or greater than
200 mg/dl. Other risk factors � like C-reactive protein (CRP),
homocysteine, Lp(a) and fibrinogen � have caused people to be distracted
from the real issue of diet, and cannot be recommended over traditional
risk factors for use in predicting risk of heart disease.3
Unfortunately, most patients and doctors will take from this journal a
message to redouble their efforts to stamp down (out) risk factors by
prescribing even more medications for blood pressure, cholesterol,
diabetes and obesity.4 Real benefits from this drug approach
are limited and/or of questionable value. The simple reason for this is
because people do not die from risk factors � I have never seen a patient
die of high blood pressure, high blood sugar, high cholesterol or
obesity. People with these signs of disease die of rotten arteries in
their heads and hearts. � strokes and heart attacks. So why not go to the
source of the trouble? The real solution to these problems is to correct
the underlying causes � the adverse diet primarily, and secondarily the
lifestyle issues (exercise, smoking, coffee, etc.) Unfortunately, there
is little profit in this approach. Besides, too many people see taking a
pill to be much easier than giving up beefsteaks and ice cream sundaes.
But they are dead wrong.
References:
1)
Khot UN. Prevalence of conventional risk factors in patients with
coronary heart disease. JAMA 2003; 290:898-904.
2)
Greenland P. Major risk factors as antecedents of fatal and
nonfatal coronary heart disease events. JAMA 2003; 290:891-897.
3)
Kackam D. Emerging risk factors for atherosclerotic vascular disease. A
critical review of the evidence. JAMA 2003; 290: 932-940.
4)
Canto CG. Major risk factors for cardiovascular disease. Debunking the
�only 50%� myth. JAMA 2003; 290:947949.
5) Palaniappan U. Fruit
and vegetable consumption is lower and saturated fat intake is higher
among Canadians reporting smoking. J Nutr. 2001 Jul;131(7):1952-8.
6) Dallongeville J.
Cigarette smoking is associated with unhealthy patterns of nutrient
intake: a meta-analysis. J Nutr. 1998 Sep;128(9):1450-7.
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