As the leading cause of death in the United States, Heart Disease has remained one of the most studied chronic conditions, and rightfully so. In fact, current research has shown heart disease to be upwards of 90% preventable (1). When this is considered, it is clear that nutritional intervention should be at the forefront of the medical approach in treating and preventing life altering heart conditions. However, misinformation and contradicting recommendations make it hard for people to know where the answer lies.
Confusion is due to largely misrepresented animal studies and epidemiological research dating back to the 1940s and 50s. These studies proposed the idea that saturated fat and cholesterol raise the cholesterol in the blood, thus increasing risk for heart disease. Based on this suggestion, compounded with media hype and general scare tactics, it was recommended to strictly avoid dietary fat and cholesterol and rather consume highly processed vegetable oils and refined carbohydrates. These suggestions were quickly disproven with further evidence stating there was no correlation between saturated fat intake and heart disease, but not before the medical community and and public views on the topic were so deeply ingrained.
Consequently, low fat, high carbohydrate diets have been collectively promoted as “heart healthy” when in fact human clinical trials point to it being quite the opposite for a large quantity of people. More recent high quality scientific evidence and long term meta analyses suggest dietary intake of cholesterol and saturated fat have no significant impact on heart disease risk (2). Inversely, the high intake of processed and refined carbohydrates accompanied by the low fat diet has had the suggested potential of worsening heart disease rather than preventing it. A scientific review of research on heart disease and carbohydrate intake concluded that a diet high in refined carbohydrates is associated with increased triglycerides and small LDL particles, decreased HDL particles, insulin resistance, and obesity (3). When this occurs, lipids can become oxidized, disrupting vessel walls and ultimately leading to the formation of plaque and heart disease.
If saturated fat caused heart disease, as previously suggested, we would expect to see heart disease on the rise with the lower carb diet trends since they tend to be higher in fat intake. However, a meta analysis of low carb clinical trials found that low refined carb diets improved cardiovascular risk factors such as decreases in triglycerides, blood glucose, BMI, abdominal circumference, insulin levels, inflammatory markers (4).
While a low refined carbohydrate, whole food diet may be a health conscious choice with those struggling with cardiovascular risk factors, it is important to note this approach may need to be adjusted for those with genetic anomalies such as familial hypercholesterolemia or the APOE4 gene. That is why it is so important for everyone to get tested for genetic single nucleotide polymorphisms to determine which genes play an important role in preventing heart disease. Working with a practitioner with knowledge in this area can help you to understand the role of bio individuality when it comes to choosing which diet is best for you.
Amanda Miller MS, RN, is our Integrative Nutrition Nurse Consultant at the Akasha Center for Integrative Medicine. You can make an appointment with her by calling us at 310-451-8880 or emailing us at firstname.lastname@example.org