The standard low-fat, low-calorie advice routinely provided to diabetics, among other patient groups, is not effective at reducing illness or death, a cardiologist claimed today.
Instead patients should be pointed towards healthy forms of fats, such as fish, olive oil and nuts, all found in Mediterranean-style diets, according to Dr Aseem Malhotra.
Dr Aseem Malhotra and colleagues at Frimley Park Hospital, Surrey, UK, state that because the damage to arteries that causes heart disease builds up gradually, it is generally believed that it "will therefore only reverse slowly, if at all".
"However, this perception is wrong," they write in the journal Open Heart.
"Extensive empirical and trial evidence reveals that substantial reductions in mortality can occur within months of quitting smoking, or making healthy dietary changes," they report.
They add: “Shifting the focus away from calories and emphasising a dietary pattern that focuses on food quality rather than quantity will help to rapidly reduce obesity, related diseases, and cardiovascular risk.
“Primary and secondary care clinicians have a duty to their individual patients and also to their local populations. Our collective failure to act is an option we cannot afford.”
And these reductions apply to both individuals and to entire populations. For example, in one trial, 2,033 heart attack survivors who were advised to eat fatty fish had a 29% reduction in mortality from all causes compared with comparable patients, within months. A further study found that omega 3 fatty acid supplementation significantly and rapidly reduced all-cause mortality in 11,324 heart attack survivors.
Further studies show that, compared with a low-fat diet, a Mediterranean-style diet "is a more powerful coronary intervention tool than aspirin, statins, or coronary stents".
The authors add that these dietary interventions lead to large reductions in heart risk "irrespective of weight and cholesterol".
A recent review concluded that dietary carbohydrate restriction is the "single most effective intervention for reducing all of the features of the metabolic syndrome" and should be the first approach in diabetes management.
Furthermore, the extensive Global Burden of Disease studies show that poor diet is consistently responsible for more disease and death than physical inactivity, smoking and alcohol combined.
Dr Malhotra, who was yesterday appointed a trustee of think-tank the King’s Fund, said last night: "Government policy interventions that decrease the affordability of junk food and sugary drinks and increase the affordability of healthy foods such as vegetables, nuts, oily fish and olive oil would reduce hospital admissions within a short time frame."
Malhotra, A. et al. It is time to stop counting calories, and time instead to promote dietary changes that substantially and rapidly reduce cardiovascular morbidity and mortality. Open Heart 27 August 2015; doi 10.1136/openhrt-2015-000273 [abstract]
Leave a Reply