Icon WebMD Expert Blogs

The Heart Beat

with James Beckerman, MD, FACC

Heart disease can be prevented! Your personal choices have a big impact on your risk of heart attacks and strokes. Dr. James Beckerman is here to provide insights into how making small, livable lifestyle changes can have a real impact on your heart health.


The opinions expressed in WebMD User-generated content areas like communities, review, ratings, or blogs are solely those of the User, who may or may not have... Expand

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.


Tuesday, March 9, 2010

The Low-Fat Diet – The Trojan Horse of Heart Disease?

Cardiologists everywhere are thinking about swallowing their pride, or at least a nice sirloin steak.

For more than forty years, we have been recommending a relatively consistent dietary approach to prevent heart disease. We tell our patients to avoid saturated fat from animal products and to increase intake of fruits and vegetables. This recommendation is widespread and widely endorsed by the American Heart Association and other organizations.

And it makes sense, right? Eating cholesterol and saturated fat should translate into more cholesterol and plaque in your heart’s coronary arteries.

Except when it doesn’t.

Common wisdom was first put to the test when we began to learn more about how dietary cholesterol impacts blood cholesterol levels – many physicians then reconsidered prior recommendations to avoid eggs. Eggs are not very high in saturated fat, but are high in cholesterol. Eating cholesterol was believed to increase blood levels of cholesterol, thereby increasing the risk of heart disease.

But it turns out that dietary cholesterol plays a pretty small role in your own cholesterol profile. Many now recommend eggs as a high-protein breakfast food that may actually be preferable to refined carbohydrates and simple sugars found in many cereals and baked goods. More on those later.

So now that eggs were in, cardiologists united against saturated fat – a clear “no-no” that no one could argue with. But a growing number of journalists and scientists began to question the saturated fat-heart disease hypothesis with increasing justification.

In recent weeks, a study published in the American Journal of Clinical Nutrition tried to solve the controversy once and for all. Pooled data from twenty-plus studies and nearly 350,000 participants and found no difference in the risk of heart disease between people with the lowest and highest intake of saturated fat.

This is huge. It’s like telling people that bicycle helmets don’t protect them from head injuries or seatbelts don’t save lives. Sure, it’s not a perfect study. Some of the research relies on people’s recollections of what they ate, and it’s hard to draw any conclusions about whether there may be some benefit to a low-saturated fat diet in older or higher risk populations.

But we can’t ignore such a clear challenge to our way of thinking and hope that it just goes away. We need more research, more data and more open minds. Many are calling for a new approach to official dietary recommendations that takes the focus off of pyramids and nutrients like protein and fat, and more towards general dietary patterns.

Most people are now in agreement that highly processed foods and refined carbohydrates and sweets are not as good for us as a more plant-based diet enriched with whole grains, unsaturated fats and animal protein from fish. This seems like fact, but the cynic might just call it the next wave of conventional wisdom. Time will tell… but until it does, I’ll have mine cooked medium, please.

- James Beckerman, MD, FACC

Comment on this blog post and ask your questions on the Heart Disease Exchange.

Posted by: James Beckerman, MD, FACC at 1:59 pm


Leave a comment

Subscribe & Stay Informed

Heart Health

Sign up for the Heart Health newsletter and keep up with all the latest news, treatments, and research with WebMD.


WebMD Health News