Advice from experts on heart health and diets
You’re being bombarded by bogus evidence and bad advice about what to eat by charlatans, advertisers and feckless devotees to fad dieting.
I’m sorry about that, so every once in a while I feel compelled to unpack the idea of eating yourself healthy with actual experts. Unfortunately the truth is boring and again, I’m sorry.
If you’re the sort of person who only reads the first few paragraphs of a long story, here it is in a nutshell: Add a few servings of fresh fish, fruit, vegetables and nuts to your diet and they’re almost certainly going to be better for you than whatever they displace.
“There are a lot of eating regimes and diets promoted out there and it’s really hard for people to decipher what is and isn’t a healthy approach,” said Amanda Nash, manager of community nutrition with the Heart and Stroke Foundation. “It creates a lot of confusion.”
The truth is that your mom and her mom were right and Nash’s message echoes our traditional notions about home-cooked food: “We want to eat a healthy, balanced diet with a variety of minimally processed foods, whole grains, fruits and vegetables.”
Buying prepared foods with the word natural on the label is NOT going to cut it. The foods we’re talking about here don’t even have labels. Think: apples, onions, spinach and lettuce or single-ingredient staples such as brown rice or lentils.
Basically, if there’s an ingredients list, it has too many ingredients. Is it hard? Well, for sure it’s harder than what you’ve been doing until now, but there’s a payoff.
Processed food — that’s just about any product that’s ready-to-eat or found in a jar or a box — contains about 77 per cent of the sodium in the Canadian diet.
“The main messaging around salt hasn’t really changed,” notes Nash, a registered dietitian. “We know that we want to limit sodium. The way to do that is to buy whole, natural foods and cook at home.”
Limiting highly processed foods is the single action that has the biggest impact on your sodium consumption.
“When it comes to heart health, sodium can make you hold extra water and that leads to higher blood pressure,” she said. “We know there’s a direct relationship.”
Though even that message is under siege.
Recent research by a German scientist monitoring Russian cosmonauts on the Space Station Mir found that increasing salt intake appeared to help them process fat into water. Researcher Jens Titze also found that mice had to eat 25 per cent more food to maintain their weight on a high-salt diet.
Nash doesn’t care and neither should you. They’re astronauts and mice and you are neither.
The confusing thing about nutrition research is the reckless way that the media reports scientific findings without any helpful context. People use that information to make life-changing decisions.
Heart and Stroke position statements are a superior source of information on diet and health.
Boring Take-Away 1: You can’t believe everything you read, so be selective.
North Americans are extremely prone to faddish eating, from gluten avoidance to wolfing down supposed superfoods, such as coconut oil.
“There is some really confusing messaging around saturated fats right now,” she said.
Plant-based coconut oil is extraordinarily high in saturated fat and depending on which study or internet quack you look to for advice, that’s either really good or really bad.
A sample of recent headlines: “Coconut oil ‘as unhealthy as beef fat and butter;’ Please calm down, coconut oil is fine; U-turn on ‘superfood’ coconut oil.
Devotees are buying this former pariah oil by the tub and cooking everything in it. The American Heart Association recently reiterated its position that saturated fat is a cause of heart disease. Nash is more circumspect.
“It’s hard to tell (the risk), but it could be that the foods that are made or eaten with saturated fat that are the real problem, like cinnamon buns,” she said. “We do know that saturated fat raises LDL cholesterol and that is a risk factor for heart disease.”
Like sodium, processed foods are the main source of saturated fats in our diet and you needn’t worry about it too much beyond that.
“If you are filling half your plate with vegetables it doesn’t matter that much whether you put a small amount of coconut oil or margarine or butter with that,” Nash said. “In small amounts, use the fat of your choice.”
Tropical wonder-fats sound super-sexy and have their share of breathless devotees, but little to no evidence that eating them will benefit you in any way.
Boring Take-Away 2: Fixating on faddish fats is foolish.
Goji berries, milk thistle, acai berries and mega-doses of turmeric have their hardcore adherents.
But to know whether any food confers a benefit you would have to design an experiment to control people’s intake for decades, said Simon Fraser University Prof. Scott Lear, a research chair in cardiovascular prevention.
People are terrible at remembering what they eat and if you ask them to keep records and measure it, that acts like an intervention, changing what they eat and how much, he said.
That’s why proving a health benefit is notoriously hard to do. So hard that you should disregard pretty much all the health claims swirling about the internet. They’re mostly assumptions or outright bunk.
“If we find that people who eat a lot of fish live longer that suggests that maybe fish is beneficial,” said Lear. “But you also have to wonder what people who aren’t eating fish are eating instead. Is it the food that we added or the one that we took away?”
If you replace saturated fat with refined carbohydrates — as so many people did in response to the misguided fat-phobia promoted by Western governments in the ‘70s and ‘80s — the result can be obesity, Lear said.
Replacing saturated fat with olive oil, however, has a measurable health benefit.
The Mediterranean Diet and the DASH Diet — Dietary Approaches to Stop Hypertension — boast convincing evidence of benefit, a rarity. Both favour whole grains, legumes, vegetables, nuts and fish over red meat and processed foods.