1/8 this topic needs a few comments: 1- The Mediterranean diet does have more fat than AHA recommends, but its mainly in olive oil. Taking into account the usual limitations of diet studies, Mediterranean diets do reduce CVD events, nejm.org/doi/full/10.10…
https://twitter.com/shivadas29/status/1332916853836980226
1/2 2- The AHA has done an admirable job in public health in advocating low LDL-C, this led to all stakeholders getting it down, and taking into account that average LDL-C has slowly gone down in US, it likely has saved hundreds of thousands in not millions of lives.
1/3 3- the AHA did not emphasize caloric restriction enough along with reducing fat, so people felt they could eat as much as they wanted to as long as it was not fat. It goes to my earlier point, when you take away something, somehting else fills the void- 2 variables changing
1/4 4- one unintended consequence of of this is that all fats were equal offenders and as fat was removed from foods, food became much less tasty. So to make up the void, the "industry" added carbs with higher content of simples sugars to make people feel satiated.
1/5 5- excess carbs can lead to insulin resistance, high TG, etc. You have to be a skinny teenager or exercise like a madman to use them up as you age. In some people, you trade high LDL-C for metabolic syndrome, with less tasty food to boot. Vicious cycle...
1/6 6- There is a funny anecdote in Greece- Bread is called "psomi" ψωμί. (looks more elegant in Greek letters)
Large buttocks, particularly in women (of course highly chauvinistic) are called psomakia, little loaves of bread..so if you want to avoid this, eat less bread...
Large buttocks, particularly in women (of course highly chauvinistic) are called psomakia, little loaves of bread..so if you want to avoid this, eat less bread...
1/7 7- The obesity and diabetes epidemic likely has some roots in this public health endeavor. On balance, I think we are better off, but now need to deal with too many carbs and simple calories in public health.
1/8 8- I think this is why a large number of people, incuding on this forum, are trying to rebalance what we eat, as they see cutting down fat without context on what is replacing it is not necessary a complete answer
1/9 All this notwithstanding, diet will not deal effectively with risk of high LDL, Tg and Lp(a), so diet should be the basis, but many people will need drugs to maintain a healthy and uncomplicated CVD life. Thus, these should be seen as complementary, not mutually exclusive
• • •
Missing some Tweet in this thread? You can try to
force a refresh
