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The NEW Track Your Plaque Diet: Part 1

Nutritional Chaos

How is it that, as a nation, we’ve dissected our diet, sliced it and diced it into its component saturated and polyunsaturated fats, complex and simple carbohydrates, analyzed it down to its flavonoids, polyphenols, and micronutrients, yet still emerge overweight, diabetic, and generally unhappy? How can populations consuming their traditional cultural fare, cultures with dietary habits as wildly different as the Japanese, the Inuits, the southern French, and Cretans, live longer with less heart disease, diabetes, cancer, and obesity, following eating habits arrived at by tradition rather than science?

Over the last 50 years, an unprecedented amount of information has poured into our lives about diet, nutrition, the right and wrong ways to eat. We’ve experienced broad systematic campaigns of information on “proper” nutrition delivered to us by the Surgeon General’s office, the U.S. Department of Agriculture (USDA), the Federal Drug Administration (FDA), the American Heart Association (AHA), the American Diabetes Association, the American Cancer Society. They all pretty much agree on several principles: Eat low-fat, eat plenty of whole grains, and include abundant fruits and vegetables. The mantras of these “official” diets are surely familiar to everyone by now.

But what if they proved wrong on several basic points? What if the basic precepts that form the basis for advice to eat low-fat, for instance, originated with misinterpretations or limited observations? What if the advice somehow morphed into a style of eating and shopping that had little to do with health, but sprung from the considerable financial opportunity that appears when an “official” agency like the American Heart Association endorses a particular food or group of foods? What if the “culprits” in diet were replaced with foods that were worse health offenders than the original?

That is precisely what has happened. The original well-intended advice accomplished precisely the opposite of what it set out to do: Rather than reducing the burden of disease, an increase in conditions like diabetes and pre-diabetes, obesity, cancer, and heart disease has resulted.

The diet advocated by the AHA is a fat-restricted program designed to lower LDL cholesterol by 10%. Absent from the conversation is any mention of using diet to facilitate coronary disease control or reversal, tailoring diet to genetic or blood patterns, or weight loss. The AHA approach is simply meant to reduce cholesterol and it hardly even achieves that. Likewise, the USDA Food Pyramid advocates a diet that, in our experience, causes obesity, pre-diabetes and diabetes, fatigue, abdominal symptoms like cramping and diarrhea, and fuels heart disease. Surely we can do better. “Official” diets tend to be guilty of a one-size-fits-all and a people-really-can’t-stick-to-diets-anyway mentality.

How about an ultra low-fat diet? In years past, I prescribed the Ornish diet, a vegetarian program with no added oils and less than 10% of calories from fat sources, compared to 40% in the average American diet. People following this diet showed two varying responses: A few (a minority) did well - reducing LDL cholesterol, losing weight, and apparently slowing their heart disease. Others - the majority - enjoyed little or none of these benefits. The larger second group gained weight, dropped HDL cholesterol and increased triglycerides, and increased blood sugar into near-diabetic or diabetic range. When lipoproteins were examined, there was increased small LDL. These are all changes that encourage growth in coronary plaque. Low-fat diets, including the ultra low-fat variety, do not represent a solution.

For further proof of the misguided consequences that result from conventional diet advice, you need only take a look at the American Heart Association “Check Mark” Program stamp of approval on boxes of Cocoa Puffs®, Count Chocula®, and Berry Kix® to understand that marketing and financial motivations lie behind much diet advice, rather than nutritional wisdom.

Throw into the mix all the varying opinions on how to best lose weight, reduce cholesterol, reduce risk for cancer, the dizzying explosion of health claims issuing from food manufacturers and the result is . . . nutritional chaos.

In search of the perfect diet

Having zig-zagged through countless variations, the American obsession with diet has amounted to a nationwide experiment. America leads the world in diet experimentation. Despite millions of “casualties,” every diet fad has taught us something new. If we look back at all the mistakes made, we should be able to take a few lessons and extract some wisdom. There will surely be some areas of nagging uncertainty, even issues we differ on. But we should emerge from this 50-year national diet experiment with some practical, healthy strategies for our Track Your Plaque efforts, as well as overall health.

Can we construct a perfect diet?

There are undoubtedly many variations on the healthy eating theme. Every iteration on diet has pluses and minuses, strengths and weaknesses. Reductions in fat reduce LDL cholesterol but raise triglycerides. Reductions in carbohydrates exert another series of effects but many people complain about the limited food choices. Eating in a state of calorie deprivation vs. calorie excess causes the same foods to exert different effects. Genetic differences, such as apoprotein E variants, cause us to respond differently to the same diet. A diet that reduces one person’s LDL cholesterol 30 points and weight 10 lbs. could cause someone else to increase LDL and gain weight.

The strength of the Track Your Plaque approach is that it is not a one-size-fits-all diet. There is no such thing. Nor do we want to get bogged down micromanaging every aspect of food choice.

The Track Your Plaque approach is to start with several basic principles that should be a part of every diet, regardless of genetic type. We then add the important variations that are necessary to accommodate several genetic and physiologic types. The result is a more rational approach that borrows from lessons learned over the past 50 years, but can also be tailored to suit specific genetic and lipoprotein patterns.

Are humans omnivores?

Does the ideal diet include animal products like meat, fish, cheese, eggs, and dairy products? Or should the ideal diet be devoid of all animal products - a vegetarian diet?

We can find proponents of both extremes. The Atkins’ diet, for instance, advocates unrestricted intake of animal products, regardless of production methods or curing (sausage and bacon). At the opposite extreme are diets like Ornish (Dr. Dean Ornish’s Program for Reversal of Heart Disease) and the experiences of Dr. Colin Campbell, articulated in his studies and book, The China Study, in which he lambastes animal products, including dairy, as triggers for cancer and heart disease.

So which end of the spectrum is correct, but more importantly, ideal?

Putting aside philosophical questions (like not wanting to eat animal products because of aversion to killing any living being) or ethical concerns (inhumane treatment of farm animals, cruel slaughtering practices, etc.), does the inclusion of animal products provide any advantage? Any disadvantage?

The traditional argument against animal products has been its saturated fat content. But, let’s put aside the saturated fat question for a moment. Beyond saturated fat, several questions emerge:

  • If humans were meant to be vegetarian, why do omega-3 fatty acids (mostly from wild game and fish) yield such substantial health benefits, including dramatic reduction in sudden death from heart disease?
  • Why would vitamin K2 (from meats and milk, as well as fermented foods like natto and cheese), obtainable in only the tiniest amounts on a vegetarian diet, provide such significant benefits on bone and cardiovascular health?
  • Why would vitamin B12 (from meats) be necessary to maintain a normal blood count, prevent anemia, keep homocysteine at bay, and lead to profound neurologic dysfunction when deficient?

Omega-3 fatty acids and vitamins K2 and B12 cannot be obtained in satisfactory quantities from a pure vegetarian diet. The consequences of deficiency are not measured in decades, but in a few years. The conclusion is unavoidable: Evolutionarily, humans are meant to consume at least some foods from animal sources.

It pains me to say this, since I’ve always favored a vegetarian lifestyle, mostly because of philosophical concerns, as well as worries about the safety of our factory farm-raised livestock and rampant inhumane practices. But, stepping back and objectively examining what nutritional approach appears to stack the odds in favor of optimal health, I believe that only one conclusion is possible: Humans are omnivorous, meant to consume some quantity of animal products in addition to vegetables, fruits, nuts, and other non-animal products.

Let’s take this argument a step further: If humans were meant to consume the kill of the clan of wild Stone Age hunters, what role is there for cultivated grains? Grains, of course, had no role in the diet of hunter-gatherers, who were nomadic by necessity, never staying put long enough to till a field and plant seeds.

Vocal proponent of this “Paleolithic diet” concept, Dr. Loren Cordain, and author of the book, The Paleo Diet, has pointed out that the profile of human disease (judging by analysis of fossilized remains of primitive humans, examination of their last meals from stomach contents, and other such piecing-together-of-the-puzzle) shifted dramatically 8,000 years ago (a mere second on the evolutionary time scale) - just at the time when humans learned to cultivate wheat. While earlier hunter-gatherer predecessors died of trauma and infection, the grain-consuming humans that followed began to develop cancer, diabetes, and heart disease, diseases previously rare

Fast-forward to the 21st century and the “healthy whole grain” craze has seized everyone from the USDA and AHA, to Kelloggs and General Mills, all the way down to the grain-consuming obese pre-diabetics or diabetics on Main Street, U.S.A. While this grain-crazed phenomenon seized us to replace calories lost with the low-fat mistake, surely we’ve taken yet another wrong turn in the national nutritional experiment.

The new thinking on diet

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Copyright 2008, Track Your Plaque.