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Article for the January 22, 2015 edition of the Herald News Living Well Section
Learn the new dietary advice for lowering heart disease risk
Heart disease — which includes high blood cholesterol, hypertension, heart disease, heart
attacks, and stroke — continues to be the number one cause of death in Fall River. While deaths
from these diseases have dropped 37% over the past decade, mostly due to better treatment and
medications, the rate of heart disease in the City — 9.3% in Fall River compared to 6.8%
statewide (2005-2007 average) — continues to be high.
What accounts for these high rates has been the basis for a lot of research over the years. Clearly
a percentage of heart disease is related to genetic factors, as some people inherit a number of
conditions that put them at greater risk of a number of cardiovascular conditions. The other big
risk factor in our area is the rate of diabetes, which dramatically increases cardiovascular risk.
But the bulk of the research continues to point to two non-genetic and non-disease-related factors
that drive the numbers: diet and exercise.
So, we’ve all heard the advice to lower fats, and especially saturated fats, in our diets. We’ve
also heard the recommendation to get 150 minutes of total moderate exercise each week to keep
our hearts and blood vessels healthy. And, of course, we’ve all heard the advice to lower our
weight, especially the weight we carry around our waists.
While no recent research has contradicted two of these three recommendations, the one about the
composition of our diets has begun to undergo a radical change in the past several years.
Specifically, the recommendation to lower fats in our diet has been called into question by
several major studies, and more and more researchers are pointing to evidence that eating large
amounts of carbohydrates, especially refined grains and sugars, are more likely to increase our
risk of heart disease and stroke.
This about-face has come about as our ability to understand how these dietary components affect
our blood vessels. Thirty years ago, we began to hear warnings about keeping our blood
cholesterol levels low to reduce the risk of heart attacks. When researchers began to have better
ways to measure the components of cholesterol in our blood, such as LDL cholesterol and its
subcomponent VLDL, they discovered that total cholesterol by itself was not a very good
predictor of risk of heart disease mortality.
What now appears to do the most damage to blood vessels is the level of VLDL, or very low
density lipoproteins, in the blood. The other subcomponent of LDL cholesterol is a “light and
fluffy” lipoprotein that seems to be neutral in causing vascular damage. So, having high LDL
levels is only bad for you if the VLDL subcomponent is high.
So does dietary fat cause VLDL levels to increase as we’ve been told? According to the latest
research, it’s the presence of carbohydrates, especially refined carbohydrates and sugars in the
diet, that appears to be the main culprit. The inclusion of fats in the diet, even of saturated fats,
appears to be nearly neutral and largely unrelated to the development of heart disease.
So, our avoidance of dietary fat, rather than decreasing our risk for developing heart disease, may
have actually contributed to or risk given what’s taken place in the American diet over the past
thirty years. While removing fats in our food, the food industry has replaced it with sugars of all
types, some of which may be disguised by any of more than thirty product names, some of which
sound healthy like honey or fruit juice concentrate.
When we increase our intake of sugars, starches and other carbohydrates, two things happen: 1)
our livers convert anything we don’t immediately need for energy into fats, so our blood
triglyceride levels go up, and 2) we then store these triglycerides as body fat. This is one reason
so many of us have put on weight over the past several decades even when we’re following the
dietary guidelines of the government and healthcare providers. Of course, as we get heavier, it
becomes even more difficult to stay active, so we become more sedentary, further increasing our
risk of developing high blood pressure and other cardiovascular conditions.
So why do we continue to hear recommendations to eat low-fat diets? I believe it’s primarily due
to the failure of medical providers and national organizations to move with the current research.
The “low-fat mantra” has become so ingrained in our thinking that most of us resist adding more
fats and removing more carbs from our diets, even as the evidence becomes more and more clear
that this is the right way to go.
What all of this suggests is that there is a way to significantly lower our high heart disease rates
in Fall River: cut the carbs and add healthy fats to our diets. I’ve written that advice in every
January Living Well column for the past five years, but the idea is slow to catch on, especially
among medical professionals. However, I am finding less resistance to the idea as more
registered dietitians and physicians are starting to recommend lower carbohydrate diets.
In order to make it easier for people to make the switch from low-fat to low-carb diets, the
Greater Fall River Fitness Challenge is scheduling free nutrition class every Saturday at 10:00
a.m. until May 9th at Greater Fall River Re-Creation headquarters at 72 Bank Street. These
sessions will feature local dietitians and nutrition instructors who will take people through the
steps in changing their diets to a more heart-friendly approach. These classes are open to anyone,
whether you’re participating in the Challenge events beforehand or not.
“I’ll be demonstrating how easy it is to cook low-carb meals,” stated Chef Jessica Williams,
DTR, owner of Creating Healthy Solutions, who will be offering one-hour sessions of her all
new “Fit-Trition” cooking/tasting program once a month. Registered Dietitian Amanda Raposo
from Southcoast Health will be at many of the other sessions to help participants lower their
cardiovascular risk by learning how to cut the carbs and increase heart-healthy fats.
“We have a huge challenge in getting people to understand that what they’ve heard for years
about lowering heart disease risk is probably wrong,” stated Raposo. “The great thing is that
people will see very quickly that following this new approach will show up in lower blood
cholesterol and blood sugar levels, as well as weight loss, in just a few weeks,” she added.
For more information about the nutrition sessions and low-carb diets, call 508-679-0922 or go to
www.FallRiverFitnessChallenge.com and look for the “How can I eat better” link on the left.