Newsletters & Publications
17 - Number 2
BMI: body mass index (kg/m2)
CAD: coronary artery disease
CHD: coronary heart disease
CI: confidence interval
CVD: cardiovascular disease
HDL: high density lipoprotein
LDL: low density lipoprotein
Lp(a): lipoprotein (a)
MI: myocardial infarction
MUFA: monounsaturated fatty acids
NCEP: National Cholesterol Education Program
P:S: dietary polyunsaturated:saturated fat ratio
PUFA: polyunsaturated fatty acids
RR: relative risk
SFA: saturated fatty acids
VLDL: very low density lipoprotein
For a longtime, people with elevated blood
cholesterol were recommended to follow a low-fat diet, but the
decrease in plasma HDL cholesterol and the increase in TAG levels
associated with this diet have some researchers questioning the
universal use of this diet therapy. But now data by Asztalos and
colleagues indicate that the degree of plasma HDL cholesterol change
following initiation of a low-fat diet varies widely among individuals.
For example, normocholesterolemic subjects with low baseline HDL
cholesterol levels (<35 mg/dl) decreased their plasma
HDL cholesterol levels by 1.3 mg/dl compared to a 5.2 mg/dl drop
in HDL cholesterol levels in normal HDL cholesterol (>35 mg/dl)
subjects, 6 weeks after changing to an isocaloric, Step 2 diet.
In this study, the researchers investigated
the effects of 3 test diets on the plasma lipid and lipoprotein
profiles in 76 normocholesterolemic males between 22 and 65 years
of age. The main difference in the 3 test diets was total fat calories;
the All American Diet (AAD) diet contained 36.8% fat (14.1% SFA)
compared to 28.1% (8.7% SFA) and 23.7% (6.2% SFA) in the NCEP Step
1 and Step 2 diets, respectively. Daily caloric levels were regularly
adjusted to maintain the subject's body weight.
Analysis of fasting blood samples following
each diet phase showed that plasma total cholesterol, HDL, LDL,
apo A-I, apo B, LDL:HDL cholesterol ratio, and HDL:apo A levels
were all lower following the Step 1 and Step 2 diets compared to
the AAD. Plasma TAG levels increased with the 2 low-fat diets.
The percentage of subjects with low HDL cholesterol levels (<35
mg/dl) increased from 33% during the AAD to 55% with the Step 2
diet. However, when the plasma lipid and lipoprotein responses
to the 2 low-fat diets were separately analyzed based on baseline
AAD plasma HDL levels, it showed that the HDL cholesterol and apo
A decreased by 1.3 mg/dl and 4.8 mg/dl, respectively, in individuals
with low HDL cholesterol levels while in the normal HDL cholesterol
individuals, the HDL cholesterol and apo A decreased by 5.2 mg/dl
and 8.7 mg/dl. The change in total cholesterol, LDL, TAG, and apo
B were similar in the two HDL cholesterol subgroups. The baseline
atherosclerotic index, expressed as the LDL: HDL ratio, was higher
in those with low HDL cholesterol levels on the AAD compared to
those with normal HDL levels (3.92 vs 2.87). However, with intake
of the low-fat diets, the LDL:HDL cholesterol ratio decreased by
11% (3.92 to 3.49) in those with low HDL as a result of the decrease
in plasma LDL cholesterol with little change in HDL cholesterol
levels. In contrast, those with normal HDL cholesterol levels lowered
both the LDL and HDL cholesterol levels with intake of the low
fat diets resulting in no change in the LDL:HDL ratio. In response
to a low-fat diet, there was also a difference in distribution
of HDL subpopulations between these 2 groups. For example, apo
A-I decreased more in the normal HDL cholesterol subjects than
in the low HDL cholesterol group. The major change in plasma HDL
occurred in the alpha-1 fraction which is a large apo A-I only
subpopulation corresponding to HDL3. "The distribution
of a1 concentration peaked between 14-15 mg/dl on the Step 2 diet
compared to a peak at 22-25 mg/dl on the AAD." Of all the changes
in lipid and lipoprotein levels following the low-fat diets, only
the HDL cholesterol and alpha-1 was different between the 2 HDL
Based on an earlier study which found that
nomolipidemic low HDL cholesterol subjects have a significantly
different distribution of apo A-I containing HDL subpopulations
than individuals with normal HDL cholesterol, the researchers tested
the theory that feeding a low-fat diet would decrease plasma HDL
cholesterol more in normal HDL cholesterol individuals than those
with low HDL cholesterol. Even though the current study supports
this hypothesis showing that plasma HDL and apo A decreased more
in the normolipidemics with normal HDL levels than low HDL levels,
it is a paradigm shift to think that initiation of a low-fat diet
in those having a lower HDL level is more advantages to the heart
than intake of a low-fat diet in those with higher HDL levels.
The question yet to be answered is whether a low-fat diet is beneficial
in those with normal HDL cholesterol levels.
Asztalos B, Lefevre M, Wong L, et al. Differential
response to low-fat diet between low and normal HDL-cholesterol
subjects. J. Lipid Res. 2000. 41:321-328.
- Low-fat diet lowers HDL cholesterol levels differently in
normal cholesterolemic men with normal HDL (>35
mg/dl) and low HDL (<35 mg/dl) levels.
- HDL and apo A decreased
by 1.3 mg/dl and 4.8 mg/dl following the Step 2 diet in the low
HDL cholesterol subgroup compared to 5.2 mg/dl and 8.7 mg/dl
in normal HDL group.
- The LDL:HDL ratio decreased by 11% in the low HDL cholesterol
group, but no change was noted in the normal HDL group.
Table of Contents
Klipstein-Grobusch et al. tested the association
between serum carotenoid levels and atherosclerosis in the abdominal
aorta of the Rotterdam Study participants. According to the findings
from this case-control study with 217 subjects (108 cases and 109
controls), of the 6 carotenoids investigated, only serum lycopene
levels exhibited a modest inverse association with the presence
Using previously frozen sera samples from
middle-aged adults in the Netherlands, the researchers determined
the link between plasma carotenoid levels and atherosclerosis.
The presence of atherosclerosis lesions was diagnosed by detecting
calcified plaques in the abdominal aorta using a laternal radiographic
film. Health status and life style factors associated with CVD
were measured and included in the multivariate analysis. As expected,
the incidences of hypertension, diabetes, high BMI and high systolic
blood pressure were higher in the cases compared to the control
group. Another difference between the 2 study groups was that the
case group had lower plasma levels of alpha-carotene, �-carotene,
The age and sex adjusted log regression showed
that serum lycopene was inversely associated with atherosclerotic
risk. The odds ratio for the highest quartile of serum lycopene
was 0.55 compared to the lowest quartile. The serum levels of alpha-carotene, �-carotene,
lutein, and zeaxanthin did not correlate with atheosclerosis progress.
Lycopene levels were especially benifical against atherosclerosis
in a subset of current and former smokers.
In conclusion, the modest inverse relationship
between serum lycopene and aortic atherosclerosis found by Klipstein-Grobusch
et al. suggests that lycopene, which has the strongest antioxidant
properties, has a modest effect on atherosclerosis risk and that
lycopene levels are especially important in neutralizing free radicals
in current and former smokers.
Klipstein-Grobusch K, Launer LJ, Geleijnse
JM, et al. Serum carotenoids and atherosclerosis. The Rotterdam
Study. Atherosclerosis. 148: 2000; 49-56.
Table of Contents
According to a large prospective study conducted
by William et al., angry people has one more reason to be angry.
It seems they are 3 times more likely to suffer a heart attack
than their less anger prone counterparts. When the researchers
compared the degree of anger with CHD incidences in 12,986 participants
in the Atherosclerosis Risk In Communities (ARIC) Study, it showed
a direct relationship.
Using the responses from the 10-item Spillberger
Trail Anger Scale (4 point scale), William and coworkers were able
to categorized subjects into a low anger group (37.1%), a moderate
anger group (55.2%), and a high anger group (7.7%). The low anger
group had a trait anger score of 10-14, the moderate group had
a score of 15-21, and the high group had a score of 22-40. The
people in the highest anger group tended to be younger, heavy-set
men, who drank and smoked, with a lower education level than the
participants in the moderate and low anger groups. Plasma LDL and
HDL levels were similar in all 3 groups.
During the 6-year follow-up period, 416 cases
of CHD events were noted, which equals 7.4 events per 1,000 person-years.
As a group, the multivariate adjusted hazard ratio (HR) for CHD
was 1.54 (95% CI 1.10 to 2.16) and 1.10 (95% CI 0.88 to 1.36) for
the high versus the low trait anger group and the moderate versus
the low trait anger group, respectively, and 1.63 (95% CI 1.07
to 2.48) and 1.08 (95% CI 0.82 to 1.43) for "hard events" such
as MI and CHD deaths. However, when the data were subdivided into
hypertensives and normotensives, an anger-CHD relationship was
only evident in the normotensive population. For example, the age
adjusted HR for CHD events in normotensives were 2.61 in the highest
anger group compared to 1.14 in the hypertensive group. The HR
for hard CHD events were 2.97 and 1.05 for the normotensive and
hypertensive groups, respectively. The difference in HR between
the moderate anger group and the low group was substantially less
than the difference between the highest to lowest group. Compared
to a 3-fold difference, it was only 40% higher in the moderate
anger group compared to the lowest anger group. Even though the
differences in multivariate adjusted HR for CHD events in the 3
anger trait groups were 1.00, 0.95, and 1.08, respectively, the
actual CHD event-free survival probability was dramatically lower
than in the normotensive groups than hypertensive groups. Thus
indicating that in spite of similar HR across different degree
of anger trait, they are more likely to suffer a CHD event than
the normotensive groups, regardless of anger traits. And in the
normal blood pressure groups, the highest anger score group had
a dramatically lower CHD-free survival probabilities. The CHD-free
survival probabilities for the lowest and moderate anger groups
with normal blood pressure were relatively similar.
The researchers initially thought that anti-hypertensive
medications used by the hypertensive men and women in the study
protected them against CHD by preventing vasoconstriction, thrombus
formation, cardiac arrhythmias, and plaque disruption; however,
subset analysis of hypertensives not taking medications for blood
pressure showed no CHD-anger relationship. Results from these bi-ethnic
subjects showed that the CHD-anger relationship was similar between
blacks and whites, and males and females.
Results from this study suggest that anger
is a major CVD risk factor in normotensive middle-aged adults independent
of biological risk factors. The findings suggest that by lowering
the degree of anger from high to moderate, an individual could
significantly cut their risk from 300% to 40%. In contrast, hypertensive
adults did not show an anger-CHD relationship, which may be related
to their higher CHD risk status compared to normotensive individuals.
Williams JE, Paton CC, Siegler IC, et al.
Anger proneness predicts coronary heart disease risk. Prospective
analysis from the atherosclerosis risk in communities (ARIC) study. Circulation. 200;101:2034-2039.
The popularity of functional foods has dramatically
increased in the pass decade and omega-3 enriched eggs are among
a growing number of functional food items available in the marketplace.
High omega-3 fatty acid eggs are produced from chickens fed high
flax or algae diets and not from genetically modified birds, as
some consumers mistakenly believe. These omega-3 eggs are suitable
alternatives for people who want to increase their omega-3 fatty
acid intake but dislike fish. In light of earlier findings that
showed a cardioprotective role of omega-3 fatty acids, Lewis et
al. tested the effects of omega-3 enriched eggs on serum lipids
in hyperlipidemic adults.
The 25 healthy volunteers (13 men and 12 women)
in the study ate 3 test diets; a low-fat, self-selected diet with
12 omega-3 enriched eggs per week, a low-fat, self-selected diet
with 12 control eggs per week, and a low-fat, self-selected diet
without eggs. Each test diet was consumed for 6 weeks followed
by a 6 week washout period. The omega-3 fatty acid levels in the
high omega-3 eggs and control eggs were 412 mg/egg and 65 mg/egg,
respectively. The majority of the increase in omega-3 fatty acids
came from linolenic acid (260 mg/egg) compared to docohexaenoic
acid (79 mg/egg). Analysis of dietary records indicated that the
subjects were compliant with low-fat diet of 22% of calories from
total fat and 7% SFA throughout the study. The dietary cholesterol
during the 2 diets with eggs were 333 mg/day higher compared to
the no egg diet.
Serum lipid levels after the test diets showed
that 2 people in the study were sensitive (hyper-responders) to
dietary cholesterol. In these people, the total serum cholesterol
levels increased beyond 2 standard deviations following the 2 test
diets with eggs compared to the other 23 subjects. And as a result,
the researchers analyzed the data separately with and without the
hyper-responders, which resulted in dramatic differences in study
outcomes. For example, when these individuals were excluded from
the analysis, including either omega-3 eggs or control eggs did
not adversely alter plasma total cholesterol, LDL cholesterol,
and HDL cholesterol levels. On the other hand, including the hyper-responders
in the analysis resulted in a significantly higher plasma LDL cholesterol
level with egg intake. The LDL cholesterol increased by 7% and
5%, respectively, with the omega-3 eggs and the control eggs. The
15% and 9% decrease in TAG levels following the omega-3 egg diet
and the control egg diet compared to the no egg diet was relatively
constant with or without the hyper-responders. Including eggs,
regardless of type of eggs, was associated with an increase in
calories from total fat and MUFA as well as increased cholesterol
As other studies have shown, data from the
study by Lewis et al. clearly show that a small population of individuals
is sensitive to dietary cholesterol. However, it also shows that
for a majority of people, including 12 eggs/week, regardless of
the omega-3 fatty acid content, to a low-fat diet does not significantly
alter plasma total cholesterol, LDL cholesterol, and HDL cholesterol
levels. And as a matter of fact, in the case of TAG level, including
eggs in the test diets had a beneficial effect by lowering TAG
levels. In conclusion, this study shows that omega-3 enriched eggs
are an easy way to provide a convenient source of omega-3 fatty
acids in the diet without negatively altering lipid profile in
majority of people.
Lewis NM, Schalch K, Scheideler SE. Serum
lipid response to n-3 fatty acid enriched eggs in persons with
hypercholesterolemia. JADA. 2000;100:365-367.
Table of Contents
Along with other studies, the Seven Countries
Study has established that certain ethnic groups benefit from having
lower blood cholesterol levels, and as a result their rate of CHD
is much lower. Now, according to a study by Van Den Hoogen et al.,
these ethnic groups also have lower blood pressure levels. In this
25-year follow-up study, cohorts from Japan, Serbia, and Mediterranean
southern Europe were found to have lower systolic and diastolic
blood pressures than the cohorts from the United States, northern
Europe, and inland southern Europe. The average systolic and diastolic
blood pressure of the Serbians were 132.5 mm Hg and 83.3 mm Hg,
respectively, compared to 143.7 mm Hg and 86.6 mm Hg in northern
Europeans. And, as expected, the percentage of hypertension in
the cohorts, corresponded with mean blood pressure levels.
Of the 12,031 middle-aged men recruited between
1958 and 1964, 1,291 cases of CHD deaths were reported during the
study period. The Japanese cohort had the lowest number of CHD
deaths (30 cases) followed by Serbians (77 cases), Mediterraneans
(116 cases), inland southern Europeans (253 cases), Americans (354
cases), and northern Europeans (461 cases). The actual rates of
CHD were approximately 20 per 10,000 person-years in Japan and
Mediterranean southern Europe compared to 70 per 10,000 person-year
in the United States and northern Europe at a systolic blood pressure
of 140 mm Hg. Even though the absolute CHD rate varied significantly
among different cohorts, the relative risk for CHD was similar.
For example, an increase of 10 mm Hg in systolic or 5 mm Hg in
diastolic blood pressures increased the relative risk for CHD deaths
by 28% in all 6 study cohorts. To minimize the effects of fluctuating
blood pressure within individuals, when the data was re-analyzed
using mean blood pressure from first 5 year instead of single base-line
values, the adjusted RR for was 2.13 compared 1.77, indicating
that high blood pressure is a strong risk factor for CHD death.
Also, similar to blood pressure levels, the
absolute risk of CHD deaths associated with hypertension varied
among the 6 study cohorts. For example, the age-standardized 25-year
mortality rate differed by almost 4 fold. The Japanese and Mediterranean
hypertensives had 44 deaths per 10,000 person-year compared to
153 per 10,000 person-year in northern Europeans.
with the same blood pressure level, results from this study indicate
that Americans and northern Europeans are much more likely to die
from CHD than people from Japan and Mediterranean countries. However,
current findings show that everyone, regardless of country of origin,
should control their blood pressure since any increase in systolic
and diastolic blood pressure is associated with an increase in
CHD events in all populations. The data are similar to a previous
report from the Seven Countries Study by Veschuren et al. showing
that across cohorts a 20 mg/dl change in plasma cholesterol changed
CHD relative risk by 17%; however, absolute risk of CHD differed
by 5 fold at the same plasma cholesterol level. These studies show
clearly that CHD risk is determined by factors beyond the 3 major
risk factors - smoking, hypertension, and hypercholesterolemic.
Van Den Hoogen PC, Feskens EJ, Nagelkerke
NJ, et al. The relation between blood pressure and mortality due
to coronary heart disease among men in different parts of the world. N
Engl J Med. 2000;342:1-8.
Table of Contents
The incidence of CVD and type 2 diabetes are
much higher in the African-American and Hispanic communities compared
to Caucasians. In our diverse culture, this disparity among different
ethnic groups is a major public health problem yet the etiology
behind this multifactorial problem is unclear. In a study of 95
healthy children (54 whites and 41 blacks), Linquist and colleagues
tested the theory that differences in dietary patterns among cultures
explained difference in blood lipid and insulin profiles between
the study cohorts.
Both groups of children in the study were
similar in age (mean 10 years), body composition, and stage of
pubertal development (stage 1 or 2); however the African-American
children had lower social class background as determined by parent's
education level and occupational status. The mean 24-hour dietary
recall revealed that the African-American children ate more fruits
and vegetables and less dairy products. Contrary
to earlier findings which found unfavorable lipid profiles in blacks,
this study found more favorable lipid profiles among blacks. The
plasma TAG were lower among black children and total cholesterol
levels were similar to white kids. The 2 insulin sensitivity measurements
indicated that black children were 40% less sensitive to insulin
and had twice as high acute insulin levels than whites. In this
study, only the insulin profiles indicated that the African-American
children had potential risk factors for future CVD and diabetes
compared to the white group. Multivariate analyses showed that
macronutrients and food group intakes could not account for ethnic
differences in lipid profiles observed in earlier studies.
Results from this study indicate that when
social class, body composition, macronutrient and food group consumption
were accounted for, ethnic differences in early disease risk profiles
were not significantly altered by dietary patterns as the researchers
hypothesized. As a matter of fact, except for slightly higher fruit
(0.6 serving) and vegetable (0.7 serving) intake and lower dairy
(0.6 serving) intake, diets of study cohorts were very similar
regardless of race. However, the diets consumed by both groups
were far from ideal. For example, 40% of the total calories in
these diets came from the tip of the Food Guide Pyramid. Regardless
of the dietary pattern, lower insulin sensitivity and higher insulin
levels strongly suggest that the African-American children are
more susceptible to metabolic disorder such as type 2 diabetes
and heart disease compared to Caucasian children.
Linquist CH, Gower BA, Goran MI. Role of dietary
factors in ethnic differences in early risk of cardiovascular disease
and type 2 diabetes. Am J Clin Nutr. 2000;71:725-732.
Table of Contents
For a long time, patients with lipid metabolism
disorders such as pancreatic lipase deficiency have successfully
been treated with medium-chain triacylglycerol (MCT) therapy. However,
the data on lipid and lipoprotein profiles following MCT therapy
are mixed. According to a new study by Asakura et al., in hyper-triglyceridemic
subjects, MCT has a potentially atherogenic effect by increasing
both plasma total and LDL cholesterol levels.
In this study with 10 hypertriglyceridemic
adults without histories of diabetes, renal, and hepatic disease,
subjects followed 5 test diets with varying degrees of added corn
oil and MCT. The sequence of the diet feeding was as follows; low-fat
diet (2 weeks), 100% corn oil (4 weeks), and 3 subsequent periods
with corn oil and MCT ratios of 3:1, 1:1, and 0:1 (2 weeks each).
The two types of oils only increased the net fat content by 16
g/d to 24 g/d from the low-fat diet. The 16% and 19% increases
in fasting total cholesterol and LDL cholesterol following the
100% MCT diet were the only significant changes noted between MCT
and the 100% corn oil diet. The TAG level increased by 8% with
the 100% corn oil diet compared to the 100% MCT diet. Analysis
of postprandial plasma TAG and total cholesterol showed that the
MCT diet sustained a higher total cholesterol level throughout
the fat absorption phase (8 hours post meal) relative to the liquid
corn oil diet. But, compared to the stable post-prandial TAG levels
following the MCT diet, the liquid corn oil diet resulted in a
steady increase in post-prandial TAG levels.
In conclusion, even though MCT are an effective
way to provide fats for individuals with fat malabsorption, MCT
use is not warranted for people with heart disease, as it seems
to increase plasma total cholesterol and LDL cholesterol levels.
Asakura et al. speculated that the 100% MCT diet raised these levels
due to the higher saturated fat content of this diet. According
to the researchers' findings, diets high in MCT were associated
with an increase in both fasting and postprandial total cholesterol
levels compared to the 100% corn oil diet.
Asskura L, Lottenberg AM, Neves MQ, et al.
Dietary medium-chain triacylglycerol prevents the postprandial
rise of plasma triacylglycerols but induces hypercholesterolemia
in primary hypertriglyceridemic subjects. Am J Clin Nutr. 2000;71:701-705.
Table of Contents
Most studies in nutrition have focused on
individual nutrients or foods and their impact on prevention or
promotion of certain diseases. Kant et al. examined the health
effects of dietary patterns, which included a complex mixture of
foods. By measuring the overall diet quality, instead of single
nutrients, the data are more representative of a free-living diet.
The finding of this study is that mortality risk was inversely
related to eating patterns recommended by current dietary guidelines.
The 42,254 females in the study were originally
part of a larger prospective study, and were enrolled in this case-control
study after completing a 62-item food frequency questionnaire.
Subjects were followed for 5.6 years during which time 2,065 deaths
were reported. The researchers measured the overall quality of
the dietary pattern in terms of the Recommended Foods Score (RFS).
The RFS was determined from the number of fruits, vegetables, whole
grains, low-fat dairy products, and lean meats each subjects reported
consuming. The range of RFS varied from 0 to 23 and the mean was
11.4. Due to the difficult nature of accurately recalling portion
sizes, the RFS was measured independent of portion amounts. The
group with highest RFS, compared to rest of the study cohorts,
were more educated, slightly older, more active, took supplements
and hormones, and smoked less.
There was an inverse relationship between
RFS and all cause mortality. The multivariate-adjusted RR was 0.82
in quartile 2, 0.71 in quartile 3, and 0.69 in quartile 4. Even
though the women with the highest intakes of fruits, vegetables,
whole grains, low-fat dairy products, and lean meats had a 30%
lower risk of prematurely dying, the major benefit was obtained
between RFS of 1-11. After a RFS value of 11, benefit associated
with following the current dietary guidelines was less dramatic.
This trend continued even after the data for women with medical
conditions at baseline were excluded, thus indicating that the
dietary pattern was not different in healthy women or women with
illnesses. Finally, women in the highest intake level of recommended
foods had significantly lower mortality from all types of cancers,
CHD, strokes, and all other causes.
Due to the observational nature of the study,
Kant et al. were unable to declare a causal relationship between
low RFS and mortality, especially in light of other unhealthy lifestyle
choices. However, this study strongly suggest that current food-based
dietary guidelines are more applicable than single nutrients in
improving overall health outcomes.
Kant AK, Scharzkin A, Graubard BI, et al.
A prospective study of diet quality and mortality in women. JAMA.
Table of Contents
Each day it gets more and more difficult to
distinguish fact from fiction, and to keep the agenda based pseudo-science
from baffling the public, and burying those who value honest and
open discourse of controversies. And with today's excitement over
anything smelling of deceit and collusion, print and electronic
media just seem to love giving credibility to those who yell the
loudest, or at least the most outrageously. It has been said that
if you tell a lie often enough and for a long enough, it will eventually
be believed. Add on top of that a public mistrust of science and
corporate enterprises and you have the perfect scapegoat for wide
dissemination of agenda based misinformation, and public acceptance
of false "facts." Watching organizations dedicated to an agenda
propagate misinformation about individuals and organizations is
nothing new, but, when they continue to do so publicly even after
they have been provided with documentation of their error, it is
clear that they put agenda above facts at a substantial cost to
the credibility of those falsely accused.
In a law suit filed to block the report of
the Dietary Guidelines Advisory Committee, the Physicians Committee
for Responsible Medicine (PCRM) claimed that 6 of the 11 committee
members were unsuitable for their position because they had "industry
connections" and had taken money, or had grants, or spoken for
and received honorariums from, the animal protein industries. The
bad guys were meat, dairy and eggs, and those obviously disreputable
scientists who ever had anything to do with these dastardly organizations
were without a doubt not qualified to speak for the nutrition community.
I guess that anyone who has ever been "bought and paid for" by
the animal food industries is considered to no longer be capable
of evaluating the science and making rationale judgments. And how
dare these terrible industries support research by and pay honorariums
to these national nutrition experts to do research on or speak
about nutrition? It really does seem like an obvious conspiracy
to me! How could anyone really trust a report on nutrition from
such a clearly biased Advisory Committee?
What was most surprising was that PCRM accused
Dr. Scott Grundy of being biased because he had served on the American
Egg Board Grant Review Committee from 1972 to present. Since there
was no basis for this statement, PCRM was informed that: [a] the
American Egg Board was started in 1976, 4 years after Dr. Grundy
was supposedly reviewing grants for it; [b] as a member of the
American Egg Board Scientific Advisory Panel since 1984, and Executive
Director of the Egg Nutrition Center since 1995, I could certainly
verify that Dr. Grundy had not served as a grant reviewer during
that past 16 years; and [c] If Dr. Grundy was biased towards the
egg industry then the industry was doing something terribly wrong
given that he is an outspoken and influential supporter of the "dietary
cholesterol raises blood cholesterol" hypothesis and a strong supporter
of dietary cholesterol restrictions. If he is the "bought and paid
for" egg industry representative on the Dietary Guidelines Advisory
Committee then the egg industry was certainly not getting its moneys
And while these facts were communicated to
PCRM in January 2000, as of May you could still find this misinformation
on their web site and included in their press releases. Indeed
it remains part of their attempt to get a restraining order against
the guidelines. Maybe before the press and TV media give credibility
to this organization and their unsubstantiated harangues, they
should ask PCRM what they consider their "responsibility" to the
facts, and what is their "concern" for the reputation of highly
respected physician-scientists who have made nationally recognized
contributions to our understanding of the diet-health relationships.
PCRM certainly seems to have failed at living up to its high principled
name. But even more important is the question of why the media
accepts this garbage without doing its homework. After awhile it
makes you wonder about the validity of just about everything you
see, hear and read.
Donald J. McNamara, Ph.D.
Executive Editor, Nutrition Close-Up
Table of Contents
The USDA/HHS Dietary Guidelines for Americans
2000 have now been released and the fat guideline has been changed.
The 1995 guideline read "Choose a diet low in total fat, saturated
fat and cholesterol." The new guideline reads "Choose a
diet low in saturated fat and cholesterol and moderate in total
fat." What is confusing is, given the last five years of research
showing no relationship between dietary cholesterol and heart disease
risk, the fat guideline actually puts an enhanced emphasis on restricting
dietary cholesterol. Given the lack of evidence for a reduction
in heart disease with a reduction in dietary cholesterol, it is
too bad that the committee did not recommend "Choose a diet
low in saturated fat and moderate in total fat and cholesterol." Somehow
we seem unable to separate "saturated fat and cholesterol" from
our nutrition phrase book. A note for those who haven't noticed,
not all cholesterol containing foods are high in saturated fat.
Table of Contents
Editor: Donald J. McNamara, Ph.D.
Writer/Editor: Linda Min, M.S., R.D.
Nutrition Close-Up is published quarterly
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up-to-date reviews, summaries and commentaries on the latest research
investigating the role of nutrition in health promotion and disease
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