Category Archives: Cardiovasular

Physician Profile: Kim Williams, M.D.

This physician profile is republished from the Winter 2015 edition of Good Medicine. Dr. Williams will be speaking at our upcoming conference on the topic of a plant-based diet for cardiovascular disease. To learn more or register for the International Conference on Nutrition in Medicine: Cardiovascular Disease, visit PCRM.org/Conference.

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Kim Williams, M.D., president of the American College of Cardiology, will be among the world’s leading physicians and researchers speaking at the Physicians Committee’s International Conference on Nutrition in Medicine: Cardiovascular Disease on July 31 to Aug. 1, 2015, in Washington, D.C.

In this Good Medicine exclusive, Dr. Williams, who began following a vegan diet in 2003, answers questions about the state of heart disease and tips for preventing it.

Describe nutrition or lifestyle recommendations that you discuss with your patients.

Everyone who is able should exercise for at least 45 minutes most days of the week. But food quality and content are also important. High fat and high sugar content increases mortality. Plant-based diets lead to better outcomes, reduce health risks, and have a much more favorable effect on obesity, compared with the standard American diet.

What is the one thing someone can do today to improve their heart health?

Everyone needs to know their critical numbers, such as blood pressure, fasting blood sugar, cholesterol levels, body mass index, and waist circumference. They say knowledge is power. In this case, being aware of risk factors helps motivate people to make a difference.

What do you think is the No. 1 cause of the heart disease epidemic?

I’m happy to say that there is not an escalating epidemic in the United States. We have reduced cardiovascular mortality about 50 percent over the last few decades. However, internationally the numbers are climbing as people and low and middle income countries adopt a more sedentary lifestyle with less healthy foods.

Cholesterol Confusion: Let’s Make Sense of It

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Dietary confusion just reached a whole new level. The Dietary Guidelines Advisory Committee has just announced it is backing off suggesting that traces of cholesterol in foods pose a health risk. The idea is that its effect on blood cholesterol is less dramatic, compared with saturated fat—so maybe an egg here or there is no worse than an occasional drag on a cigarette. Coupled with recent reports questioning how bad “bad fats” really are, many people are unsure what to believe.

Let’s clear up the confusion. Here are the facts, starting with cholesterol:

Cholesterol is not the same as fat. Fat is the white streak in a steak and the grease that dribbles out of a drumstick. But cholesterol is invisible. Cholesterol particles are found in the membranes that surround the cells that make up an animal’s body. Cholesterol is in all animal products and is especially abundant in the lean portions of meats. There are also loads of cholesterol in eggs, cheese, and shellfish, such as shrimp and lobster.

Cholesterol in these foods causes your blood cholesterol level to inch upward.1 The cholesterol-raising effect is not as strong as that of bacon grease and other saturated-fat-laden products, but it is still there. Especially for people whose diets are modest in cholesterol to start with, adding an egg or two a day can cause a noticeable worsening on a cholesterol test.

Some people make a point of saying that cholesterol in foods is not as bad as saturated fat in foods. Maybe, but the issue is academic, because the two travel together. Fat and cholesterol are the Bonnie and Clyde of the culinary world. An egg, for example, has a whopping 200 milligrams of cholesterol and gets nearly 20 percent of its calories from saturated fat. They conspire together to raise your cholesterol level. But most foods from plants—vegetables, fruits, beans, and grains—have virtually none of either one.

Okay, so what about fat? Is it really a health problem or not?

The short answer is yes, it’s a problem. “Bad” fat—that is, saturated fat—raises your blood cholesterol level and increases your risk of health problems, including heart disease and Alzheimer’s disease. Saturated fat is found in meats, dairy products, eggs, and coconut and palm oils. Trans fats—the partially hydrogenated oils used in some snack foods—are bad, too, and people who avoid these products do themselves a favor.

Some news reports have mistakenly suggested that saturated fat isn’t really so bad after all. The confusion came from statistics:

Studies that compare people who indulge in “bad” fats with those who generally avoid them clearly show fat’s tendency to boost heart risks. But studies where fat intake does not vary much from person to person do not show much effect. For example, a Finnish study in which most all the participants followed high-fat diets was unable to detect any benefit of avoiding “bad” fats—largely because there was no group in the study that actually avoided them.

A 2014 meta-analysis combined all the studies—the good ones and the not-so-good ones—and concluded that, if you jumble the data together, the dangers of “bad” fat are no longer clear.2 The study was widely quoted by food writers who saw it as an excuse to try to rehabilitate pork chops’ reputation.

The meta-analysis had another problem. It used adjusted statistics that downplayed the dangers of saturated fat. One of the studies it used was Harvard’s Nurses’ Health Study.3 In the original study, a high saturated fat intake boosted heart disease risk by 52%. But the numbers were then adjusted for protein intake, cholesterol intake, and other factors, and these adjustments made the dangers of “bad” fat hard to see. It’s a bit like studying whether alcohol causes car accidents. If you alter the statistics to compensate for whether people weave as they drive or have blurry vision, the relationship between alcohol and accidents can be made to disappear.

So the answer is not to tuck into a hunk of bacon. The answer is to look at good studies, and they clearly show the risks of fatty, meaty diets.

And what’s that about Alzheimer’s disease? In a 2003 study, the Chicago Health and Aging Project reported that people eating the most saturated fat had a higher risk of developing Alzheimer’s disease, compared with people who avoided “bad” fat.4

So the bottom line is that “bad” fat and cholesterol are as bad for you as ever. The products that harbor them—meat, dairy products, and eggs—are best left off your plate. People following plant-based diets have healthier body weight, better cholesterol levels, lower blood pressure, and much less risk of diabetes.5-7

So jump in. At the Physicians Committee, the 21-Day Vegan Kickstart Program starts fresh every single month, providing menus, recipes, and cooking videos free of charge. It is available in English, Spanish, and Mandarin, with a special program for people from the Indian subcontinent—plus our new Japanese program. As the confusion clears up, so will many health concerns.

1. Hopkins PN. Effects of dietary cholesterol on serum cholesterol: a meta-analysis and review. Am J Clin Nutr. 1992;55:1060-70.
2. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis. Ann Intern Med. 2014;160:398-406.
3. Chiuve SE, Rimm EB, Sandhu RK, et al. Dietary fat quality and risk of sudden cardiac death in women. Am J Clin Nutr. 2012; 96:498-507.
4. Morris MC, Evans EA, Bienias JL, et al. Dietary fats and the risk of incident Alzheimer’s disease. Arch Neurol. 2003;60:194-200.
5. Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.
6. Berkow S, Barnard ND. Vegetarian diets and weight status. Nutr Rev 2006;64:175-188. 7. Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, Okamura T, Miyamoto Y. Vegetarian diets and blood pressure: a meta-analysis. JAMA Internal Medicine 2014;174(4):577-87.

The First Lady Can Turn this Milestone into Motivation

This week, Michelle Obama celebrates her 50th birthday. While we honor the occasion and also congratulate her on years of hard work with the Let’s Move campaign, news of her big day comes alongside news regarding diminished school lunch standards and reports of junk-food marketing in schools. It’s impossible not to wonder—how many of today’s kids will be healthy when they reach 50?

Michelle Obama by Joyce N. Boghosian, White House photographer

Michelle Obama by Joyce N. Boghosian, White House photographer

More than one-third of children are overweight or obese, putting them at an increased risk for a whole host of problems: diabetes, heart disease, stroke, osteoarthritis, and even cancer. These kids are our future. But when we see what school lunches really look like, the future starts to seem grim. The First Lady has certainly made momentous efforts to draw attention to this issue, but we have yet to see the changes necessary to subdue the rising tide of childhood obesity.

We’re starting to see a generation with a shorter life expectancy than their parents. That said, it’s not too late for action. There are many ways governments, schools, and parents can team up to get things back on track. But let’s start by getting processed meat out of school lunches. It’s an easy change with a big impact. There are so many other versatile and cholesterol-free options—beans, quinoa, and legumes. Processed meat is strongly linked with colorectal cancer, and the cholesterol and saturated fat contribute to cardiovascular troubles. There are many more steps that need be taken, but getting the worst out of school lunches is a key first step.

Michelle Obama has both the power and the responsibility to take a stand and change our nation’s future for the better. Let’s hope that as the party winds down and the guests go home, our government commits to making sure every child has the nutrition resources necessary to see 50, and many decades beyond in the best of health.

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