Archive for the ‘Cardiac risk factors’ Category

Risk Factors, Diet, and Blood Lipids

Thursday, June 26th, 2008

“Part of the secret of success in life is to eat what you like and let the food fight it out inside.”

Mark Twain

There are over 260 “risk factors”, i.e. conditions, habits, stress, or being just alive, all associated with the risk of developing coronary disease, heart attacks, or sudden death. Unlike bacteria causing specific infections, however, these risk factors are not proven causes of coronary disease. Proving true causality in medicine, in fact, is often a game of endless pirouettes, stretches and rule changes.

For example, these risk factors may be strong and therefore impressive, or weak and debatable. Strong associations with coronary disease, besides age and gender, include heredity, smoking, high blood pressure, diabetes, obesity, probably in that order-and for true believers, the worst culprits are serum fats or lipid levels which include total triglycerides, total cholesterol and its sidekicks, LDL and HDL cholesterol, among other fatty compounds.

Dietary fat has been blamed over the decades for affecting, if not controlling, the blood level of serum lipids. The link, however, between diet, especially the consumption of cholesterol and different types of fats- solid or semi-solid fats (“saturated”) vs. oils or liquid fats, and the level of various lipids or fats in the blood continues in many quarters to be highly questionable.

Moreover, the secondary link between blood levels of fat, including cholesterol-related lipids and the development of coronary disease is a variable, and often confusing one. While individuals with certain metabolic diseases, especially diabetes, have abnormal levels of blood lipids and a high incidence of coronary disease, many normal people with high lipids never develop significant heart disease. Further, almost half of all coronary patients and patients admitted for heart attacks have normal blood lipids. For years, the dietary research community has been reluctant to admit that the scare over dietary fats has long been over-hyped. Diet fat hysteria received its final coffin nail last year when a major study concluded that low-fat diets provide no demonstrable health benefits over high-fat diets.

For decades the diet police told us animal fats like butter were dangerous, and more recently announced that fettucini Alfredo was “a coronary on a plate.” They urged us to substitute margarine for animal fats, and to stay away from red meat. Of course in those rosy times, no one talked or wrote about “trans fats,” abundantly produced when vegetable oils were turned into solid fats like Crisco and margarine. Now, the diet police have done an about-face all the while failing to admit that their butter scare was bogus from the outset, but margarine, containing high trans fats was bad. It turns out that now butter, palm oil, lard, containing natural trans fats, and (new) Crisco, if not tops on the list of desirable fats, are at least considered OK by the diet dogs.

Stay tuned for more on diet and trans fats.