This is a phrase I occasionally heard growing up: “The road to hell is paved with good intentions.” It recently came to mind as I was reading some startling new information on what has been practically dietary gospel.
New recommendations are now coming out that focus on reducing sugar intake and easing restrictions on fat and cholesterol intake. After so many years of one message, why is this changing?
Taking good science and translating it into effective positive change is something that is considerably harder than it looks. Take the cigarette. There are many disease-causing chemicals in cigarette smoke and consuming less of them would clearly be better, right?
“Light cigarettes” were developed with this in mind and had measurably less tar and nicotine. Imagine our surprise when cigarette smokers unconsciously inhaled the “lighter smoke” more deeply to get the same amount of nicotine, and ultimately got the same amount of disease.
In this instance, good science, with the best of intentions, totally backfired.
Diet and heart disease have been studied intensively for the last three decades.
Good, sensible eating advice has encouraged people to put this knowledge into practice. We were advised to eat a diet low in total fat consumption (less than 30 percent), and reduce saturated fat to less than 10 percent of total calories. These were truly words to live by. And like the light cigarette, apparently foolproof. Or not …
A funny thing happens to people that attempt to reduce their saturated and total dietary fat: they replace them with carbohydrates. Everyone knows there is no fat in sugar. The trouble is, sugar and carbs make people gain more weight, which messes up their LDL cholesterol and cancels the benefit of the lower fat diet.
In our single-minded quest for an ever lower total cholesterol number, people make trade-offs that are actually harmful. Some take an anti-cholesterol medication, like Lipitor, and then feel perfectly safe eating all the fast food they want. You can imagine how that works out.
In an attempt to develop a communication strategy that will actually accomplish change, a prominent Harvard researcher, Dr. Dariush Mozaffarian, suggests we worry less about numbers and more about real food.
He has shared broad-sweeping statements about food. Rather than focus on avoiding cholesterol, focus on eating a variety of fresh foods, avoiding highly processed meats.
Dr. Mozaffarian also says that saturated fats from dairy are much less concerning than saturated fats from meats. So we are back to recommending eating fewer highly process meats (fast food), and increasing the amount of nuts, grains, fruit and vegetables – the classic Mediterranean diet.
It is perhaps human nature to like neat, matter-of-fact answers. Science is happy to oblige and gives us a steady stream of numbers to shoot for
However, life is messy. Anyone know how to make dinner out of rice, olives, lamb and apricots?
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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