Salim Yusuf says brand-new proof fails to support many significant diet recommendations.
Among the world's leading cardiologists, he states that much of the major nutrition guidelines have no great basis in science.
" I'm not a nutrition researcher which might be a benefit due to the fact that weekly in the paper we read something is good for you and the same thing the next week is bad for you," stated Salim Yusuf, MD, DPhil,( McMaster University), at Cardiology Update 2017, a seminar presented by the European Society of Cardiology and the Zurich Heart Home.
Yusuf provided evidence that a number of the most considerable and impactful nutrition recommendations relating to dietary fats, salt, carbs, and even veggies are not supported by proof.
Yusuf's talk relied greatly on findings from the PURE research study, a big ongoing epidemiological research study of 140,000 people in 17 nations. Though PURE is an observational research study, "its style and comprehensive data collection are geared toward addressing significant questions on causation and development of the underlying determinants of heart disease."
Much of the data provided by Yusuf has actually not been released yet and ought to be considered initial, he said. In 2014 publication of the salt results stirred significant debate.
The results from PURE will likely add fuel to the ongoing intense argument over carbohydrates and fats. Yusuf displayed data showing that the occurrence of heart disease in the PURE population increases as carbohydrate intake (as a portion of overall calories) increases.
" Previous guidelines stated lower fats and make up for it by increasing carbs ... therefore basically we have actually increased carbohydrate consumption in most Western countries and this is likely damaging. We are in for a big surprise. We actually discovered that increasing fats was protective."
The PURE findings reveal a steep boost in CV danger as carb intake increased beyond 55% of total energy. World Health Organization standards specify that up to 75% of energy can originate from carbohydrates. "But that is incorrect," stated Yusuf.
" We in fact discovered that increasing fats was protective," he stated. Low intake of total fat was associated with increased threat. Really high fat is likewise "probably bad," Yusuf stated, based on earlier studies from Finland with individuals who had "incredibly high fat levels, not the usual fat levels that populations consume."
No clear patterns emerged for various types of fats, Yusuf reported. Patterns recommended that saturated fats were not harmful and perhaps even useful, while monounsaturated oils appeared advantageous. Polyunsaturated oils had a neutral result, he stated.
" You've got to consider the change in oils that have taken place in the world in the last 30 years," stated Yusuf. "It was completely industry owned. We went from natural fats, which are animal fats, to veggie fats, since the market can produce it and therefore charge for it, and this was swallowed hook, line, and sinker by the AHA, and the WHO simply repeated it."
This is partially why many health conscious professionals shy away from recommending the consumption of oils altogether if they can help it.
If the general population had access to the right types of oils easily it may change some opinions on this.
However, as it stands now, oils as part of a standard diet are considered a bad idea by Dr. Wallach, as well as many other nutrition-minded experts.
Yusuf likewise took aim at milk usage trends in the US. "Even if you consume milk they desire you to consume 2% or 1% of fat" but, he asked, "what is the proof?" "A huge, huge, no," he said. In truth, he stated, there "actually are no data at all to lower the fat content of milk."
Yusuf came down squarely in favor of fats over carbohydrates: "Basically, some fats are good, some fats may be neutral, but it's carbs that are the worst thing." He offered a piece of suggestions: "so when you eat a hamburger throw away the bun and eat the meat."
Yusuf summed up the PURE findings, which found that hydrogenated fats from dairy sources were protective and hydrogenated fats from meats were neutral. White meat from chicken or fish appeared to have a beneficial result, while red meat in moderate quantities was not related to damage.
Yusuf volunteered a strong endorsement for Nina Teicholz, author of The Big Fat Surprise, who has been heavily criticized by the nutrition industry for her defense of dietary fat. "She shook up the nutrition world but she got it right," said Yusuf.
The demonization of fats-- hydrogenated fats in specific-- came from earlier observations connecting saturated fat usage to LDL levels. Yusuf reported that PURE verified this finding, but he likewise noted that the overall difference in LDL was less than expected, however, more studies are needed as there was some variance in the results.
More importantly, randomized studies that have actually taken a look at fat reduction to reduce cardiovascular episodes have not shown benefit, other than in cases where fat levels were incredibly high, he said.
Yusuf said that the ApoB/ApoA ratio is a much more highly delicate marker of danger. Data from PURE shows that this ratio goes up with carbohydrate consumption but is neutral with hydrogenated fats or polyunsaturated fats and declines with monounsaturated fats.
Regarding salt consumption Yusuf reiterated findings from the previous released reports from PURE and the more current report from a working paper from WHO. He said the low salt position was based upon the reputable relationship in between salt and high blood pressure. But, he argued, the advantages of exceptionally low levels of sodium have never been tested in a randomized controlled trial.
Further, since salt is an important nutrient it is unavoidable that taking sodium levels too low will be damaging. He likewise explained that although decreasing blood pressure through salt reduction might turn out to be beneficial in individuals with high blood pressure, it is totally possible that non-hypertensives will obtain no gain from sodium reduction but they may well be susceptible to the harms connected with low sodium levels.
Vegetables and fruits
Yusuf likewise raised concerns about basic suggestions that are almost never based on important analysis. "Where on earth did the concept that we should consume 5 portions of vegetables and fruits originate from?" asked Yusuf.
" Why not 4, why not 3, why not 6, why not 7? Is it all fruits, is everything veggies, is it what kinds of fruits, what type of vegetables?"
He reported that the PURE data discovered a neutral result for vegetables, and that the literature is "really irregular." More significantly, he dismissed the concept that foods need to be judged based on their effect on health. "However I need to tell you, when it's relating to diet, neutral is good. You have to consume something. If you like it consume it. Not every food has to be good or bad."
Yusuf then explained that it is almost difficult for a big part of the world to follow these fruit and vegetable recommendations. "Why are vegetables and fruits not taken in? All the guidelines are written by people sitting in Geneva or Dallas who are white, abundant, and male. They are male, and so they don't know the cost of foods, they do not go do the grocery shopping. They're white and they only think about exactly what takes place in their nations."
In high income countries like Canada and Sweden individuals spend just about 10% of their earnings on food. But in lower income nations like Pakistan, India, Zimbabwe, 65% of earnings is invested in food. It is then "no surprise that they're going to buy the cheapest food," he said. The cost of purchasing 2 portions of fruit and 3 servings of vegetables, as recommended by the World Health Organization, is completely unaffordable for numerous peoples.
More and more professionals are question the nutrition guidelines set out by international organizations. Hopefully, over time a more clear picture of proper nutrition will emerge.