Presented by: Dr. Jim Painter PhD,

Transcription

1 Presented by: Dr. Jim Painter PhD,

2 Disclosures Jim Painter, PhD, RD Jim is Scientific Advisor for Sun-Maid Growers of California and Paramount Pistachios and serves as a consultant for the National Pasteurized Egg Board and the National Dairy Council. Honoraria for talks, Dietitians of Canada, Exxon Mobil, Frito Lay, Pennsylvania Nutrition Network, California Raisin Marketing Board, Alaska Tanker Company, Dairy Max, Texas AND, California AND, Florida AND, MINK, NY AND, South Carolina AND, Iowa AND, Nebraska AND, Manitoba Dairy Farmers, Dairy Farmers of Canada.

3 Why did those recommendations last for so long?

4 The Big Fat Lie: Politics vs Sound Science Dr. Ancel Keys influential, Seven Countries Study 1961 Keys persuaded AHA to release 1 st guidelines targeting saturated fat 1970 Congressional hearings on low-fat, cholesterol, anti-saturated fat campaign; many scientists opposed it Why do we still have fat/cholesterol recommendations? Keys aggressively discredited opposition (sugar causes HD) Current health authorities are too embarrassed or too loyal Based on Key s research, drug companies created the most lucrative drug ever: statins Andrade, 2009

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6 British physician Malcolm Kendrick used same data available to Keys and discovered that by choosing different countries you can prove an inverse relationship Bowden, J., & Sinatra, S. (2012). The Great Cholesterol Myth. Beverly, MA: Fair Winds Press. Fat and cholesterol intake Risk of Heart Disease

7 Where did the Cholesterol Recommendations come from? Based on animal studies Studies did not take into account other risk factors Studies provided excessive amounts of DC Cholesterol Recommendations

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9 Even Ancel Keys, who some consider the father of the cholesterol-heart disease hypothesis said in 1997: "There's no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we've known all along. Cholesterol in the diet doesn't matter at all unless you happen to be a chicken or a rabbit". Rosch PJ. Cholesterol does not cause coronary heart disease in contrast to stress. Scand. Cardiovasc. J. 42, (2008).

10 The three deciding opinions: 1. American Heart Association USDA Dietary Guidelines Most recent meta analysis 2015 All three agree there isn t enough evidence to make a recommendation.

11 In the 2000 the AHA states that there is no precise basis for selecting a target level for dietary cholesterol for all individuals but recommends 300 mg/day on average AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk There is insufficient evidence to determine whether lowering dietary cholesterol reduces LDL-cholesterol (Eckel, et al, 2014).

12 Dietary Guidelines- 2015

13 DGAs for Americans

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18 Increase in dietary cholesterol from two eggs and energy restriction led to decrease in plasma LDL similar to one of an energy restricted diet alone Conclusion: weight loss alone can reduce serum cholesterol

19 Research examining two studies (The Nurses Health Study and the Health Professionals Follow-up Study ) with over 1 million participants, could find no significant difference in cardiovascular disease risk between groups consuming less than one egg a day and groups consuming more than one egg a day Lee, A., & Griffin, B. (2006). Dietary cholesterol, eggs and coronary heart disease risk in perspective. British Nutrition Foundation, 31,

20 Hu et al adjusted for other factors often associated with egg consumption, such as smoking and bacon consumption, and found no significant relationship with fatal CHD or nonfatal MI. Hu, F., Stampfer, M., Rimm, E., Manson, J., Ascherio, A., Colditz, G.,... Willett, W. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. Journal of the American Medical Association, 281(15), Barraj et al stated that often the benefits of egg consumption are not considered when examining cholesterol: Egg intake raises HDL levels, provides lutein which lowers CHD risk, and is a great source of choline. Barraj, L., Tran, N., & Mink, P. (2009). A comparison of egg consumption with other modifiable coronary heart disease lifestyle risk factors: A relative risk apportionment study. Risk Analysis, 29(3),

21 Change in LDL, HDL, and LDL Size as a Response to DC provided by Egg in Various Populations POPULATION DURATION ADDT L DC LDL HDL LDL:HDL RATIO CHILDREN 4 wk 518 mg/d No Change WOMEN 4 wk 640 mg/d No Change MEN 12 wk 640 mg/d No Change MEN/WOMEN 12 wk 215 mg/d No Change No Change MEN/WOMEN 4 wk 640 mg/d No Change LDL SIZE MEN/WOMEN 12 wk 250 mg/d No Change N/A MEN/WOMEN 12 wk 400 mg/d No Change No Change No Change N/A Fernandez, M., & Calle, M. (2010). Revisiting dietary cholesterol recommendations: Does the evidence support a limit of 300 mg/d? Current Atherosclerosis Reports, 12,

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