New book in Dutch

Eet vet word slank

Eet vet word slank gepubliceerd januari 2013

In dit boek lees je o.a.: * heel veel informatie ter bevordering van je gezondheid; * hoe je door de juiste vetten te eten en te drinken kan afvallen; * hoe de overheid en de voedingsindustrie ons, uit financieel belang, verkeerd voorlichten; * dat je van bewerkte vetten ziek kan worden.

Trick and Treat:
How 'healthy eating' is making us ill
Trick and Treat cover

"A great book that shatters so many of the nutritional fantasies and fads of the last twenty years. Read it and prolong your life."
Clarissa Dickson Wright

Natural Health & Weight Loss cover

"NH&WL may be the best non-technical book on diet ever written"
Joel Kauffman, PhD, Professor Emeritus, University of the Sciences, Philadelphia, PA

Dr. Scott Grundy Tries to Defend the Cholesterol Myth

There is always a protest when anyone speaks out against the fatty diet causes heart disease theory. Dr Scott Grundy wrote the following letter in reply to Taubes' paper.

Dietary Fat: At the Heart of the Matter

The role of dietary fat in the causation of coronary heart disease (CHD) has long been a topic of interest and dispute. In his News Focus article, Gary Taubes discusses what he calls "The soft science of dietary fat" (30 Mar., p. 2536). He reviews the history of the diet-heart issue and concludes that public health recommendations regarding dietary fat have not been based on solid science. He is primarily critical of the "low-fat" recommendation that has long been made by authoritative bodies to the American public. Taubes covers many aspects of the diet-heart issue, but he focuses on the question of whether there has been an overemphasis on fat without sufficient evidence that dietary fat is a major cause of CHD. He points out that recent trends in heart disease mortality both in the United States and worldwide are not well correlated with changes in dietary fat intake. Certainly he makes several astute observations, but in some areas, particularly in cardiovascular epidemiology, he does not appropriately recognize several other factors that confound the role of certain dietary fats in causation of CHD.

In my view, Taubes does not rightly identify saturated fatty acids as the predominant dietary factor contributing to the development of CHD. The significance of saturated fatty acids has been demonstrated by an enormous number of high-quality studies carried out with dietary fat in the fields of animal research, epidemiology, metabolism, and clinical trials (1). Although all questions have not been answered, a clear picture of the metabolic and health effects of saturated fatty acids has emerged. One fact is incontrovertible. As shown in multiple metabolic studies in humans, saturated fatty acids as a class, compared with unsaturated fatty acids and carbohydrate, raise serum low-density lipoprotein (LDL). Evidence is abundant that elevated LDL is a major cause of CHD and that lowering serum LDL levels reduces CHD risk (2). Even moderate reductions in LDL levels, such as those obtained by reducing dietary saturated fatty acids, are projected to substantially reduce risk of CHD in populations (3). Early prospective epidemiological studies gave results that are consistent with these projections (4). For example, in Northern and Eastern Europe, where intake of animal fats (mostly saturated fatty acids) previously was very high, serum LDL levels and CHD rates also were high. Conversely, in Southern Europe, where plant oils (mostly unsaturated fatty acids) are the predominant fat source, serum LDL levels and CHD rates were much lower. These relations were established more than 30 years ago, before increasing social and cultural homogenization in Europe partially obscured the relation of dietary fat to CHD (4). These population results, which in themselves were suggestive although perhaps not definitive, have been confirmed by results of controlled clinical trials. Several trials reveal that substitution of unsaturated fatty acids for saturated fatty acids lowers the incidence of CHD (1).

Although Taubes acknowledges the difference between saturated and unsaturated fatty acids, he does not draw a clear enough distinction in his discussion of dietary fats in general. Consequently, the article obscures the potential for public health benefits of substituting unsaturated for saturated fatty acids in the American diet. Such confusion does a disservice to the public health effort to further reduce the incidence of CHD through a reduction in intake of saturated fatty acids. On the other hand, Taubes does rightly note that other nutritional factors, for example energy imbalance leading to obesity, excessive carbohydrates, and insufficient intake of fruits and vegetables also influence population risk for CHD (1, 2).

Scott M. Grundy
Center for Human Nutrition and the Departments of Clinical Nutrition and Internal Medicine,
University of Texas Southwestern Medical Center,
Dallas, TX 75390-9052, USA.
E-mail: scott.grundy

References and Notes
1. Report of the Dietary Guidelines Committee on the Dietary Guidelines for Americans, 2000 (U.S. Department of Agriculture, Agricultural Research Service, Washington, DC, 2000).
2. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, J. Am. Med. Assoc. 285, 2486 (2001).
3. M. R. Law, N. J. Wald, T. Wu, A. Hackshaw, A. Bailey, Br. Med. J. 308, 363 (1994).
4. A. Keys et al., Am. J. Epidemiol. 124, 903 (1986).

Related Articles