2015 Dietary Guidelines Include Healthy Revisions, but Still Falls Short for Effective Prevention of Heart Disease
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 |
Butter made from raw grass-fed organic milk |
| Raw nuts, such as macadamias and pecans |
Organic pastured egg yolks |
Avocados |
| Grass-fed meats |
Palm oil |
Raw cacao nibs |
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.
- Neurodegenerative diseases
- Musculoskeletal disorders and motor nerve damage. Research17 has shown that statin treatment lasting longer than two years causes “definite damage to peripheral nerves.”
- Cataracts
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 |
| NMR LipoProfile
|
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. |
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