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AUTHOR:
Alvin B. Lin, MD, FAAFP
Associate Professor of Family and Community Medicine, University of Nevada School of Medicine
Adjunct Professor of Family Medicine and Geriatrics, Touro University Nevada College of Medicine
Advisory Medical Director, Infinity Hospice Care
Medical Director, Lions HealthFirst Foundation
Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at http://alvinblin.blogspot.com/.
Paradigm shifts. Disruptive technologies/innovations. Upsetting the apple cart of conventional wisdom. Last month, I pointed a study suggesting that fried foods (possibly due to non–reuse of olive oil) might not be as bad for our hearts as we've come to believe. But as I've also pointed out on many occasions, I'm not a believer in flukes but rather trends. In other words, while one study might make for interesting cocktail hour conversation, two or more suggest a need to re-evaluate our way of practicing medicine.
Along that vein of thought, I'd like to point out a study published in February in Nutrition in which the authors dig deep into the dietary guidelines espoused by the US Departments of Agriculture (USDA) and Health and Human Services (DHHS) along with reports promulgated by the Institute of Medicine (IOM) and a third by the European Food Safety Authority. By now, we should all be familiar with the gist of their suggestions: consume less than 10% of calories from saturated fats by replacing them with mono- and polyunsaturated ones; and keep saturated fat intake as low as possible while consuming a nutritionally adequate diet.
These now well known recommendations should be based upon controlled trials demonstrating that saturated fat consumption increases LDL (“bad”) cholesterol; saturated fat is associated with heart disease; and replacing saturated fat with polyunsaturated fat decreases heart disease. In fact, in Table 1 of this review, the authors suggest that the evidence required above doesn't really support the guidelines. In Table 2, the authors dissect and compare the (overblown) recommendations presented by the IOM to the less impressive statistics published in specific studies.
I can already hear the conspiracy theorists out there mumbling and grumbling already. Is the USDA, DHHS and IOM trying to pull a fast one over us (again)? All I can recommend is that you take some time to read over this review and think long and hard about how to interpret the scientific literature for yourself. And then decide what you want to eat for dinner tonight.
