2015 Dietary Guidelines Include
Healthy Revisions, but Still Falls Short for Effective Prevention of
Heart Disease
February 10, 2016
Story at-a-glance
−
The 2015 to 2020 dietary guidelines for Americans is
shifting away from focusing on specific nutrients toward
a general focus on eating real food, moderating protein
consumption and, for the first time, limiting added
sugars
The limit on dietary cholesterol has been removed
entirely. This is good news, since dietary cholesterol
is actually one of the most important molecules in your
body
They refuse to review recent studies and continue to
vilify saturated fat, stating it raises LDL while
ignoring that it only increases safe large fluffy LDL
particles and actually increases HDL
By Dr. Mercola
On January 7, 2016, the U.S. government released its 2015 to 2020
dietary guidelines
1,2,3,4,5
many of which are steps in the right direction. Perhaps one of the
most promising changes is a shift away from focusing on specific
nutrients toward a general focus on eating real food.
My main objections are that they still do not consider the
hazards of eating too many non-fiber carbs, which can exacerbate
insulin and leptin resistance. And they still inaccurately accuse
saturated fats of promoting heart disease.
On the upside, they do suggest reducing processed grains overall.
The following graph, created by the U.S. Department of Agriculture,6
shows the discrepancies between the 2015-2020 dietary
recommendations and what Americans actually consume, comparing
statistics from 1970 and 2013.7
Beneficial Changes in the 2015 Dietary Guidelines
Among the beneficial changes brought forth in the 2015 dietary
guidelines for Americans, we have:
New sugar limit: For the first time, the
guidelines recommend limiting added sugars to a maximum of 10
percent of your daily calories. Based on a 2,000-calorie-a-day
diet, that would equate to about 50 grams of sugar per day,
which is still too high if you’re insulin-resistant or diabetic.
I recommend limiting your total fructose intake to 25 grams
per day for optimal health, and as low as 15 grams a day if
you’re insulin resistant or diabetic.
Artificial sweeteners should not be used for weight
loss. While they say artificial sweeteners such as
aspartame are probably OK in moderation, they should not be
promoted for weight loss.
This recommendation reflects the overwhelming amount of
evidence showing that
artificial sweeteners in fact tend to promote weight gain,
and have been shown to worsen insulin resistance and metabolic
disorders to a greater degree than refined sugar.
Moderate protein consumption. The new
guidelines note that men in particular, tend to eat too much
protein.
The guidelines do not go so far as to suggest a
limit, however, although it does specify eating 8 ounces of
seafood per week which, besides protein, is a source of healthy
omega-3 fat.
Nor does it strictly warn against eating processed meats,
even though it mentions processed meats have been associated
with an increased risk for cardiovascular disease.
For reasons detailed in my previous article, “The
Very Real Risks of Consuming Too Much Protein,” I recommend
limiting your protein to about one-half gram of high-quality,
organic, pastured/grass-fed protein per pound of lean body mass,
which for most would be 40 to 70 grams a day.
Eating more high-fat/low-mercury fish in lieu of red meat is
one great way to reduce your protein consumption, as fish is far
lower in protein than meat. As for
processed meats, they have far more risks than benefits, and
are best avoided as much as possible.
The International Agency for Research on Cancer, a part of
the World Health Organization, has actually classified processed
meats as a Group 1 carcinogen, as the evidence strongly shows it
can cause colorectal cancer in humans.
Eat more veggies. The guidelines recommend
eating 2.5 cups of a wide variety of vegetables. In my view, you
can’t really overdo it when it comes to vegetables, as they’re
very low in calories, and supply much needed
fiber and prebiotics that nourish beneficial gut bacteria.
Good News: Limit on Dietary Cholesterol Has Been Removed
For the past four decades, the U.S. government has warned that
eating cholesterol-rich foods, such as eggs, would raise LDL
cholesterol in your bloodstream and promote heart disease. Alas,
decades’ worth of research has utterly failed to demonstrate this
correlation.
Now, finally, the Dietary Guidelines Advisory Committee has
addressed this scientific vacuum, announcing that “cholesterol is
not considered a nutrient of concern for overconsumption.”8
In the past, the guidelines suggested a limit of 300 milligrams
(mg) per day; the equivalent of about two eggs. Now, the limit on
dietary cholesterol has been removed entirely. This is good news,
since dietary cholesterol is actually one of the most important
molecules in your body.
Cholesterol plays an important role in brain health and memory
formation, and is indispensable for the building of cells and the
production of stress and sex hormones, as well as vitamin D. (When
sunlight strikes your bare skin, the cholesterol in your skin is
converted into
vitamin D.)
Eggs are a healthy source of cholesterol, provided you buy
high-quality eggs, meaning organic and pasture raised. The
Cornucopia Institute has created an
egg scorecard,9
based on 28 organic criteria, to help you select eggs of the highest
quality possible.
Bad News: Saturated Fat Myth Remains
Unfortunately, they still do not retract their previous
misinformation and do not tell the truth about saturated fat.
Insisting that it raises LDL, while ignoring that it only raises
safe fluffy LDL particles, they still omit the very important
fact that it actually increases HDL.
This is surprising, considering all the evidence. For example, a
2014
meta-analysis10
published in the Annals of Internal Medicine (which included data
from 76 studies and more than a half-million people) found that
those who consume higher amounts of saturated fat have no more
heart disease than those who consume less.
Moreover, those who ate higher amounts of unsaturated fat,
including both (healthy) olive oil and (unhealthy) corn oil — both
of which are recommended over saturated fats — did NOT have lower
incidence of heart disease.
Another meta-analysis11
published in the British Medical Journal last year also failed to
find an association between high levels of saturated fat in the diet
and heart disease. Nor did they find an association between
saturated fat consumption and other life-threatening diseases like
stroke or type 2 diabetes.
Saturated Fat Recommendations Do Far More Harm Than Good
Despite such findings, the updated dietary guidelines still
recommend limiting both trans fats (which are indeed
harmful) and saturated fat (which is not) to less than 10 percent of
your daily calories. This is a far cry from what most people
probably need for optimal health. Saturated fats not only are
essential for proper cellular and hormonal function, but also
provide a concentrated source of energy in your diet.
If you’re insulin-resistant, which most Americans are, then you’d
likely benefit from getting as much as 50 to 80 percent of your
daily calories from healthy fats. I personally consume about 75
percent of my diet as healthy fat.
For weight loss, they also recommend sticking to low- and non-fat
dairy, which I believe is a serious mistake. Low-fat recommendations
do more harm than good across the board, but it may be particularly
counterproductive if you’re trying to lose weight. In fact, mounting
evidence clearly shows that a high-fat, low-carb diet can be
exceptionally effective for weight loss — provided you’re eating the
right kinds of fats.
For example, research from Johns Hopkins University School of
Medicine shows low-carb, high-fat diets promote
faster weight loss than a low-fat diet. Low-carb dieters lost 10
pounds in 45 days, while the low-fat dieters needed 70 days to lose
the same amount of weight.
Summary of Heart Healthy Diet
To break it down into simple terms, to protect your heart health
you need to address your insulin and leptin resistance, which is the
result of eating a diet too high in sugars and grains (non-fiber
carbs). To safely and effectively reverse insulin and leptin
resistance, thereby lowering your heart disease risk, you need to:
Eat REAL food, ideally as close to their natural state as
possible. Avoid processed foods and other sources of refined
sugar and processed fructose, and limit non-fiber carbs to under
50 grams a day.
Focus your diet on whole foods, ideally organic, and
replace the grain carbs with:
Large amounts of vegetables
Low-to-moderate amounts of high-quality protein (think
organically raised, pastured animals and
high-fat/low-mercury fish, such as wild Alaskan salmon,
anchovies, and sardines)
As much high-quality healthy fat as you want (saturated
and monounsaturated from animal and tropical oil sources).
Sources of healthy fats that you'll want to add to your diet
include the following:
Organic seeds
Coconuts, and
coconut oil (for all types of cooking and baking), MCT
Oil
Flawed Cholesterol Treatment Guidelines Turn Healthy People Into
Statin Users
According to the U.S.
cholesterol treatment guidelines, issued in 2013, if you answer
"yes" to ANY of the following four questions, your treatment
protocol calls for a statin drug:
Do you have heart disease?
Do you have diabetes? (either type 1 or type 2)
Is your LDL cholesterol above 190?
Is your 10-year risk of a heart attack greater than 7.5
percent?
Your 10-year heart attack risk involves the use of a
cardiovascular risk calculator,12
which researchers have warned may overestimate your risk by anywhere
from 75 to 150 percent13
— effectively turning even very healthy people at low risk for heart
problems into candidates for statins. The guideline also does away
with the previous recommendation to use the lowest drug dose
possible and instead basically focuses all the attention on
statin-only treatment and at higher dosages.
While shifting attention to LDL cholesterol rather than total
cholesterol is a step in the right direction, the guidelines still
ignore the density of the lipoproteins. The division into
HDL and LDL is based on how the cholesterol combines with protein
particles. LDL and HDL are lipoproteins — fats combined
with proteins. Cholesterol is fat-soluble, and blood is mostly
water. For it to be transported in your blood, cholesterol needs to
be carried by a lipoprotein, which is classified by density.
Large fluffy LDL particles are not harmful. Only small
dense LDL particles can potentially be a problem, as they can
squeeze through the lining of your arteries. If they oxidize, they
can cause damage and inflammation. So, you could potentially have an
LDL level of 190, but still be at low risk, if your LDLs
are large, and your HDL to total cholesterol ratio is above 24
percent. And remember, saturated fat increases your HDL.
Five Reasons to Avoid Statin Drugs
So, while the dietary guidelines no longer focus on reducing
dietary cholesterol to protect your heart, and the cholesterol
treatment guidelines have stopped using total cholesterol as a
measure of heart disease risk (honing in on elevated LDL cholesterol
instead), we’re still far off the mark when it comes down
to how to best prevent heart disease.
Refined sugar and processed fructose are in fact the primary
drivers of heart disease, so that’s where the focus needs to be;
not on driving down your cholesterol with the aid of a statin
drug (and/or avoiding healthy saturated fats in your diet). The ONLY
subgroup that might benefit from a statin are those born with a
genetic defect called familial hypercholesterolemia, as this makes
them resistant to traditional measures of normalizing cholesterol.
There are many great reasons why you should NOT take a statin
drug unless you have this genetic defect, including but not limited
to the following five:
They don't work as advertised. A 2015 report14
published in the Expert Review of Clinical Pharmacology
concluded that statin advocates used a statistical tool called
relative risk reduction (RRR) to amplify statins’ trivial
beneficial effects. If you look at absolute risk, statin drugs
benefit just 1 percent of the population. This means that out of
100 people treated with the drugs, one person will have one less
heart attack.
They deplete your body of
CoQ10. Statins block HMG coenzyme A reductase in your liver,
which is how they reduce cholesterol. But this is also the same
enzyme that makes CoQ10, which is an essential mitochondrial
nutrient that facilitates ATP production.
They inhibit the synthesis of
vitamin K2 — a vitamin that protects your arteries from
calcification.
They reduce ketone production.15
If you take CoQ10 while on statins you did not solve the
problem, as the same enzyme also inhibits your liver’s ability
to produce ketones, which are not only water-soluble fat
nutrients important for tissue health but also important
molecular signaling molecules.
Because of Nos. 2, 3 and 4 they increase your risk for
other serious diseases, including:
Cancer. Research16
has shown that long-term statin use (10 years or longer)
more than doubles women's risk of two major types of breast
cancer: invasive ductal carcinoma and invasive lobular
carcinoma.
Diabetes. Statins have been shown to increase your risk
of diabetes via a number of different mechanisms, two of
which include increasing your insulin resistance, and
raising your blood sugar.
New Class of Cholesterol Drugs May Be Even More Harmful Than Statins
Also beware of a newer class of cholesterol absorption inhibitors
called
PCSK9 Inhibitors.18
PCSK9 is a protein that works with LDL receptors that regulate LDL
in the liver and release LDL cholesterol into the blood. The
inhibitors work by blocking that protein and thus having less LDL to
circulate in the blood; in clinical trials, these drugs lowered LDLs
by about 60 percent.
While these drugs are being touted as the answer for those who
cannot tolerate some of the side effects of the other drugs, such as
severe muscle pain, trials have already discovered that PCSK9
inhibitors can produce “neurocognitive effects,” with some patients
experiencing confusion and attention deficits.19
There’s evidence suggesting these drugs may actually be even more
dangerous than statins.
Making Sense of Your Cholesterol Levels, and Assessing Your Heart
Disease Risk
Embed this infographic on your website:
Click on the code area and press CTRL + C (for
Windows) / CMD + C (for Macintosh) to copy the code.
As a general rule, cholesterol-lowering drugs are not required or
prudent for the majority of people — especially if high cholesterol
and longevity run in your family. Also keep in mind that
your
overall cholesterol level says very little about your risk for
heart disease.
For more information about cholesterol and what the different
levels mean, take a look at the infographic above. As for
evaluating your heart disease risk, the following tests will provide
you with a far more accurate picture than your total cholesterol or
LDL level alone:
HDL / Cholesterol ratio
HDL percentage is a very potent heart disease risk
factor. Just divide your HDL level by your total
cholesterol. That percentage should ideally be above 24
percent
Triglyceride/HDL ratio
You can also do the same thing with your triglycerides
and HDL ratio. That percentage should be below 2
Large LDL particles are not harmful. Only small dense
LDL particles can potentially be a problem, as they can
squeeze through the lining of your arteries. If they
oxidize, they can cause damage and inflammation.
Some groups, such as the National Lipid Association, are now
starting to shift the focus toward LDL particle number
instead of total and LDL cholesterol, in order to better
assess your heart disease risk. Once you know your particle
size numbers, you and your doctor can develop a more
customized program to help manage your risk
Your fasting insulin level
Any meal or snack high in carbohydrates like fructose
and refined grains generates a rapid rise in blood glucose
and then insulin to compensate for the rise in blood sugar.
The insulin released from eating too many carbs promotes fat
accumulation and makes it more difficult for your body to
shed excess weight. Excess fat, particularly around your
belly, is one of the major contributors to heart disease
Your fasting blood sugar level
Studies have shown that people with a fasting blood
sugar level of 100 to 125 mg/dl had a nearly 300 percent
increase higher risk of having coronary heart disease than
people with a level below 79 mg/dl
Your iron level
Iron can be a very potent oxidative stress, so if you
have excess iron levels you can damage your blood vessels
and increase your risk of heart disease. Ideally, you should
monitor your ferritin levels and make sure they are not much
above 80 ng/ml.
The simplest way to lower them if they are elevated is to
donate your blood. If that is not possible you can have a
therapeutic phlebotomy and that will effectively eliminate
the excess iron from your body
How to Lower Your Risk for Heart Disease Without Drugs
Heart disease is predominantly the end result of unhealthy
lifestyle choices, and cholesterol-lowering medications are far from
being magic bullets to lower your risk of dying from heart disease —
especially when you consider that your body needs
cholesterol for optimal functioning.
In a nutshell, preventing cardiovascular disease involves
reducing chronic inflammation in your body. Proper diet,
exercise, sun exposure, and grounding to the earth are cornerstones
of an anti-inflammatory lifestyle. For more details on how to
naturally reduce your risk of heart disease, please review the
following 10 heart-healthy strategies:
Eat REAL FOOD. Replace processed foods (which are loaded
with refined sugar and carbs, processed fructose, and trans
fat — all of which promote heart disease) with whole,
unprocessed or minimally processed foods, ideally organic,
and/or locally grown.
Avoid meats and other animal products such as dairy and
eggs sourced from animals raised in
confined animal feeding operations (CAFOs). Instead, opt
for grass-fed, pastured varieties, raised according to
organic standards. Limit your protein intake to one half
gram of protein for every pound of lean body mass which is
about 40 to 70 grams for most people.
Eliminate no-fat and low-fat foods, and increase
consumption of healthy fats. Those with insulin resistance
would likely benefit from consuming 50 to 85 percent of
their daily calories from healthy saturated fats, such as
avocados, butter made from raw grass-fed organic milk, raw
dairy, organic pastured egg yolks, coconuts and coconut oil,
unheated organic nut oils, raw nuts, and grass-fed meats.
No- or low-fat foods are usually processed foods that are
high in sugar, which raises your small, dense LDL particles.
Balancing your omega-3 to omega-6 ratio is also key for
heart health, as these fatty acids help build the cells in
your arteries that make the prostacyclin that keeps your
blood flowing smoothly.
Omega-3 deficiency can cause or contribute to very serious
health problems, both mental and physical, and may be a
significant underlying factor of up to 96,000 premature
deaths each year. For more information about omega-3s and
the best sources of this fat, please
review this previous article.
You also need the appropriate ratios of calcium,
magnesium,
sodium, and potassium, and all of these are generally
abundant in a whole food diet. To get more fresh vegetables
into your diet, consider juicing.
Optimize your vitamin D level. Some researchers, like
Dr. Stephanie Seneff, believe optimizing your vitamin D
level through regular sun exposure, opposed to taking an
oral supplement, may be key to optimizing your heart health.
If you do opt for a supplement, you also increase your need
for vitamin K2.
Optimize your gut health. Regularly
eating fermented foods, such as fermented vegetables,
will help reseed your gut with beneficial bacteria that may
play an important role in preventing heart disease and
countless other health problems.
Quit smoking and reduce your alcohol consumption.
Exercise regularly. Exercise is actually one of the
safest, most effective ways to prevent and treat heart
disease. In 2013, researchers at Harvard and Stanford
reviewed 305 randomized controlled trials, concluding there
were "no statistically detectable differences" between
physical activity and medications for heart disease.
High-intensity interval training, which requires but a
fraction of the time compared to conventional cardio, has
been shown to be especially effective. Exercise is one of
the most important stimulants of mitochondrial biogenesis.
Pay attention to your oral health. There's convincing
evidence linking the state of your teeth and gums to a
variety of health issues, including heart disease. In one
2010 study,20
those with the worst oral hygiene increased their risk of
developing heart disease by 70 percent, compared to those
who brush their teeth twice a day.
Avoid statins, as the side effects of these drugs are
numerous, while the benefits are debatable. If you are
taking statins for any reason it is imperative to take
Coenzyme Q10. I believe the best is the reduced form called
Ubiquinol.