The Three Most Important Things You Need to know About Statins!

Can you find a more polarizing topic than statins? One article says they are miracle drugs that should be given to everyone. Then you turn the page, and you read how they are poison and you should stay away from them no matter what.  How can one drug cause such differing views? And which should you believe?

 

The statin debate has intensified ever since the 2013 ACC/AHA cholesterol treatment guidelines increased the number of people without heart disease who “should” take a statin to 43 million Americans. That is for primary prevention, meaning the individual has never had a diagnosis of cardiovascular disease, never had a heart attack, and never had any type of a heart problem.

 

As you can imagine, this has been a windfall for the drug companies. But are we healthier and better off as a result? That is unknown.

 

The problem is understanding the bias of whoever is writing the story.

 

Subtleties of Science

 

But wait, you say. Won’t the science tell us if statins are good or not? Isn’t it an objective fact if they are good for us?

 

Not so fast. Beauty is in the eye of the beholder, and so is the application of science.

 

Are you getting advice from someone who believes prescribing more medicine is better? Or someone who believes a more natural lifestyle is better? 

 

Are you reading a report sponsored by the pharmaceutical company that paid for the research?

 

Or are you getting advice from a scientist who is more focused on statistical benefits, or someone who is more concerned with the potential benefit for the one individual they are taking care of at the moment?

 

It is a confusing sea of conflicting information, and you have to find which approach resonates more with your beliefs and your life.

 

The Three Keys

 

Regardless of who you are and your beliefs, I promised you the three most important things you need to know about statins. Here they are:

  1. All statin studies are worthless! That’s right. All statin studies that have been done to date are worthless and don’t apply to anyone who follows healthy lifestyle principles.
  2. Statins will not prolong your life. Not at all. Not for a single day.
  3. Statins DO reduce your heart attack risk, by about 0.7% over 5 years.

All of a sudden, statins don’t seem so powerful, do they? Let’s go deeper into these points to learn why.

 

1-All Statin Trials Are Worthless

When designing a trial, you have to decide what your control group is going to be. You have to show that the drug is better than something. The key is defining what that something is.

 

Therein lies the problem. In order to show beneficial effects, primary prevention statin trials need thousands of subjects, studied over years. That is very expensive to do. The vast majority of trials, therefore, rely on drug company funding.

 

Do you think they are going to fund a trial that makes it easier or harder to show a benefit? Of course, that was a rhetorical question.

 

Pharma companies don’t have an interest in your health and wellbeing. Their priority is to their stock holders and their bottom line. They are going to sponsor trials that are most likely going to benefit them.

 

How does this make the trials worthless? They compare statins to “usual care.” That means a brief, and ineffective attempt to educate people about healthy nutrition and physical activity.

 

In addition, the specific nutritional guidance that was used has always been a low-fat diet. As we now know, what does a low-fat diet usually include? Lots of sugars and simple carbohydrates. What does that diet do? Increase your risk of obesity, diabetes, inflammation, and eventually heart disease.

 

That’s setting the bar pretty low to show a benefit from statins. And that is exactly what the drug companies want.

 

What we need is a control group that is involved in a comprehensive lifestyle intervention program. A program that helps participants get regular physical activity. Helps them eat vegetable based, real food, low in added sugars and simple carbs, and high in natural healthy fats.

 

Since that is the way we should all be living, THAT is what the control group should be. I guarantee you, the results would be far different compared to the standard control groups used to date.

 

That is the trial the drug companies never want to see and will never fund. And that is why all statin trials to date are worthless.

 

If you can focus on proper lifestyle interventions, using healthy foods, physical activity and stress management as medicine, then we have no idea what effect, if any, statins would have. But I assure you it will be minimal if any benefit.

 

2-Statins Will Not Prolong Your life

 

You read that right. For people who have never had heart disease before, the multi-billion dollar drug won’t help you live longer. The overwhelming majority of primary prevention trials involving statins show no difference in overall mortality between those who took the drug and those who did not.

 

That surprises a lot of people. Statins are promoted as if they are wonder drugs that save lives left and right. That’s good marketing and good PR. Reality is far different.

 

If they don’t help you live longer, they must increase the quality of your life, right? Nope. In fact, 30-40% of people on statins will experience muscle aches and weakness causing them to exercise less and decreasing the overall quality of their lives.

 

So, if they don’t help us live longer, and they don’t increase the quality of our lives, why do we take them????

 

3-Statins DO Reduce Your Heart Attack Risk

 

If the news was all bad there wouldn’t be any debate about their use. But the truth is that statins do reduce the risk of heart attacks, and that is why in some cases it may be beneficial for you to take one.

 

But the big question is: How much do statins reduce your heart attack risk? The answer is not as much as you would think. Considering the recommendations keep getting more and more aggressive for statin therapy, you would think statins would be immensely powerful at reducing heart disease risk.

 

In reality, they reduce the risk of a heart attack by 0.7-1.5% over 5 years. That means you need to treat 66-140 people for 5 years to prevent one heart attack.  (as an aside, for people with pre-existing heart disease, so called secondary prevention, you need to treat approximately 40 people for 5 years to prevent 1 heart attack and 85 people to prevent 1 death)

 

When presented like that, it should certainly temper the enthusiasm for statin therapy. Again, it may still be the right choice for some people, but given the potential risks and side effects, I would hope for a much greater benefit.

 

Better Than Statins

 

A common response is that statins are “the best we have to offer” to reduce one’s risk of cardiovascular disease.  If you are talking about a drug manufactured in a laboratory, then that would be correct. But what else are options?

 

It turns out following a Mediterranean eating pattern with vegetables, fruit, fish, legumes, and lots of nuts, olive oil and avocados reduces the risk of cardiovascular events as well. For something as simple as nutritional choices the benefit must be much less than a statin, right?

 

That is what the drug companies would want you to believe. In reality, you need to “treat” 61 people with the Mediterranean diet for 5 years to reduce 1 cardiovascular event (a “combined endpoint” of stroke, heart attack or death).

 

To be fair, you cannot compare one trial to another as they have very different populations studied, and the outcome measures are different. So, it is not scientifically fair to say, “The Mediterranean diet has been proven to be more beneficial that statins.”  That would require a head-to-head trial. Unfortunately, that trial is unlikely to ever happen.

 

But it makes for an obvious answer when asked “If statins aren’t all that helpful, what else can I do to reduce my risk of cardiovascular disease?

 

  • Follow a real food, vegetable-based, Mediterranean style diet, low in sugar and high in healthy fats.

 

  • Maintain a physically active lifestyle.

 

  • Exercise with some form of moderate cardio exercise, resistance training and higher intensity interval exercises.

 

  • Practice stress reduction techniques.

 

  • Don’t smoke.

 

  • Manage your other risk factors such as diabetes and high blood pressure.

 

If you can follow these healthy lifestyle principles, you will be doing far more for your health than any pill you could take. And the best part? The only side effects are having more energy, feeling more empowered, and reducing your risk for chronic diseases.  Sounds like a good trade off to me!

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

Saturated Fat Kills! Or does it? Let the debate continue!

Dietary Saturated Fat Kills! Or does it? The Debate Rages On…..

 

A recent editorial publication in BMJ has once again stirred the raucous debate about dietary saturated fat. One subject with two completely opposing viewpoints, each one filled with ardent supporters who know in their hearts (pun intended) they are correct.

 

So……does dietary saturated fat directly cause heart disease, strokes and death? Or does it not?

 

Wait a second. This is science we’re talking about. Shouldn’t it be clear who is right? Shouldn’t the evidence prove one group right and the other wrong?

 

Nope.

 

Nutritional science is messy and rarely conclusive. That’s why we got into this mess in the first place.

 

Hooray for Debate

 

Before we get into the details, let’s all celebrate the debate itself. We should all be grateful that we can take part of an open and emotional debate among intelligent, successful and reputable individuals. Recent history has too many examples of some individuals trying to shut down debates in favor of declaring the “truth.” We all should know by now that isn’t going to fly.

 

Instead, we should celebrate every chance to debate the science and its impact on our lives. After all, we can still have free speech even if we can’t have free healthcare.

 

Bad Data

 

Here is the problem with nutritional science. It is really bad science.

 

Remember your science fair project as a kid? You were supposed to design an experiment that tested a hypothesis, controlled for one variable, and proved if that hypothesis was valid or not.

 

Nutritional science doesn’t work that way. Instead, most nutritional studies are observational studies. We observe how people live their lives, collect as much data as we can, and follow them to see who has heart attacks, who has diabetes, who lives and dies, etc. We can then see what habits each person had and try to draw statistical associations.

 

The problem is that this cannot prove anything. It can only suggest an association. When compared to your middle school science fair experiment, you can see the stark differences.

 

The observational study does not control any variables (they try to control for certain variables, but that is an impossible task especially since we can’t know all the variables for which we need to control), does not test a single hypothesis, and does not prove anything.

 

Why Does This Matter?

 

Here’s the problem. There are lots of studies that show an association between saturated fat intake (mostly animal products) and an increased risk of heart disease, strokes and death.

 

But here is the kicker. There are also lots of studies that show there is no association between saturated fat intake (mostly animal products) and an increased risk of heart disease, strokes and death.

 

Huh? How can that be?

 

There are many reasons why but here are the two big ones. 1- People are all different, and 2- Food is all different

 

People are Strange, I mean Unique

 

In the BMJ article, the authors propose that inflammation, not saturated fat, is the main cause of heart disease. There is definite sound evidence to support inflammation as a contributing causative factor in heart disease.

 

However, we need to acknowledge that inflammation is different in everyone. We are all unique. Our internal environments, from our degree of inflammation to our gut microbiome, are all different.

 

Therefore, how we respond to our external environment (i.e. the food we eat) is going to vary from person to person.

 

LDL cholesterol is a prime example. LDL is not inherently “evil.” Why would our bodies evolve to produce a substance whose job it is to kill us?

 

LDL is a necessary component in our cells, our brains and for making our hormones. We cannot live without it. Our internal environment, however, can alter LDL and turn it into an oxidized and inflamed structure that is more likely to cause heart disease. That may not be an inherent property of LDL, but rather, something our body’s environment does to LDL.

 

The same can be said of eating saturated fat. It is certainly plausible that introducing large quantities of saturated fat into an oxidized and inflamed environment can cause harm. But what if the individual exercises regularly, eats a veggie-first/real foods diet, practices mindfulness regularly, gets regular restorative sleep, and therefore has very low levels of inflammation and oxidation?  Chances are, the same amount of saturated fat in this individual is unlikely to cause damage (that’s my hypothesis, I haven’t don’t my science fair project on this yet).

 

Observational studies cannot tell the difference between these two types of people with different degrees of inflammation and oxidation. Instead, the trials try to reach a general conclusion that then is applied to everyone.

 

Does that sound like good science to you? I’d give it a C- in the middle school science fair (and that is being generous with extra points for their passion). Should we be making decisions about our health based on C- science?

 

We Don’t Eat Saturated Fat, We Eat Food!

 

Picture a big greasy burger on a huge bun, soaked in ketchup, with a side of fries and a coke. Observational studies call that a saturated fat eater.

 

Now picture a spinach and kale salad with beets, strawberries, walnuts, carrots and tomatoes topped with 4 ounces of grass fed steak. No fries. No coke. Observational studies also call this person a saturated fat eater.

 

I’ll say it once again. We don’t eat saturated fat. We eat food! It is crazy to think we can isolate one specific macronutrient and know all that it does. For starters, there multiple different types of saturated fat of highly variable quality with variable effects on our bodies.

 

Second, what we don’t eat (i.e. avoiding saturated fat) is just as important as what we do eat (instead, eating refined, processed, simple carbohydrates and sugar vs. veggies, fruit, nuts etc.). 

 

In the example above, the first person had a huge bun, fries and a coke. There wasn’t a veggie to be seen. Tough to pick just one villain in that so-called meal.

 

Don’t Throw It All Away

 

Don’t get me wrong. I am not about to suggest that we throw out all nutritional research. We still need it to guide future research and help us generate hypothesis.

 

I will suggest, however, that we need to be very careful about interpreting the research. Anyone who claims observational trials definitively prove anything must be seriously questioned.

 

And when they claim a “vast collection” of evidence, or an “overwhelmingly consistent conclusion” from the evidence, keep in mind that a vast collection of dog poop is still just a bunch a dog poop.

 

I respect and value ardent supporters on both side of the saturated fat aisle. But I also know that neither has the strength of evidence that their conviction conveys.

 

What Do We Do???

 

Be wary of anyone who claims they have the “answer” and the “conclusive” evidence. Try not to get caught up in all the debate if you don’t want. You can keep it simple and keep it healthy.

 

Eat real food. Mostly vegetables and some fruits with healthy fats such as extra virgin olive oil, avocados, nuts and seeds. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes.

 

If you enjoy the debate, by all means participate. It’s good for science. But here is the one and only thing I can say with absolute certainty.

 

I can’t prove anything that I recommended in this article.

 

There has never been a randomized study to prove my personal nutritional consensus. No one has done their middle school science fair project to prove my hypothesis.

 

Sometimes, we need to take a leap and say, “this makes sense.” We need to integrate all the evidence, combine it with clinical experience, and come up with our best solution.

 

That is why experts can be so passionate and so resolute in their position, and yet the positions can be so variable.

 

And that is why we need to find reliable voices we can trust. 

 

My voice? Keep it simple.

 

Eat real food. Mostly vegetables and some fruits with healthy fats such as extra virgin olive oil, avocados, nuts and seeds. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes. Take away the stress, be mindful in your eating, and enjoy!

 

Action Item:

Identify a belief you hold to be true about nutrition. Something that is ingrained in your core that must be true. Saturated fat is a perfect example, but there are plenty others. Salt? Carbs? Juicing? Whatever you feel is undoubtedly healthy or unhealthy. Next, search online for the exact opposite position. Keep an open mind and explore what the opposing side says. This will hopefully help you understand the complexities and uncertain nature of nutritional science.

 

Then, get back to the basics and (say it with me now….) eat real food. Mostly vegetables and some fruits with healthy fats. Add smaller portions of high quality animal sources and smaller portions of minimally processed whole grains and legumes. Take away the stress, be mindful in your eating, and enjoy!

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

 

 

 

 

 

 

 

Should I salt My Food? Let’s Hear the Truth!

How guilty do you feel when you reach for the salt shaker? Do you look to make sure no one is watching as you quickly shake the little white granules on your food, salivating as you anticipate the bursting flavor that sodium brings? It may be time to stop feeling guilty. You can salt with impunity. At least most of you can.

 

For decades, nutritional guidelines have recommended consuming less that 2300mg of sodium per day. This was most recently perpetuated in the 2015 American dietary guidelines. Yet the evidence to support such a guideline for all Americans is lacking at best.

 

In reality, there is substantial evidence that sodium restriction for the average American does nothing to reduce one’s risk of heart attacks, strokes or death. So, why should we limit it?

 

Approximately 25% of the population is sensitive to salt and may have dramatic increases in blood pressure, increased fluid retention, and increased risk of cardiovascular complications. But that is 25% of the population. Not the entire population. Trying to devise a single guideline for everyone is destined to fail. And it did.

 

Before I get into the specifics of the evidence, here is the conclusion:

 

If you are not salt sensitive (you do not have difficult to control hypertension, you do not have salt sensitive congestive heart failure) then salt restriction is not going to benefit your health.

 

That doesn’t give you license to start eating salt laden processed junk food. No, no, no. But it does give you the freedom to add high quality, minimally processed salt (Celtic sea salt, Himalayan salt, Real Salt, etc.) to your vegetable based, minimally processed, real food diet. 

 

Salt away and experience the flavors that salt can bring.

 

How Did We Get Here?

 

The controversy around salt all started in 1997 when an early version of the DASH study was published in NEJM. This study showed that those with hypertension could reduce their blood pressure by 11/5mmHg by reducing their sodium intake. The less publicized part of the study, however, was that those without hypertension only reduced their BP by 3/2, hardly earth shattering.

 

The follow up DASH study, also in NEJM, followed only 400 people for 30-days. They concluded that those eating the standard American diet could reduce their systolic BP by 6mmHg by limiting sodium to 2300mg.day. Interestingly, those eating a diet higher in fruits and vegetables only reduced their BP by 2mmHg by reducing sodium. Again, a disparity was seen between those who were presumably salt sensitive and those who were not.

 

Notice that neither of these studies reported changes in heart attacks, strokes or death. It was just assumed that any reduction in BP, no matter how small, would automatically translate into improved health. That assumption lead to the guidelines committee recommending sodium restriction for all.

 

The Real Evidence

 

Since the original DASH study in 1997, we still have no randomized trials demonstrating reduced risk of heart attack, strokes or death by decreasing sodium intake.

 

In fact, we have plenty of evidence to the contrary.

 

One large meta-analysis showed no clear association between sodium reduction and cardiovascular complications.

 

Another study demonstrated that sodium restriction caused a cascade of deleterious effects including increased blood levels of renin, aldosterone, adrenaline, and noradrenaline. These are all hormones that lead to higher blood pressure over time.

 

Newer evidence suggests that excessive sodium intake (greater than 7 grams per day) and low sodium intake (less than 2500mg/day) could both lead to increased risk of heart attacks and death.

 

Lastly, recent trials suggest a more prominent response to sodium in those who already have hypertension and eat more than 5 grams/day (there was no report of increased cardiovascular risk). Interestingly, higher potassium consumption was associated with a decreased BP.

 

The Devil That We Know

 

The result? We have the wrong enemy.

 

I have seen countless of patients and clients who report to me, “I’m eating much better. I won’t touch salt anymore!” Salt became the devil we know, and we could feel much better about ourselves by avoiding it.

 

The problem is that it may lead us to ignore the other “evils” in our nutrition. The added sugar, the processed foods, the industrial trans-fats, the fake stuff. It takes too much energy to avoid everything. Our brains are wired to focus on one thing, get rid of it, and feel like we have succeeded.  Don’t make salt the one thing you focus on!

 

Quality Matters

 

What did we learn from all the above studies?

  1. There is no evidence supporting reducing sodium intake to less than 2300 mg/day in the general population
  2. Very high (>7g/d) and very low (<2.5g/d) sodium consumption could be potentially dangerous for most Americans
  3. Where you get you sodium matters!

 

Number 3 deserves more attention. Where we get our sodium matters. If our sodium comes from processed junk food, high sugar or simple carb foods, then we aren’t doing ourselves any favors.

 

Also, why do you think increased potassium lead to reduced BP? First let’s look at potassium rich foods.

  • Avocado
  • Spinach
  • Sweet Potato
  • Acorn Squash
  • Wild salmon
  • Pomegranates
  • Citrus fruits
  • Bananas
  • White Beans

What do these foods have in common? They are real, unprocessed foods that come from nature.

 

Focusing on real, veggie-based foods is going to reduce your BP, and more importantly, lower your long-term risk of cardiovascular disease, diabetes, Alzheimer’s and other chronic diseases.

 

Don’t Make It Too Complicated

 

Remember, there is no one size fits all approach to nutrition. Guidelines that assume otherwise will likely fall short of being helpful. With that in mind, here are the 3 take home points regarding sodium consumption and your health.

 

  1. If you have poorly controlled hypertension or heart failure, then you may need to be careful with sodium intake
  2. If not, which applies to most the population, focus on real foods from nature. Have no hesitation adding real, minimally processed salt.
  3. Don’t get your sodium for processed junk food.

 

It’s that simple. Let’s not make it more complicated than it needs to be.

 

ACTION ITEM: Change the type of salt you use. Invest in Celtic Sea Salt, Himalayan Salt, Real Salt, or other minimally processed salt. Liberally enjoy this salt in your steamed, roasted, or sautéed veggies. Make sure you are limiting your processed food and junk food that contains refined salt (potato chips, pretzels, crackers etc.).  

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Can Eating Better Save 400,000 Heart Attack Deaths?

By now you have likely heard the news that poor nutritional choices cause almost half of all cardiovascular deaths. Wouldn’t it be amazing if by eating better 400,000 people would still be alive today? You bet it would.

 

While it’s no surprise that nutrition and heart health are directly related, causing half of all cardiovascular deaths is a dramatic finding that deserves further scrutiny.

 

The recent study, funded by the Bill and Melinda Gates Foundation, was presented at the 2017 annual AHA meeting. They retrospectively looked at years of observational data to correlate nutritional habits and the subsequent risk of dying. Instead of focusing only on the “bad” foods that people ate, they also looked at the “good” foods people did not eat. They concluded that Americans need to eat more nuts, vegetables and whole grains, and less salt and trans fats.

 

Yawn. That finding is hardly earth shattering as we have been hearing this for decades. Does this new study add anything to the current literature? I’m afraid not.

 

We have plenty of observational data suggesting the same.  In fact, another similar study published in JAMA at the same time provided more observational evidence that 318,000 out of 702,000 cardiovascular and diabetes related deaths are related to (in order of statistical strength), too much salt, not enough nuts and seeds, too much processed meats, not enough omega 3 rich seafood, not enough veggies or fruit and too many sugary beverages.

 

Bad Studies Yield Bad Data

 

Two studies with similar results. Does that sound conclusive? Not so fast. The problem is that all this data is observational, and therefore weak data. It can point out associations, but it cannot prove cause and effect (see chapter 2 in my book, Your Best Health Ever for a more detailed discussion).  What we need is a randomized, controlled trial investigating the question of nutrition and cardiac deaths, not more observational drivel (see my post on The Best Weight Loss Trial You Will Never See here)

 

As an example, processed food is high in salt. Fruits and veggies are low in salt. Can we say with certainty that the salt is the problem? Or is it the company it keeps, i.e. too much crackers, chips and baked goods instead of fruits and veggies? This study cannot determine between the two. Also, those who eat more veggies also tend to be more health conscious, more physically active, and have less dangerous habits (i.e. smoking). The opposite is true for those who eat more processed junk food. Again, observational studies cannot completely control for those variables (they can try, but statistics are imperfect for this).

 

Does this mean we need to throw out the study completely? Not necessarily. It raises important questions, even if it does not provide clear answers.

 

Instead, we should combine the findings with the higher quality, randomized trials to see what the science truly supports.

 

Good Studies Yield Good Data

 

The more conclusive studies are the randomized controlled trials. One such recent trial was the PREDIMED study (see more on this study and the Mediterranean diet here).  Briefly, this trial investigated a diet that included a “high intake of olive oil, fruits, nuts and vegetables; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation with meals.” This pattern of eating significantly reduced the risk of cardiovascular disease when compared to low-fat diet.

 

Since this was a randomized trial, there was no need to control for other healthy habits and self-selection bias. In addition, they didn’t measure surrogate outcomes like blood pressure, weight, or cholesterol. They measured the events we really care about- heart attack, stroke and death. In the end, a simple nutritional intervention reduced that risk.

 

This is an impressive study that tells us something conclusive about nutrition. I hope you can see the difference between this study and the throngs of poor-quality observational trials.

 

Do you see any similarities between the PREDIMED study and the recent observational trials?

 

Encourage nuts, veggies, and fish. Discourage processed meats and sweets.

 

In short, eat real food.

 

Can We Find A Common Ground?

 

After that, the science gets murky.

 

What about poultry? It was encouraged in the PREDIMED study and was not mentioned much in the recent observational trials. There doesn’t seem to be significant evidence to avoid it, and there may be reason to eat it. So be aware of your portion size and go for it.

 

What about salt? It wasn’t limited in the PREDIMED study. Some studies suggest increased risk with high sodium intake, and some studies suggest increased risk with low sodium intake. In the observational trials, it can be difficult to separate salt from processed foods, and therefore difficult to know if it is dangerous.

 

You may be thinking, if there is any question, why not just avoid it?  Is there a compelling reason to eat salt? You bet there is. Taste. Salt helps food taste better. If you are adding it to your cookies, white bread or potato chips, you aren’t doing yourself any favors. However, if you are adding a sprinkle of sea salt on your freshly steamed veggies or your roasted broccoli, then go for it. An observational study can’t tell the difference between those two circumstances, but trust me, your body can.

 

What about red meat? This is a big one. We don’t have any evidence that red meat reduces the risk of cardiovascular disease. However, all the evidence suggesting that red meat and animal protein increase the risk of cardiovascular disease is poor quality observational data. In addition, there is plenty of poor quality observational data that claims the exact opposite, that red meat does not increase the risk of cardiovascular disease. So again, we must ask, if there is controversy, should we just avoid it? Is there a compelling reason to eat meat? For some there is. Animal meat is the most efficient source of B-vitamins, iron and protein, it is filling and it tastes great.

 

Once again, the specifics matter. Are you eating a 16oz porterhouse steak with mashed potatoes? Or are you eating a fresh vegetable salad with 6-ounces of grass-fed steak on top? A study may not know the difference, but your body sure does.

 

Wrap It Up

 

Can improving what you eat reduce your risk of heart attacks and strokes? It sure can. The PREDIMED study showed that.

 

Do these new observational studies add anything new? That’s debatable.

 

We come back to the basics. Eat more real food. Eat more veggies and fruits. Eat less processed junk. Avoid manufactured trans fats. If you do that, you are doing 95% of the work (I made up 95%, but it seems right to me).

 

Spend all the time you want arguing about the remaining 5%. There is plenty of evidence to support your claim whether you are for or against salt, meat, eggs etc.

 

As for me, I am going to step out of the argument and go eat my spinach and kale salad with Brussel sprouts, cauliflower, squash, nuts and seeds, topped with olive oil and 4 oz. of wild salmon and a hard-boiled pasture raised egg. Heaven on earth. Bon Appetite.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com 

 

Action Item:

Look for ways to add veggies, nuts and seeds to your meals. Sprinkle pumpkin seeds on your oatmeal, eggs or salad. Ask for a double portion of veggies and half the protein when you go out to dinner. Watch our veggies and eggs video to see how easy it is to make a veggie-based breakfast. Focus on real food, veggies first. Try it today and see how easy and rewarding it can be!

Bret Scher, MD FACC

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